Abstract
Objective: Determine the accuracy of intraoperative salivary gland frozen section (FS) and to evaluate the effects of misdiagnosis on surgical outcomes and postoperative complications.
Method: Data were retrospectively reviewed for all patients undergoing intraoperative salivary gland FS at a tertiary care center from January 2000 to June 2010. FS was correlated with permanent pathology and categorized as concordant, discordant, or deferred. Patients with discordant/deferred FS were evaluated for appropriateness of surgical intervention and for postoperative complications of inappropriate surgery.
Results: Over 2,000 patients underwent salivary gland surgery in the 10-year study period. One hundred eighty underwent intra-operative FS, including 73% (132) concordant, 2% (3) discordant, and 25% (45) deferred (non-definitive) FS interpretations. One of 3 patients with discordant FS underwent surgery of inappropriate extent resulting in an unnecessary neck dissection and permanent spinal accessory nerve paralysis. 7% (3/45) of patients with deferred/nondefinitive FS underwent suboptimal surgery, resulting in one re-operation but no other major complications. Overall, 98% (176/180) of patients that underwent salivary gland FS received operations consistent with permanent pathology. Pleomorphic adenoma was the most commonly deferred entity.
Conclusion: Though deferred and discordant salivary gland FS diagnoses may lead to suboptimal surgical intervention and potential postoperative complications, the use of FS correlates with optimal surgical intervention in the vast majority of cases.
Get full access to this article
View all access options for this article.