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June 19, 1996

Otolaryngology-Head and Neck Surgery

Author Affiliations

Duke University Medical Center, Durham, NC; The Johns Hopkins University School of Medicine, Baltimore, Md

JAMA. 1996;275(23):1838-1839. doi:10.1001/jama.1996.03530470066039

The recent otolaryngology literature provides novel insights into a spectrum of common diseases including cancer and hearing impairment. In particular, many of these reports describe newer diagnostic methods that are likely to yield observations with implications for prevention and treatment.

Cancer surgery is often guided by microscopic analysis of the margins to achieve complete tumor resection while maximizing preservation of uninvolved tissues. In the head and neck, multiple tissue planes and the topography of this region can confound total excision. Moreover, tumors may have clinically indistinct borders and aggressive growth patterns. These factors underscore the importance of an accurate assessment of margins.

The identification of a single tumor cell or small cell clusters in a pathologic specimen is not possible using conventional assessments of resected head and neck cancer specimens. Using molecular genetics techniques to evaluate the surgical margins of patients with known p53 mutations, resection margins were assayed for