Inferior alveolar nerve drill out

Considerations

• • Anatomy

  • Inferior alveolar nerve

  • Indications 

    • Perineural invasion by malignancy 

  • Review of the literature

  • 1977: Spread of epidermoid carcinoma of the lip along the inferior alveolar nerve

  • 1995: Spread of squamous cell carcinoma of the lower lip along the inferior alveolar nerve: a case report

  • 1995: Recurrent lower gingival squamous cell carcinoma spreading along the pathway of the inferior alveolar nerve

  • 1998: Perineural invasion of the lower alveolar nerve by oral cancer: a follow-up study of 12 cases

  • 2013: Perineural infiltration of the inferior alveolar nerve in mandibular ameloblastomas

  • In relation to cutaneous malignancy of the lower lip

  • 1984: Unusual manifestations of multiple cranial nerve palsies and mandibular metastasis in a patient with squamous cell carcinoma of the lip

  • 1988: Lower lip carcinoma. Infiltration of the mandible along the mental nerve

  • 1990: Carcinoma of the lower lip with perineural extension to the middle cranial fossa

  • 1998: Surgical treatment of squamous cell carcinoma of the lower lip: evaluation of long-term results and prognostic factors--a retrospective analysis of 184 patients

  • Imaging 

  • 1994: Obliteration of fat planes by perineural spread of squamous cell carcinoma along the inferior alveolar nerve

  • 1998: Imaging features and clinical significance of perineural spread or extension of head and neck tumors

  • 1999: Advanced concepts in the imaging of perineural spread of tumor to the trigeminal nerve

  • 2010: Imaging of perineural spread in head and neck tumours

  • 2013: Perineural spread in head and neck malignancies: clinical significance and evaluation with 18F-FDG PET/CT

Preparation

Procedure

Sample operative report

Post-op

Pearls & Pitfalls

High-Yield

Links

• eMedicine - Perineural Spread of Tumor Along the Fifth and Seventh Cranial Nerves