Of the various oral carcinoma subsites, the carcinomas related to the mandibular region (alveolar ridge, floor of mouth, lower retromolar area, lower buccal sulcus) are among those with the highest rate of recurrences. Neoplastic invasion of the mandible is one of the factors promoting the recurrences, Determining the presence and extent of bony involvement is therefore critical in the management of patients. The surgeon has several methods to aid in the determination of margins of invasion: radiology, gross clinical inspection, and intraoperative frozen section. Each has its deficiences and in the end, it is a combination of the methods, tempered by clinical judgment, that produces the best result.
Get full access to this article
View all access options for this article.
References
1.
BrownJSGriffithJFPhelpsPDBrowneRM. A comparison of different imaging modalities and direct inspection after periosteal stripping in predicting the invasion of the mandible by oral squamous cell carcinoma. Br J Oral Maxillofac Surg1994; 32: 347–59.
2.
WeismanRAKimmelmanCP. Bone scanning in the assessment of mandibular invasion by oral cavity carcinoma. Laryngoscope1982; 92: 1–4.
TotsukaYUsuiYTeiK. Mandibular involvement by squamous cell carcinoma of the lower alveolus: Analysis and comparative study of histologic and radiologic features. Head Neck1991; 13: 40–50.
5.
LydiattDD. Mandibular resection. Head Neck1995; 17: 247–51.
6.
McGregorADMacDonaldG. Routes of entry of squamous cell carcinoma to the mandible. Head Neck Surg1988; 10: 294–301.
7.
McGregorADMacDonaldDG. Patterns of spread of squamous cell carcinoma within the mandible. Head Neck1989; 11: 457–61.
SuciYTanimotoKTaguchiAWadaT. Radiographic evaluation of bone invasion of adenoid cystic carcinoma in the oral and maxillofacial region. J Oral Maxillofac Surg1994; 52: 821–6.
10.
CarterRLTannerNSBCliffordPShawHJ. Direct bone invasion in squamous carcinomas of the head and neck: Pathological and clinical implications. Clin Otolaryngol1980; 5: 107–16.
11.
CarterRLTsaoS-WBurmanJFPittmanMRCliffordPShawHJ. Patterns and mechanisms of bone invasion by squamous carcinomas of the head and neck. Am J Surg1983; 146: 451–5.
12.
CarterRL. Patterns and mechanisms of localized bone invasion by tumors: Studies with squamous carcinomas of the head and neck. Crit Rev Clin Lab Sci1985; 22: 275–315.
13.
McGregorIAMacDonaldDG. Spread of squamous cell carcinoma to the nonirradiated edentulous mandible—a preliminary report. Head Neck Surg1987; 9: 157–61.
14.
ForrestLASchullerDELucasJGSullivanMJ. Rapid analysis of mandibular margins. Laryngoscope1995; 105: 475–7.
15.
SchustermanMAHarrisSWRaymondAKGoepfertH. Immediate free flap mandibular reconstruction: Significance of adequate surgical margins. Head Neck1993; 15: 204–7.
