TITLE:
Diagnostic Role of Computerised Tomography in Mandibular Invasion among Patients with Oral Squamous Cell Carcinoma
AUTHORS:
Lokendra Singh, Pawan Singhal, Anjali Bansal, Dhirendra Tak, Ravi Saharan, Anshu Rawat, Amreen Singh, Mehak Anand, Neeraj Kumar Bairwa, Siddharth Nirwan, Kailash Singh, Anjani Kumar Sharma, Rajeev Yadav
KEYWORDS:
Oral Squamous Cell Carcinoma, Mandibular Invasion, Mandibular Resection
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.13 No.6,
October
15,
2024
ABSTRACT: Background: Oral cavity malignancy can result from surface epithelium, salivary glands, or submucosal soft tissue. Common symptoms may include non-healing ulcers, slurred speech, dysphagia, neck mass and pain which may indicate cortical invasion. Morbidity and quality of life have been seen to rise with mandibular excision in oral cavity squamous cell carcinoma. Therefore, in order to design the surgery appropriately, it is vital to be aware of the mandibular invasion prior to the procedure. Various researches have been focused on the accuracy of clinical examination and imaging technique in predicting tumour invasion of the mandible in oral malignancy. The goal of this study was to find a correlation between histological assessment, clinical examination, and computed tomography results in patients with mandibular involvement and oral cavity squamous cell carcinoma. Objectives: To determine the sensitivity, specificity, NPV and PPV of CECT and clinical diagnosis in patients with oral squamous cell carcinoma with mandibular invasion. Methods: A cross-sectional observational study was set out to review preoperative clinical and radiological assessment; and post operative histopathological finding of mandibular resection specimen in clinically evaluated and diagnosed cases of oral cavity squamous cell carcinoma (SCC) with mandibular invasion. Results: 43 individuals of oral cavity SCC with mandibular involvement were examined. 12 out of 28 mandibular resections had bone invasion, with numerous tumour entry sites being the most frequent mechanism of invasion, according to post-operative HPE. The positive predictive value (PPV) of contrast enhanced computerised tomography (CECT) scans was 42.8%, as 28 individuals had invasions revealed; sensitivity is almost 100%; specificity is 48.3. Conclusion: Prioritizing the identification of mandibular invasion is essential to enhance the prognosis of patients with oral SCC. There is an urgent necessity to review the usefulness of radiology in the treatment of mandibulectomy. Combination of clinical and radiological examination increases sensitivity and specificity.