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Updated: Jun 15, 2026
Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
Intraoperative evaluation of bony margins with frozen-section analysis and trephine drill extraction technique: A
Andreas Wysluch1, Ingo Stricker, Frank Hölzle
1Department of Oral and Plastic Maxillofacial Surgery, Central German Armed Forces Hospital, Rübenacher Str. 170, D-56072 Koblenz. andreas.wysluch@gmx.de
Background:
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.
Methods:
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.
Results:
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%.
Conclusion:
This technique promises to be suitable for intraoperative detection of malignant bone infiltration.
