Buccal Mucosa Elasticity Influences Surgical Margin Determination in Buccal Carcinoma Resection.

PURPOSE: Little is known about whether buccal mucosa elasticity influences the determination of surgical margins for buccal carcinomas. This study investigated whether there is a difference in elasticity of the buccal mucosa in patients with buccal carcinoma compared with controls without the disease.

PATIENTS AND METHODS: A case-and-control study comprised of patients with buccal carcinoma and controls without the disease was conducted. In each patient, 2 gutta-percha points were attached to the buccal mucosa horizontally and examined twice by lateral cephalometry, once with the mouth closed and once during maximal mouth opening (MMO). Changes in distance between the gutta-percha points were used as a measurement of buccal elasticity. Information on age, alcohol consumption, betel nut chewing, smoking habits, oral submucosa fibrosis (OSF), temporomandibular joint (TMJ) subluxation, and interincisal distance at MMO (IDMMO) was collected. The results were analyzed using independent-sample and paired-sample t tests.

RESULTS: Ten patients with buccal carcinoma and another 11 patients without buccal carcinoma were enrolled in this study. There was a significant increase in magnification percentage in patients with carcinoma (32.35%; P < .001) during MMO. Magnification of the comparison group during MMO measured 51.55%, also a significant increase (P < .001). Betel nut chewing significantly decreased mucosa elasticity; magnification was 29.20% (P = .013). Magnification was significantly higher in patients with TMJ subluxation (54.50%; P = .041) than in the controls. Age, alcohol consumption, smoking, OSF, and IDMMO did not affect buccal mucosa elasticity.

CONCLUSIONS: Buccal mucosa elasticity increased considerably at MMO in patients with buccal carcinoma. This elasticity should be taken into account when calculating adequate surgical margins for transoral resection of buccal carcinoma.