A 62-year-old man with oral cavity squamous cell carcinoma (T2, floor of mouth) invading the mandibular periosteum but not the medullary cavity on imaging. What is the most appropriate surgical management of the mandible?
- A Hemimandibulectomy
- B Segmental mandibulectomy
- C Marginal mandibulectomy ✓
- D No mandibular resection needed
Correct answer: C. Marginal mandibulectomy
Explanation
When oral cavity tumors abut or invade the periosteum but do not erode into the medullary cavity, a marginal mandibulectomy (rim resection) is appropriate. This preserves mandibular continuity, avoiding the need for reconstruction with free flaps. Segmental mandibulectomy is required when there is gross medullary invasion. The decision is based on imaging (CT showing cortical erosion) and intraoperative assessment. Marginal mandibulectomy provides adequate oncologic margin while maintaining function and cosmesis.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.