Frozen section for parotid surgery: should it become routine?

BACKGROUND

The role of fine-needle aspiration (FNA) in salivary gland lesions as a preoperative diagnosis has always been under scrutiny. Several studies have shown that frozen section (FS) is accurate for pathological diagnosis and decision-making during the surgery. This study has been carried out to assess the accuracy of FNA and FS in parotid surgeries.

METHODS

All parotid lesions removed between July 1998 and June 2003 by the Department of Otolaryngology, Head and Neck unit at Monash Medical Centre were reviewed. FNA, FS and definitive pathology were collected and discrepancies were identified.

RESULTS

Eighty-five parotid tumours had been removed. Thirty-three were malignant in which squamous cell carcinoma was the most common. FS was able to differentiate benign tumours from malignant with 100% accuracy (30 cases). FS was able to alter the surgical decisions in six cases. FNA had been carried out in 62 cases, with sensitivity and specificity of 77.2 and 90%, respectively.

CONCLUSION

Frozen section in parotid surgery is accurate, inexpensive and may add important information that alters management and improves the outcome. The use of FS routinely in parotid surgery is recommended.