A. Zupi et al., PERINEURAL INVASION OF THE LOWER ALVEOLAR NERVE BY ORAL-CANCER - A FOLLOW-UP-STUDY OF 12 CASES, Journal of cranio-maxillo-facial surgery, 26(5), 1998, pp. 318-321
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.