Dr. Paris performs many types of oral biopsies and is one of only a select few in the DFW area qualified to perform these types of biopsies and procedures. A biopsy is the removal and examination of tissues, cells or fluids from the oral cavity placed in an appropriate transport medium sent to a specialized oral pathology laboratory. The specimen is processed and evaluated by an Oral Pathologist for histological diagnosis which aids in the clinical diagnosis of the patient's condition. Many times Dr. Paris is in communication with the patient's Internal Medicine physician to obtain appropriate laboratory tests to further aid in the patient's diagnosis.
Dr. Paris is certified as a Clinical Microbiologist by the American Society of Clinical Pathology and trained in the proper methods of obtaining biopsies from the oral cavity.
Several types of biopsies can be performed. A scraping biopsy is performed on surface tissue cells, which determines the presence or absence of abnormal tissue. It will not render a specific diagnosis.
This type of biopsy techniques is a simple method of screening and is not always used in patient cases if it would in any way delay appropriate treatment.
The most popular forms of biopsies are excisional and incisional biopsies. An excisional biopsy is performed when the lesion is localized and the lesion borders are clearly defined. The entire lesion, usually including a margin of adjacent normal tissue, is removed and sent to the laboratory. Sometimes additional surgery is necessary to repair the resultant hard or soft tissue defects.
An incisional biopsy is performed when there are either multiple lesions, the lesion borders are not clearly defined, or the lesion is of such size that removing the entire mass would compromise the health of the patient. Incisional biopsies are performed in many instances when there is a high probability of a systemic or metastatic cause as a contributing factor to the lesions.
A punch biopsy is performed using a specialized instrument on a lesion that usually has an external layer that easily sloughs by any method of stability. The specialized instrument is gently rotated against the external surface of the lesion and penetrates slightly into the depths of the underlying tissues, so the entire mass can be gently rotated out and saved as a circular specimen, which allows for orientation of the tissue layers.
A needle biopsy is sometimes referred to as an aspiration biopsy and uses a very small needle which penetrates into the underlying abnormal mass, usually that of a cyst or tumor. A small amount of tissue and/or fluid is withdrawn to determine the cause of the abnormal mass, which then guides in the surgical removal of the entire mass.
These types of biopsies are performed in the O.R. suite at the hospital and are done as a method of guiding the surgeon in the best method of removing the mass. Most commonly these are done when we suspect a cancerous lesion.
The majority of the biopsy procedure utilizes one of the O.R. laser units that allows us to remove a small piece of tissue, seals any exposed tissue or vessels and enhances the patient's post-operative healing.