Microscopic laryngeal surgery is a specialized form of minimally invasive laryngeal / vocal cord surgery that involves the use of an intraoperative microscope to precisely excise lesions while minimizing vocal cord injury. Specimens received for intraoperative frozen may be a biopsy of the lesion itself or several margins after the lesion is excised. The specimens are often VERY SMALL, require careful transfer for freezing, and may require multiple cut levels for proper evaluation.
- Carefully remove the surgical pad (sometimes received stapled) from the specimen container; identify and measure the specimen (usually < 1 mm).
- Stain tissue with eosin before embedding if the specimen is white or tan.
- Do not transfer the specimen using forceps. Use a scalpel blade or wooden cotton swab stick to push the tissue onto the metal plate (with no/minimal OCT on the plate).
- Carefully trim the OCT block to face the specimen – consider trimming at 5 microns to conserve tissue.
- Additional deeper levels may be needed to fully examine the tissue for dysplasia / carcinoma:
- Do not be afraid of cutting multiple levels to examine as much tissue is necessary during frozen.
- Often, after thawing, paraffin-embedding, and re-cutting – minimal tissue remains for permanent examination. Therefore, please cut as many levels as needed during frozen.