Relationship between accessory foramina and tumour spread in the lateral mandibular surface

Area of Science:

• Anatomy
• Oncology
• Oral Surgery

Background:

• Tumor spread to the mandible is recognized, often via accessory foramina in the edentulous alveolar ridge.
• Tumor infiltration through the lateral cortical plate is possible, but accessory foramina distribution is undocumented.

Purpose of the Study:

• To chart the number and distribution of accessory foramina on the lateral surface of the mandible.
• To assess the implications of foramina presence for surgical practices and tumor invasion pathways.

Main Methods:

• Examination of the lateral surfaces of 89 human mandibles.
• Charting of accessory foramina demonstrating direct communication with cancellous bone.

Main Results:

• Accessory foramina numbers varied significantly between specimens.
• Foramina were present in 70.8% of mandibles in the coronoid, sigmoid, and condylar sections, predominantly in the condylar region (93.7%).
• On the rest of the lateral surface, foramina were most frequent in the upper third (97.8%), followed by the lower (61.8%) and middle (58.4%) thirds.

Conclusions:

• Findings support conserving the ascending ramus posterior to the coronoid process and justify rim resection in specific cases.
• The distribution of foramina highlights the alveolar section's susceptibility to early tumor invasion.
• Accessory foramina may offer direct pathways for tumor cell invasion to the medulla, especially post-radiotherapy.