Abstract
The aim of this systematic review is not only to analyse the accuracy of clinical
examination and radiological preoperative assessment of mandibular invasion reported
in isolation, but to highlight those reports that have combined them. A total of 1636
titles and abstracts published between 1995 – 2000 were screened following a literature
search in PubMed. Keywords were “mandible” and “squamous cell carcinoma”. A total
of 90 full manuscripts were reviewed with 24 meeting defined inclusion/exclusion criteria
and yielding the data reported. The most sensitive test was single photon emission
tomography with eight out of the 10 studies reporting sensitivity higher than 95%.
Magnetic resonance imaging (MRI) demonstrated superior sensitivity but was less specific
than computed tomography (CT). A single report attempted to report the combined CT
and MRI scans with a separate expert reporting but did not result in more reliable
detection. Periosteal stripping was not reported, and there was insufficient data
to establish the value of new technologies. This review confirms that, to our knowledge,
there are no reliable data on the results of combining imaging techniques with or
without clinical examination. It emphasises the lack of data for the combination of
preoperative techniques to enhance safe oncological resection of the mandible. Based
on the evidence gathered in this review an algorithm of assessment of possible mandibular
invasion is proposed. With new technologies available and 3-dimensional models to
help plan the mandibular resection and reconstruction, the potential of combining
preoperative investigations should be fully realised through prospective research.
Keywords
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Article info
Publication history
Published online: October 25, 2022
Accepted:
October 13,
2022
Identification
Copyright
Crown Copyright © 2022 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons. All rights reserved.
