A technique for the orientation of endoscopically resected laryngeal lesions

Abstract

Endoscopic resection is a widely accepted method of treating early laryngeal malignancies. Accurate histological assessment of resected laryngeal specimens can be difficult due to their small size and potential damage and distortion caused by standard orientation and processing techniques. A new technique is described which employs dehydrated cucumber to mount laryngeal specimens for orientation and processing. This technique is quick, easy, cheap and reliable, allowing accurate histological assessment of potentially malignant lesions. Better orientating and processing of laryngeal specimens can optimise treatment decisions based on histological results.

Audit of transoral laser-assisted microsurgical resection of early laryngeal cancer

“…12 More than half of our specimens were mounted and orientated for pathological examination and most followed the ENT UK recommendation of using the Glasgow technique of mounting the orientated specimen on dehydrated cucumber. 13 This is essential for the pathologist to correctly interpret margin status. Incomplete documentation regarding the surgical procedure could be due to our heavy reliance on photo documentation which is usually done pre-, intra-and post-procedure in the operating theatre.…”

Refining the ‘cucumber’ technique for laryngeal biopsy

“…We also acknowledge the contribution of Drs Torquil MacLeod and Claire Murray to the original development of the cucumber technique. 1 …”

“…Specific proposed advantages of the cucumber mounting technique included ease of handling, avoidance of tissue distortion caused by the fixation process, and accurate orientation of specimens, facilitating the pathologist's description of anatomical margins. 1 The cucumber technique has been used in our institution since 2002. However, no clinical criteria have been defined for the selection of cases for which the system would be most useful.…”

Consensus statement on management in the UK: Transoral laser assisted microsurgical resection of early glottic cancer

“…To facilitate this, the surgeon must present the specimen correctly mounted and orientated to increase accurate histological interpretation. The consensus group recommends the Glasgow technique, mounting the orientated specimen on dehydrated cucumber, enabling accurate assessment of histological margins 22 . The technique provides a permanent specimen mount, allowing the whole specimen to be processed intact.…”

“…The consensus group recommends the Glasgow technique, mounting the orientated specimen on dehydrated cucumber, enabling accurate assessment of histological margins. 22 The technique provides a permanent specimen mount, allowing the whole specimen to be processed intact. This avoids loss of orientation and distortion of specimens.…”