Frozen section during parotid surgery revisited: efficacy of its applications and changing trend of indications.

Background: Efficacy of frozen sections was assessed in terms of its various applications. The changing role of frozen sections in parotid surgery was examined.

Method: Records of parotid operations over a 15-year period in a University Department of Head & Neck Surgery were reviewed.

Results: Of 241 operations, frozen sections were performed on 32. Applications of frozen sections included diagnosis, margin clearance, and checking suspicious lymph nodes and nerve invasion. The false-positive rate for malignancy was 12.5%. Margins may still be involved despite correct tissue diagnosis from sampling error. No inappropriate surgery resulted from the information obtained. With the advent of fine-needle aspiration, frozen sections were less often called for and a shift from a diagnostic role to margin checking was seen. Frozen sections picked up all unsuspected malignant tumors.

Conclusion: Frozen sections are helpful when interpreted cautiously, but clinical assessment and fine-needle aspiration are also important components in the workup.