Objectives:1) Assess various rapid methods for processing mandible bone margins for histopathologic examination. 2) Determine the optimal method for intraoperative use.Methods:Multiple bone samples were collected from a fresh (<12 hours post‐mortem) human cadaveric mandible using a standard 3mm core bone biopsy trocar. The cored specimens were placed 30 minutes in 10% formalin (transport time) and then for 15‐75 minutes in 1 of 3 decalcifying solutions (Decal A, Calex, EDTA Decal). Controls were placed in 10% formalin. After each designated decalcification time period, specimens were cryosectioned or paraffin‐embedded and reviewed by a head and neck surgical pathologist blinded to the treatment groups. The specimens were assessed for overall quality, adequacy of decalcification, soft tissue quality, marrow quality, and presence of artifact.Results:Bone margin specimens collected with a 3mm core bone biopsy trocar and processed with all 3 decalcifying solutions for 15 minutes yielded acceptable quality and sufficient decalcification for histopathologic assessment. In addition, the trabecular, intact soft tissue and marrow were well‐preserved with good cellular architecture.Conclusions:Mandible bone margins can be rapidly processed for histologic evaluation using cored specimens with only 15 minutes of decalcification, allowing for intraoperative assessment of a bone margin. A prospective clinical trial of patients with cancer invasion in the mandibular bone to confirm cancer cells are identifiable with this rapid processing method is planned.

The face of head and neck cancer has changed dramatically over the past 30 years. There has been a steady decline in the number of tobacco and alcohol related squamous cell carcinomas over the past 30 years, but and increasing incidence of human papillomavirus (HPV) related cancers. Some estimates suggest that 70-90% of new oropharyngeal cancers have evidence of HPV. These patients have different demographic patterns, in that they are more likely to be younger, white adults in their 40s and 50s who are never smokers or have reduced tobacco exposure. Studies have shown that a higher number of lifetime oral sex partners (>5) and a higher number of lifetime vaginal sex partners (>25) have been associated with increased risk of HPV positive head and neck cancer. People can also reduce their risk of HPV linked head and neck cancer by receiving the HPV vaccine series prior to becoming sexually active. Recent evidence suggests HPV related head and neck cancers present with different symptoms than those caused by tobacco. The most popular test for HPV status is the p16 immunohistochemical stain because it is cheap, simple, and studies have shown it to have comparable sensitivity and specificity to the previous standards. It is widely recommended that all cancers of the oropharynx be tested for the presence of HPV, and some recommend it for all head and neck cancers. Overall 2-year and 5-year survival for HPV positive head and neck cancer is significantly greater than for HPV negative cancers, likely due to HPV positive cancers being more responsive to treatment.

Free accessAbstractFirst published online August 2010Facial Nerve Localization: Is Triangulation the Key?Mark Royer, MD, presenter, Michael Moore, MD, […], Susan Cordes, MD, Edward Weisberger, MD, and Mimi Kokoska, MD, +2 -2Volume 143, Issue 2_supplhttps://doi.org/10.1016/j.otohns.2010.06.283

Otolaryngology–Head and Neck SurgeryVolume 143, Issue S2 p. P172-P172 Poster Presentation Recurrent Laryngeal Nerve Branching: Modern Relevance Mark Royer MD, Mark Royer MD presenterSearch for more papers by this authorMichael Moore MD, Michael Moore MDSearch for more papers by this authorStacey Halum MD, Stacey Halum MDSearch for more papers by this authorMimi Kokoska MD, Mimi Kokoska MDSearch for more papers by this author Mark Royer MD, Mark Royer MD presenterSearch for more papers by this authorMichael Moore MD, Michael Moore MDSearch for more papers by this authorStacey Halum MD, Stacey Halum MDSearch for more papers by this authorMimi Kokoska MD, Mimi Kokoska MDSearch for more papers by this author First published: 20 June 2017 https://doi.org/10.1016/j.otohns.2010.06.306Read the full textAboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume143, IssueS2August 2010Pages P172-P172 RelatedInformation