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Clinical Commentary on Marginal vs Segmental Resection of the Mandible
Arch Otolaryngol Head Neck Surg. 2002;128:605-606.
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The authors have done very well in accurately reporting the current
literature on the complex topic of whether marginal mandibulectomy or segmental
mandibulectomy should be carried out in patients with FOM SCCA. The hypothesis
that marginal mandibulectomy is never appropriate in oral-cavity SCCA invasion
of the mandibular periosteum without clinical findings of bone invasion was
examined based on data from a MEDLINE search that produced 18 articles in
the English language from 1980 to 2001. It is clear from this review article
and from other literature that the use of marginal mandibulectomy is controversial.
Lack of prospective trials with adequate numbers of patients comparing this
procedure with segmental mandibulectomy accounts for much of this controversy.
Figure appears in full text version.
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Wax et al discuss 3 areas of assessment: clinical examination, radiographic
evaluation, and intraoperative findings. They cite articles that show that
clinical judgment of invasion and lack of invasion in SCCA . . . [Full Text of this Article]
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