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Accuracy of intraoperative frozen section diagnosis in head and neck surgery: Experience at a university medical center
Author(s) -
GandourEdwards Regina F.,
Donald Paul J.,
Wiese David A.
Publication year - 1993
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.2880150108
Subject(s) - medicine , otorhinolaryngology , frozen section procedure , malignancy , surgery , head and neck , thyroid , radiology , sampling (signal processing) , head and neck surgery , medical diagnosis , general surgery , filter (signal processing) , computer science , computer vision
We performed 2,210 intraoperative frozen sections on 258 patients from the Otolaryngology–Head and Neck Surgery Service in 1990 and 1991. Surgery involved a wide variety of benign and malignant lesions. Techniques included biopsies for diagnosis, simple excisions, thyroid and salivary gland surgeries, lymph node biopsies, composite resections with radical neck dissections, laryngectomies, and skull base surgeries. During the 2‐year period, 1,947 (88.1%) sections were requested for evaluation of surgical margins, 258 (11.7%) for diagnosis, and five (0.2%) cases for tissue identification. There was disagreement between the frozen section and permanent section in 46 (2.1%) cases, and the deferral diagnosis rate was 0.8%. Disagreements were the result of sampling errors in 33 and interpretive errors in 13 cases. There were six (0.3%) false‐negative diagnosis of malignancy and four (0.2%) false‐positive diagnoses of malignancy. Three of these had an impact on patient care as discussed. We recommend careful sampling and sectioning of small biopsies and the need for vigilant communication between surgeon and pathologist.