A 80-year-old patient present with a midline tumor of the lower jaw, involving the alveolar margin. He is edentulous. Treatment of choice:
Surgery is the treatment of choice in mandible cancers. Radiotherapy is contraindicated as it can lead to osteoradionecrosis of mandible. Mandible is managed surgically by marginal or segmental resection. Marginal (rim) resection keeps the outer/lower rim (1 cm thick mandible) intact to maintain cosmesis. It is indicated when there is involvement of periosteum only or with minimal alveolar/coical involvement. Segmental resection removes a full segment of mandible creating a defect which necessitates reconstruction.
Hemimandibulectomy
Commando operation
Segmental mandibulectomy
Marginal mandibulectomy