Composite Resection and Segmental Mandibulectomy

For oral cavity malignancies, standard management involves upfront surgical resection of the primary tumour along with removal of involved or at-risk nodal basins. For tumours intrinsic from, or extending to, the mandible, it may be necessary to perform a marginal or segmental mandibulectomy to achieve adequate disease control. In non-irradiated patients, Brown and colleagues found bone involvement to be most common at the site of direct extension for dentulous mandibles and that it was related to depth of invasion [1]. For edentulous mandibles, the majority of tumour invasion occurs through the occlusal surface. For post-irradiated patients, spread into and within the mandible has been shown to be less predictable and often is more advanced, usually resulting both from direct extension through cortical bone and from within the adjacent marrow [2, 3].