Role of Intraoperative Bone Dust Cytology for Assessing Bone Margins: A Novel Technique

Surgical margin influences the outcome of oral squamous cell carcinoma (OSCC). There are few techniques described in the literature for assessing intraoperative bone margins which are cumbersome. We present a novel technique for rapid intraoperative analysis of cortical bone. Fifty untreated patients with OSCC had their margins analysed with bone dust cytology during surgery. This was compared with standard final histopathology in terms of sensitivity and specificity. A total of 227 sites were analysed. A total of 152 sites (66.9%) were true negative while 54 sites (23.8%) were true positive in comparison to final histology following bone decalcification. Overall, 15 sites (6.6%) were false negative while 6 sites (2.6%) were false positive giving a sensitivity of 78.26%, specificity of 96.20%, positive predictive value of 90%, and a negative predictive value of 91.02%. The overall accuracy rate for bone dust cytology was 90.75%. Bone dust cytology is a simple, feasible and less time-consuming with an accuracy rate of 90.75%.