Reliability of frozen section diagnosis in head and neck neoplasms

To evaluate the reliability of frozen section diagnosis we reviewed a series of 1146 consecutive frozen sections performed during a 5-year period. The frozen section diagnosis was then compared to that found on paraffin section and the results categorized into 12 regions in the head and neck. We found an overall reliability of 96%. The total percentage of false positive and false negative results were 0.35% and 3% respectively. Frozen section diagnosis was most accurate on the submandibular gland (no errors), nose and paranasal sinuses (no error), followed by the thyroid gland (0.8% error). Areas in which frozen section diagnoses were least accurate included the nasopharynx (12.5% error) and the oropharynx (8.7% error). We conclude that frozen section diagnosis is highly accurate in most regions of the head and neck.