Skip to main content
Medicine LibreTexts

6.8.7: 7. Imaging

  • Page ID
    18409
  • \( \newcommand{\vecs}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} } \) \( \newcommand{\vecd}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash {#1}}} \)\(\newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\) \( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\) \( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\) \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\) \( \newcommand{\Span}{\mathrm{span}}\) \(\newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\) \( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\) \( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\) \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\) \( \newcommand{\Span}{\mathrm{span}}\)\(\newcommand{\AA}{\unicode[.8,0]{x212B}}\)

    Imaging is only required if it may change management

    Distant pulmonary metastases / synchronous primary: CXR / CT chest

    Radiation planned: Panorex to exclude dental disease or bone destruction

    Imaging of Primary

    • T1-3 oral cancers
      • Minority require imaging
      • Abuts mandible to decide re marginal / segmental / hemimandibulectomy
      • Trismus to rule out involvement of masticator space, PPS and ITF
    • T4 oral cancers
      • Resectable?
      • Abuts mandible to decide re marginal / segmental / hemimandibulectomy
      • Type of bone reconstruction
        • Length of bone resection
        • Mandibular height
        • Will mandibulectomy cross midline?….excludes surgery if cannot reconstruct anterior mandible (Andy Gump deformity)
    • Type of imaging
      • Soft tissue: CT / MRI
      • Bone: Panorex / CT scan / MRI
      • Perineural spread: MRI

    Cervical metastases

    • N0 neck: No need to image if elective neck dissection planned, unless concern re contralateral occult nodes with a midline cancer
    • N+ neck: Image (U/S or CT) if concern about resectability

    This page titled 6.8.7: 7. Imaging is shared under a CC BY-NC 3.0 license and was authored, remixed, and/or curated by Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery.