Intraoperative evaluation of bony margins with frozen-section analysis and trephine drill extraction technique: A preliminary study.

Abstract

The aim of this study was to examine the use of trephine drill specimens from mandible bony margins subjected to standard histologic fresh-frozen processing for intraoperative documentation of malignant bony infiltration in oral cancer. Eighty-four drill specimens were extracted from bony mandibular resection margins of 20 patients with oral cancer. Histologic results of decalcification and of intraoperative frozen-section analysis were compared. Sixty-eight (81%) of 84 specimens showed no tumor infiltration, whereas 16 (19%) were positive in frozen section analysis. Four specimens (4.8%) were evaluated as free of tumor invasion, but showed erosion of the bone by the tumor after decalcification. One specimen (2.4%) was positive, but no invasion could be found with standard decalcification. Overall, there was 94% (79) consistency between the 2 techniques, with a sensitivity of 79% and specificity of 98%. This technique promises to be suitable for intraoperative detection of malignant bone infiltration.