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Vol. 68, No. 2, 2006
Issue release date: March 2006
ORL 2006;68:83–87

Double-Bladed Scalpel: A New Option for Harvesting Margins in Head and Neck Cancers

Cernea C.R. · Velasco O. · Gomes M.Q.T. · Vellutini E. · Hojaij F.C. · de Carlucci Jr. D. · Nishio S. · Morais-Besteiro J. · Ishida L.C. · Ferraz A.R.
aDepartment of Head and Neck Surgery, bDepartment of Plastic Surgery and cDepartment of Neurosurgery, University of São Paulo Medical School, and dDepartment of Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil

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Background: In advanced head and neck tumors margins are very rarely comprehensively checked by frozen sections. The goal of this study was to analyze a new proposal for harvesting margins using a double-bladed scalpel.Methods:Thirty-eight patients underwent a comprehensive resection of advanced head and neck tumors with a double-bladed scalpel. Margins were mapped and checked by frozen sections, while tumor resection continued. When positive margins were identified, they were excised again, and checked by frozen sections. Results: Thirty-three patients (87%) had clear skin and soft tissue margins at frozen sections. Five patients (13%) had focal skin and soft tissue-positive margins at frozen sections, which were re-excised. Two patients (5%) had skin and soft tissue-positive margins only at permanent sections. One was reoperated and 1 received radiation therapy. The 3-year local control rate was 58%. Conclusions: In this preliminary study, the double-bladed scalpel appeared to be an interesting option for complete intraoperative evaluation of surgical margins of advanced head and neck tumors.

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