Is it necessary to resect bone for low-grade mucoepidermoid carcinoma of the palate?

Minor intraoral tumours of the salivary glands are relatively uncommon. Most are histologically low grade and display no aggressive clinical features such as bony invasion or regional metastases. The aim of this study was to investigate retrospectively a bone-sparing approach to resection of low grade mucoepidermoid carcinoma of the hard palate in 18 patients. Only one had radiographic evidence of bony invasion and was treated by composite resection of the hard palate. Sixteen patients were treated by wide local excision with 1cm margins of soft tissue using the periosteum of the hard palate as the deep margin. The mean (SD) follow-up time was 44 months, (range 2-140). Among patients who had only soft tissue resection the histological margins were clear in 11 patients, and 5 had close or invaded margins that were all localised to the deep margin. There were no local recurrences during the follow-up period. We suggest that a bone-sparing approach to such tumours gives adequate local control, and composite resections should be reserved for tumours that have obviously invaded the hard palate.