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Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
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Intraoperative Radiographic Assessment of Bone Resection Margins During Mandibulectomy: A Case Series
Alan Shan1, Kofi Boahene2, Karen T Pitman1,2
1Milton J. Dance, Jr. Head and Neck Center, 1499Greater Baltimore Medical Center, Baltimore, MD, USA.
Ear, Nose, & Throat Journal
|November 15, 2019
Summary
Intraoperative radiography using Faxitron effectively assessed bone resection margins during mandibulectomy for oral cancers. This technique identified close margins, enabling adjustments to ensure negative pathologic margins in all evaluated patients.
Area of Science:
- Oral surgery
- Surgical oncology
- Radiology
Background:
- Mandibulectomy is standard for bone-infiltrated oral cancers and full-thickness benign mandibular tumors.
- Accurate assessment of bone resection margins is crucial for successful outcomes.
- Current intraoperative methods for assessing bone margins are often inadequate.
Purpose of the Study:
- To evaluate the utility of an existing intraoperative radiographic system for objective determination of bone resection margins during mandibulectomy.
- To describe the application of Faxitron radiography in assessing bone margins during mandibulectomy.
Main Methods:
- Retrospective case series of 10 patients undergoing mandibulectomy with intraoperative Faxitron radiography (January 2016 - March 2019).
- Review of patient demographics, diagnoses, tumor characteristics, and bone resection margins.
- Analysis of intraoperative radiographic findings and their impact on surgical decisions.
Main Results:
- Nine patients had squamous cell carcinoma (T4 stage), and one had ameloblastoma.
- All 10 cases achieved negative final pathologic margins.
- Intraoperative radiography identified close margins in two cases, prompting further resection or operative plan modification.
Conclusions:
- Intraoperative Faxitron radiography is a promising method for assessing bone resection margins in mandibulectomy.
- This technique can guide surgical decisions to achieve negative margins.
- Further validation studies are needed to confirm its efficacy.
