Conservative mandibular resections for oral cavity malignancies: a review

The mandible plays an important role in mastication, speech and facial cosmesis. Apart from direct involvement by oral malignancies, the mandible used to be excised in oral cancers due to its proximity to the tumour, for adequate resection margins and for fear of recurrence as cancer was thought to spread via the periosteal lymphatics. However, with better understanding of spread of oral cancers and also the various routes of mandibular involvement, more and more oral cancers are being resected with only a portion of the mandible that is juxtaposed to the tumour. This allows preservation of bony continuity of at least one cortex, which improves cosmetic outcome and provides better function. In this article, we have reviewed the recent literature on this topic and outline important clinical anatomy of the mandible, the pathological and clinical basis of selection of cases suitable for marginal mandibulectomy and the types of marginal mandibulectomies.