Evidence for imaging the mandible in the management of oral squamous cell carcinoma: a review.
The accuracy of clinical examination, peroperative periosteal stripping and imaging techniques in predicting tumour invasion of the mandible in oral cancer so far reported have been compared according to their specificity and sensitivity. Clinical examination alone was not shown to be accurate, but periosteal stripping at the time of resection was extremely accurate although so far only one study has investigated it. No single imaging technique will accurately predict the invasion of tumour into the mandible, but a combination of an orthopantomogram and bone scintigraphy is recommended in early invasion. Magnetic resonance imaging is more sensitive than computed tomography and therefore may be more useful if mandibular invasion requires consideration. The decision to resect the mandible as part of the management of oral cancer should be taken on the evidence of clinical examination, periosteal stripping and at least two imaging techniques that complement each other in terms of specificity and sensitivity.
Brown
J S
JS
Regional Maxillofacial Unit, University Hospital Aintree, Longmoor Lane, Liverpool L9 A7L, UK. brownjs@globalnet.co.uk
Lewis-Jones
H
H
D000273:Adipose Tissue; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003952:Diagnostic Imaging / Q000379:methods*; D003949:Diagnostic Techniques, Surgical; D019317:Evidence-Based Medicine; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D008279:Magnetic Resonance Imaging; D008334:Mandible / Q000000981:diagnostic imaging; D008339:Mandibular Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D009361:Neoplasm Invasiveness / Q000175:diagnosis*; D010521:Periosteum / Q000601:surgery; D011862:Radiography, Panoramic; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography