Frozen section biopsy for tumors of the submandibular triangle

Abstract

Diagnosis and treatment of submandibular lesions is challenging. Carcinomas, which frequently occur, should be surgically removed with sufficient safety margins, while simultaneously protecting functional structures. In particular, the preservation of neuronal structures with simultaneous tumor control suggests that single-stage concepts are appropriate, although they are not yet established. The aim of this study was to evaluate intraoperative frozen section biopsy as apossible basis for aone-stage surgical concept to thus prevent functional alterations by reoperation. Atotal of 114consecutive patients with neoplastic lesions in whom the type of lesion could not be determined after ENT examination and imaging were included in the study. Patients with aknown history of carcinoma or evidence of an acute inflammatory or carcinogenic primary lesion in the ENT examination and/or imaging were excluded. An intraoperative frozen section biopsy was performed to determine the presence of acarcinoma. Patient-related data and the reliability of the frozen section result were recorded comparatively. Intraoperative frozen section biopsy was performed in atotal of 114patients. Carcinomas were diagnosed with asensitivity of 87% and aspecificity of 100%. There would thus not have been unnecessary radical surgery in aone-stage approach. In 26 of 30patients with carcinoma, asecond operation could have been avoided. Intraoperative frozen section biopsy is potentially an important method to histologically confirm carcinomas and avoid two-stage procedures. The absence of false-positive findings would have prevented an unnecessary radical procedure in 100% of patients.