Rapid analysis of mandibular margins

Area of Science:

• Oral oncology
• Surgical pathology
• Head and neck surgery

Background:

• Evaluating surgical margins in composite resections for carcinoma is challenging, particularly concerning bone margins.
• Standard bone margin evaluation involves decalcification, a time-consuming process.
• Accurate assessment of mandibular invasion and resection adequacy is crucial for patient outcomes.

Purpose of the Study:

• To investigate frozen section analysis (FSA) as a rapid method for evaluating the adequacy of mandibular resection margins.
• To compare FSA results with permanent section analysis and decalcified specimens.
• To determine the accuracy of FSA in predicting resection adequacy in cases of mandibular invasion.

Main Methods:

• A novel analysis method was developed based on established techniques for cortical invasion.
• Frozen section analysis (FSA) was performed on cancellous bone during mandibular resection.
• The study included 29 patients undergoing full-thickness mandibular resection, with 16 confirmed cases of mandibular invasion.

Main Results:

• Results from FSA showed complete correlation with permanent section analysis of cancellous bone.
• FSA accurately predicted the adequacy of resection in 32 out of 33 margins (97%).
• The method proved effective in assessing bone margins during surgery.

Conclusions:

• Frozen section analysis (FSA) is a reliable and rapid technique for evaluating surgical margins in mandibular resections.
• FSA can accurately assess bone invasion and predict resection adequacy, complementing traditional methods.
• This approach can enhance intraoperative decision-making for head and neck cancer surgeries.