Download PDF
J Neurol Surg B Skull Base 2016; 77(02): 140-149
DOI: 10.1055/s-0036-1579751
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Surgical Management of Perineural Spread of Head and Neck Cancers

C. Arturo Solares
1   Department of Otolaryngology, Head and Neck Surgery, Georgia Regents University, Augusta, Georgia, United States
2   Center for Cranial Base Surgery, Georgia Regents University, Augusta, Georgia, United States
,
Eric Mason
1   Department of Otolaryngology, Head and Neck Surgery, Georgia Regents University, Augusta, Georgia, United States
2   Center for Cranial Base Surgery, Georgia Regents University, Augusta, Georgia, United States
,
Benedict J. Panizza
3   Queensland Skull Base Unit and Department of Otolaryngology, Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia
4   School of Medicine, University of Queensland, Brisbane, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2016 (online)

    Permissions and Reprints

Abstract

The surgical management of perineural spread of head and neck cancers has become an integral part in the contemporary treatment of this pathology. We now understand that tumour spreads within the epineurium and in a continuous fashion. We also can rely on the accuracy of magnetic resonance neurography in detecting and defining the extent of disease. With modern skull base techniques and a greater understanding of the anatomy in this region, specific operations can be designed to help eradicate disease. We review the current approaches and techniques used that enable us to better obtain tumour free margins and hence improve survival.

Keywords

perineural invasion - perineural spread - head and neck - skin cancer - squamous cell carcinoma - skull base surgery
 

  • References

  • 1 Cernea CR, Ferraz AR, de Castro IV , et al. Perineural invasion in aggressive skin carcinomas of the head and neck. Potentially dangerous but frequently overlooked. ORL J Otorhinolaryngol Relat Spec 2009; 71 (1) 21-26
    CrossrefPubMedGoogle Scholar
  • 2 McCord MW, Mendenhall WM, Parsons JT, Flowers FP. Skin cancer of the head and neck with incidental microscopic perineural invasion. Int J Radiat Oncol Biol Phys 1999; 43 (3) 591-595
    CrossrefPubMedGoogle Scholar
  • 3 Panizza B, Solares CA, Redmond M, Parmar P, O'Rourke P. Surgical resection for clinical perineural invasion from cutaneous squamous cell carcinoma of the head and neck. Head Neck 2012; 34 (11) 1622-1627
    CrossrefPubMedGoogle Scholar
  • 4 American Joint Committee on Cancer. Cutaneous Squamous Cell Carcinoma and Other Cutaneous Carcinomas. In: Edge SB, Byrd DR, Compton CC, et al, eds. AJCC Staging Manual. 7th ed. New York, NY: Springer; 2010: 301-314
    Google Scholar
  • 5 Solares CA, Lee K, Parmar P, O'Rourke P, Panizza B. Epidemiology of clinical perineural invasion in cutaneous squamous cell carcinoma of the head and neck. Otolaryngol Head Neck Surg 2012; 146 (5) 746-751
    CrossrefPubMedGoogle Scholar
  • 6 Williams LS, Mancuso AA, Mendenhall WM. Perineural spread of cutaneous squamous and basal cell carcinoma: CT and MR detection and its impact on patient management and prognosis. Int J Radiat Oncol Biol Phys 2001; 49 (4) 1061-1069
    CrossrefPubMedGoogle Scholar
  • 7 Gandhi MR, Panizza B, Kennedy D. Detecting and defining the anatomic extent of large nerve perineural spread of malignancy: comparing “targeted” MRI with the histologic findings following surgery. Head Neck 2011; 33 (4) 469-475
    CrossrefPubMedGoogle Scholar
  • 8 Warren TA, Panizza B, Porceddu SV , et al. Outcomes after surgery and postoperative radiotherapy for perineural spread of head and neck cutaneous squamous cell carcinoma. Head Neck 2014; ; [Epub ahead of print]
    PubMedGoogle Scholar
  • 9 Mendenhall WM, Amdur RJ, Williams LS, Mancuso AA, Stringer SP, Price Mendenhall N. Carcinoma of the skin of the head and neck with perineural invasion. Head Neck 2002; 24 (1) 78-83
    CrossrefPubMedGoogle Scholar
  • 10 Nemzek WR, Hecht S, Gandour-Edwards R, Donald P, McKennan K. Perineural spread of head and neck tumors: how accurate is MR imaging?. AJNR Am J Neuroradiol 1998; 19 (4) 701-706
    PubMedGoogle Scholar
  • 11 Parker GD, Harnsberger HR. Clinical-radiologic issues in perineural tumor spread of malignant diseases of the extracranial head and neck. Radiographics 1991; 11 (3) 383-399
    CrossrefPubMedGoogle Scholar
  • 12 Panizza B, Warren TA, Solares CA, Boyle GM, Lambie D, Brown I. Histopathological features of clinical perineural invasion of cutaneous squamous cell carcinoma of the head and neck and the potential implications for treatment. Head Neck 2014; 36 (11) 1611-1618
    CrossrefPubMedGoogle Scholar
  • 13 Panizza B, Warren T. Perineural invasion of head and neck skin cancer: diagnostic and therapeutic implications. Curr Oncol Rep 2013; 15 (2) 128-133
    CrossrefPubMedGoogle Scholar
  • 14 Odobescu A, Williams HB, Gilardino MS. Description of a communication between the facial and zygomaticotemporal nerves. J Plast Reconstr Aesthet Surg 2012; 65 (9) 1188-1192
    CrossrefPubMedGoogle Scholar
  • 15 Baumel JJ. Trigeminal-facial nerve communications. Their function in facial muscle innervation and reinnervation. Arch Otolaryngol 1974; 99 (1) 34-44
    CrossrefPubMedGoogle Scholar
  • 16 Balamucki CJ, Mancuso AA, Amdur RJ , et al. Skin carcinoma of the head and neck with perineural invasion. Am J Otolaryngol 2012; 33 (4) 447-454
    CrossrefPubMedGoogle Scholar
  • 17 Jackson JE, Dickie GJ, Wiltshire KL , et al. Radiotherapy for perineural invasion in cutaneous head and neck carcinomas: toward a risk-adapted treatment approach. Head Neck 2009; 31 (5) 604-610
    CrossrefPubMedGoogle Scholar
  • 18 Dunn M, Morgan MB, Beer TW. Perineural invasion: identification, significance, and a standardized definition. Dermatol Surg 2009; 35 (2) 214-221
    CrossrefPubMedGoogle Scholar