PERINEURAL INVASION OF THE LOWER ALVEOLAR NERVE BY ORAL-CANCER - A FOLLOW-UP-STUDY OF 12 CASES

Twelve previously untreated cases of oral cancer with perineural infil tration were studied retrospectively. Age, sex, site, clinical stage a nd outcome were evaluated. Management of the neoplasm in each case inv olved surgical removal and six patients required adjuvant radiotherapy , The most frequent site was the lip. At the time of diagnosis, five p atients had sensory complaints and palpable lymphadenopathy was observ ed in three patients. The 5-year crude survival rate,vas 16.7%, In the cases with postoperative assessment of perineural infiltration, a med ian survival time of 30.8 months was observed; while in the case of pr eoperative assessment of nerve infiltration, extensive surgery was per formed with a consequent median survival time of 44.5 months, The peri neural infiltration of the lower alveolar nerve is more common (6.3%) than is generally thought. This frequency is due to the relationship w ith the lower lip and the mandibular region. In carcinoma of the lip, spread is generally limited to 10-15 mm along the lower alveolar nerve . In carcinoma of the mandibular region, spread is entirely dependent on the location of the tumour; the absence of clinical fixation to the bone and the small size of the carcinoma does not preclude the possib ility of bone involvement. Neurological symptoms should be evaluated c arefully, and a radiographic investigation of the nerve canal is manda tory.