PERINEURAL INVASION BY CARCINOMA OF THE LOWER LIP

Extension of lip cancer to the mental nerve and perineural spread was found in four patients. The main complaint in all cases was sensory di sturbance which preceded the diagnosis of recurrence by perineural spr ead as well as widening of the mandibular canal. In one patient, two c ranial nerves, the trigeminal and the facial were involved and one pat ient had bilateral neural involvement. Three patients died within 1 ye ar of the diagnosis of perineural spread. Prevention includes the sepa rate examination of specimens at the resection line near the mental ne rve, and follow-up by examination of the lower vestible, X-ray of the mandible and monitoring of sensory disturbance.