This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on ISI (4)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Oncology  • Head & Neck Cancer  • Dentistry/ Oral Medicine  • Neoplasms of Head & Neck  • Alert me on articles by topic

Indications and Controversies

Arch Otolaryngol Head Neck Surg. 2002;128:600-603.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Hypothesis: When resecting a floor-of-mouth (FOM) squamous cell carcinoma that abuts a nonirradiated mandible, if neither clinical examination nor preoperative studies have shown evidence of bony tumor invasion and if the periosteum is histologically positive for cancer on frozen section and the underlying bone is grossly normal, a segmental resection of the mandible is required. A marginal resection is never appropriate.

BACKGROUND

Historically, when an FOM tumor abutted the mandible, a complete segment of mandibular bone was resected en bloc with the tumor.¹ It was believed that the FOM lymphatics drained through the mandibular periosteum and bone to the neck, so that en bloc resection decreased the risk of later neck disease. Unfortunately, the segmental mandibulectomy left the patient with a significant functional and aesthetic deficit. Once Marchetta et al² and Carter et al³ demonstrated that cancer spreads to the mandible by direct invasion rather than lymphatic spread, preservation or partial . . . [Full Text of this Article]

PRO

Clinical Examination

Radiographic Evaluation

Intraoperative Findings

Postoperative Function and Cosmesis

CON

Clinical Examination

Radiographic Evaluation

Intraoperative Findings

Survival

Postoperative Function and Cosmesis

BOTTOM LINE

Corresponding author: Mark K. Wax, MD, Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, PV-01, Portland, OR 97201 (e-mail: waxm@ohsu.edu).