Artikel
Marginal versus segmental mandibulectomy for squamous cell carcinoma of the oral cavity
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Veröffentlicht: | 22. September 2005 |
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Gliederung
Text
Squamous cell carcinoma of the oral cavity abutting the gingiva without evidence of bony invasion are usually treated with marginal mandibulectomy.If there are signs of bony invasion,a segmental mandibulectomy is performed.
The aim of our study was to analyse the capabilities of preoperative radiological examination in detecting bone involvement and to evaluate conditions requiering a segmental mandibulectomy.
76 patients with squamous cell carcinoma of the oral cavity,who underwent marginal (n=26) or segmental (n=50) mandibulectomy,were included in the study.Clinical,radiological and histopathological data were retrospectively studied.
The invasion rate was 27% (7/26) for rims and 64% (32/50) for segmental resections of the mandible.In the latter group,9 cases showed only infiltration of the corticalis.In 23 specimen the marrow was invaded by tumor also.
Altogether,the preoperative sensitivity was 80,3%.Magnetic resonance imaging was more reliable than computertomography (92% versus 78%).
Preoperative diagnostics has to be improved,in order to reduce the amount of segmental mandibulectomies.In cases of doubt,the decision between marginal and segmental mandibulectomy should be taken intraoperatively.