Frozen section during parotid surgery revisited: efficacy of its applications and changing trend of indications.

Abstract

Efficacy of frozen sections was assessed in terms of its various applications. The changing role of frozen sections in parotid surgery was examined. Records of parotid operations over a 15-year period in a University Department of Head & Neck Surgery were reviewed. Of 241 operations, frozen sections were performed on 32. Applications of frozen sections included diagnosis, margin clearance, and checking suspicious lymph nodes and nerve invasion. The false-positive rate for malignancy was 12.5%. Margins may still be involved despite correct tissue diagnosis from sampling error. No inappropriate surgery resulted from the information obtained. With the advent of fine-needle aspiration, frozen sections were less often called for and a shift from a diagnostic role to margin checking was seen. Frozen sections picked up all unsuspected malignant tumors. Frozen sections are helpful when interpreted cautiously, but clinical assessment and fine-needle aspiration are also important components in the workup.