Crazy huge ENT cases

[Arctic Char]

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For all those who practice in private practice/community practice . . . do you see these wild 25+ block ENT cases where they submit ditzels from every weird corner of the sinuses north of the nose?

our hospital recently hired two aggressive ENT surgeons who perform radical resections, ask for 20 block frozens, and submit cases that can go from A to AX.

does this occur purely at large regional cancer centers and academia, or is this common in the community? my hunch says its the former . . .

 

[yaah]

We rarely get them, but they do happen. We don't usually get 25 margins. The highest I have seen is 14 here, and that one had multiple positive ones so it just kept going. In residency we got up to 30 at times (sometimes 12 at once).

Radical ENT surgeries are mostly the bane of academic centers but sometimes can occur at larger regional hospitals, usually they are the more "routine" ones like larynxes and tongue base though, not the sinus stuff and skull base.

 

[NuckingFuts]

Our ENT people routinely (almost daily) produce numerous parts for frozen eval.

I believe our record is a grand total of 63 blocks that had been submitted.

 

[deleted314957]

I'm at a ~180 bed community hospital and thankfully i don't get that stuff.

 

[KCShaw]

My rearview memory may be a bit blurry, but I don't recall even our deep hemi-face-ectomies / radical ENT surgeries having massive numbers of frozens or blocks -- a significant number, yeah, but not 25+ I don't think. We didn't get a "lot" of them, mostly fairly standard necks/larynges, but they came through on occasion; academic center. Like everything else, there were usually some margins the surgeon was concerned about and would freeze and/or we would focus on at gross, and a few typical margins (major airway mucosa, large nerves, large blood vessels, etc.) with targeting based on the gross &/or discussion with the surgeon. Perhaps we just had fairly confident surgeons who didn't feel compelled to demand a section from every surgically separated surface, or were pretty good about getting around the thing with negative margins on frozen in the first place (or perhaps I just blocked out the worst of it..). Either way, unless you're getting quite a lot of these irregular complex specimens and have some relevant data to support minimizing, you're probably a bit stuck doing whatever the surgeon voices questions about.

 

[2121115]

For all those who practice in private practice/community practice . . . do you see these wild 25+ block ENT cases where they submit ditzels from every weird corner of the sinuses north of the nose?

our hospital recently hired two aggressive ENT surgeons who perform radical resections, ask for 20 block frozens, and submit cases that can go from A to AX.

does this occur purely at large regional cancer centers and academia, or is this common in the community? my hunch says its the former . . .

I'm in community practice and we get them. Most recently had one with 25 frozens.