A 57-year-old male with an alveolar (gingival) squamous cell carcinoma has CT evidence of erosion limited to the inner cortical table of the mandible without medullary involvement. Which operative procedure best balances oncological clearance with preservation of mandibular continuity?

• A Periosteal stripping alone with soft tissue clearance
• B Segmental mandibular resection with reconstruction plate only
• C Marginal (segment-sparing) mandibulectomy ✓
• D Hemimandibulectomy including the condyle

Explanation

When imaging shows periosteal or limited inner cortical erosion without marrow invasion, a marginal mandibulectomy achieves adequate margins while maintaining mandibular continuity and avoiding donor morbidity. Segmental resection is reserved for gross cortical destruction, medullary invasion, or a previously irradiated mandible, and periosteal stripping alone gives an inadequate deep margin once cortex is eroded.

Reference: Shah's Head and Neck Surgery and Oncology, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.