An oral squamous carcinoma abuts the mandible. CT shows superficial cortical erosion but no medullary invasion, and the patient has a functioning dentate mandible. What resection principle is most appropriate?
Superficial cortical involvement may be cleared with a marginal resection while preserving continuity. Segmental mandibulectomy is required when medullary invasion, canal involvement or inadequate residual height prevents safe clearance.
A. Consider marginal mandibulectomy if oncological clearance is achievable: Superficial cortical involvement may be cleared with a marginal resection while preserving continuity. Segmental mandibulectomy is required when medullary invasion, canal involvement or inadequate residual height prevents safe clearance.
B. Segmental mandibulectomy is mandatory whenever tumour touches bone: Contact alone does not prove deep invasion.
C. Strip tumour from periosteum without a margin: This risks leaving involved tissue.
D. Radiotherapy alone is always equivalent: Resectable oral cancer often requires surgery and neck management.
E. Ignore dental and reconstructive planning: Occlusion, residual strength and rehabilitation affect the operation.
If MRI or CT demonstrated medullary invasion reaching the inferior alveolar canal, segmental resection would be favoured.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for current guidance, local policy and specialist judgement.
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