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Rapid mandible margins for intraoperative assessment
Allison Mayer1, Mark C Royer2, Don-Jon Summerlin3
1Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN.
American Journal of Otolaryngology
|January 30, 2015
Summary
Rapid processing of mandible bone margins for intraoperative histopathologic examination is feasible. A 30-minute EDTA decalcification method using a 4mm burr provides high-quality bone margin assessment for tumor evaluation.
Area of Science:
- Surgical pathology
- Histotechnology
- Oral oncology
Background:
- Intraoperative assessment of bone margins is crucial for oncologic surgery.
- Current methods for processing bone specimens can be time-consuming.
- Rapid histopathologic evaluation of mandible bone margins is needed.
Purpose of the Study:
- To evaluate the feasibility of a rapid processing method for mandible bone margins.
- To compare the effectiveness of different specimen types (fine, coarse, core) and decalcifying solutions.
- To determine optimal decalcification time for intraoperative assessment.
Main Methods:
- Human cadaveric mandible bone samples were processed using a 4mm burr, diamond drill, or core biopsy trocar.
- Specimens underwent decalcification with EDTA Decal, Decal A, or Calex for 15-75 minutes, or fixation.
- Histopathologic quality was assessed by a surgical pathologist.
Main Results:
- Processing with a 4mm burr and 30-minute EDTA decalcification yielded the highest quality slides.
- Adequacy of decalcification significantly impacted histopathologic assessment quality.
- Rapid processing (30 minutes) is achievable and provides adequate evaluation.
Conclusions:
- Mandible bone margins can be rapidly prepared and evaluated within 30 minutes.
- This rapid method offers potential for acceptable intraoperative assessment of bone margins in tumor cases.
- Further clinical studies are planned to validate this technique in patients with mandibular bone tumors.
