A Novel Technique for Intraoperative Assessment of Surgical Margin Using Lugols Iodine and Frozen Section Methods in Oral Squamous Cell Carcinoma

Abstract

Surgery is considered to be the primary mode of treatment of head and neck malignancies and the ultimate aim of surgical resection is to obtain a tumor-free margin. No uniform criteria to define a clear surgical margin exist among practicing surgeons. This study intends to find the adequacy of surgical margin marking intraoperatively by Lugol’s iodine solution considering the frozen section method for oral squamous cell carcinoma (OSCC). Intraoperative staining with Lugol’s iodine and Frozen section analysis of margins of the surgical bed was negative in anterior, superior, and inferior specimens in all the cases, except in one case (4.3%), a posterior margin was found to be positive (unstained) for tumor. The chi-square value of the Lugol’s stained margins following resection of the tumor and negative results of frozen section analysis of the same was found to be statistically significant with the P value <0.001. Hence, we conclude that Lugol’s iodine helps in obtaining a clear surgical margin intra-operatively where inter-surgeons bias/judgment errors regarding safe margin can be avoided, especially in cases where the frozen section is not feasible.