The effect of surgical resection in the region of the retromolar trigone.
Tumours in the mucosa of the retromolar trigone (RMT) are rare, but develop insidiously and spread rapidly into surrounding structures. Resection may require radical dissection beginning usually on the medial side of the mandible. Such surgery can put important structures at risk. The normal anatomy of the RMT and its relations has been studied together with simulated surgical incisions and resections. Tissue removed was processed by histological techniques in order to demonstrate structures excised or damaged by the operation. The simulated incision showed that the lingual nerve, submandibular duct and palatoglossus were at particular risk. This could affect sensation, speech, swallowing and movements of the tongue. The findings pose immediate concerns for surgeons operating in this area. Although cancer surgery often involves sacrificing tissue, care should be taken to preserve structures vital to the patient's oral function without compromising oncological principles.
Goldie
Stephen J
SJ
Department of Human Anatomy, University of Glasgow, University Avenue, Glasgow G12 8QQ, Scotland, UK. stephen_goldie@hotmail.com
Soutar
David S
DS
Shaw-Dunn
John
J
D006801:Humans; D008036:Lingual Nerve / Q000033:anatomy & histology; D061222:Lingual Nerve Injuries; D008334:Mandible / Q000033:anatomy & histology / Q000601:surgery; D009055:Mouth / Q000033:anatomy & histology; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D013363:Submandibular Gland / Q000033:anatomy & histology / Q000293:injuries