Unilateral widening of the inferior alveolar nerve canal: a rare anatomic variant mimicking disease

Terzic, A.; Becker, Minerva; Imholz, Benoît; Scolozzi, Paolo

doi:10.1007/s11282-012-0118-9

Cited by 8 publications

(27 citation statements)

References 49 publications

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“…Furthermore, distinct asymmetrical distension of the mandibular canal is considered to be a profound indicator of neural pathology [13] and a welldefined sclerotic border suggested benign nature [5]. There was a fusiform widening of the mandibular canal in our case which is rare (10%) [13]. Other main causes of the widening of the mandibular canal are vascular malformations, but it is ruled out in our case due to negative aspiration.…”

Section: Discussionmentioning

confidence: 59%

“…Some authors say multilocularity in the two-dimensional imaging modality might be due to the peripheral scalloping, that is, due to the shadowing of corrugations on the walls of the bone cavity containing the tumor [5,7,12]. Furthermore, distinct asymmetrical distension of the mandibular canal is considered to be a profound indicator of neural pathology [13] and a welldefined sclerotic border suggested benign nature [5]. There was a fusiform widening of the mandibular canal in our case which is rare (10%) [13].…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic imaging of a Rare Intraosseous Mandibular Schwannoma using Cone Beam Computed Tomography – A case report

Ramesh¹,

Jayachandran²

2020

IJCR

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S chwannoma (neurilemmoma, neurinoma, or perineural fibroblastoma) is a benign tumor of Schwann cells, which forms the inner layer of nerve sheath (World Health Organization grade-I, International Classification of Diseases-O 9560/0). It is classified as Central schwannoma (intraosseous) and Peripheral schwannoma (in soft tissues). It is relatively common in the head and neck region (25%) [1,2]. Intraorally, it is rare (1-12%) with the tongue as the most predilected site. Intraosseous schwannomas are even rarer, <1% of primary bone tumors [2-5]. Here, we report a case with detailed cone-beam computed tomographic (CBCT) image findings of the intraosseous mandibular schwannoma of inferior alveolar nerve (IAN) and becomes first of its kind in the literature [2,6] to the best of our knowledge CASE REPORT An otherwise healthy 35-year-old female patient reported to our Department of Oral Medicine and Radiology with complaints of pain and swelling on the left side of the lower jaw for the past 6 months. There was a history of swelling which was gradual in onset and slow in progress, also associated with dull and continuous pain in the left body of the mandible region for the past 6 months, and paresthesia of the lower lip for the past 1 month. Past medical and surgical histories were non-contributory. The patient was conscious, alert, and oriented. No signs of pallor, icterus, cyanosis, clubbing, edema, and lymphadenopathy were present. The pulse rate was 72/min, respiratory rate was 16/ min, blood pressure was 120/80 mmHg, and the temperature was 98.6°F. On extraoral examination, an ill-defined, diffuse swelling, approximately 5×2 cm on the left side of the mandible extending from the angle to the parasymphysis medially was evident (Fig. 1a). On palpation, the swelling was non-warmth, non-tender, and hard in consistency. On neurosensory examination, twopoint discrimination, and light touching tests showed decreased sensation on the lower lip and the labial mucosa. Intraorally, an ill-defined, hard, non-tender, and non-pulsatile tumefaction with bicortical expansion obliterating the left mandibular buccal vestibule in relation to 33-38 was evident (Fig. 1b). Electric pulp vitality testing showed a negative response in those teeth. Teeth 35, 36, and 37 were inclined lingually with grade-I mobility. Intraoral periapical radiograph (IOPA), lateral mandibular occlusal, and the panoramic radiograph showed a

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Diagnostic imaging of a Rare Intraosseous Mandibular Schwannoma using Cone Beam Computed Tomography – A case report

Ramesh¹,

Jayachandran²

2020

IJCR

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“…Around 15%–45% of non-Hodgkin lymphomas of the oral cavity involve both the maxilla and mandible, and only 0.6% affect the mandible alone. Furthermore, non-Hodgkin lymphoma has a male predilection 367. Oral non-Hodgkin lymphomas are often characterized by a bony swelling, which can be symptomatic or asymptomatic, as well as tooth mobility, pathological fractures, and sensory disturbances 37.…”

Section: Resultsmentioning

confidence: 99%

“…The distance between the mandibular canal and the buccal cortical plate in the molar region is greater than that in the ramus region, and may vary from 0.57 mm to 5.8 mm in the ramus region and from 0.40 mm to 70 mm in the molar region 12. The mandibular canal has several normal anatomical variations, such as a bifid canal, a trifid canal, or an enlarged canal 13. However, mandibular canal widening is a rare finding.…”

Section: Introductionmentioning

confidence: 99%

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Common conditions associated with mandibular canal widening: A literature review

et al. 2019

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Purpose The aim of this study was to review the common conditions associated with mandibular canal widening. Materials and Methods General search engines and specialized databases including Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus were used to find relevant studies by using the following keywords: “mandibular canal,” “alveolar canal,” “inferior alveolar nerve canal,” “inferior dental canal,” “inferior mandibular canal,” “widening,” “enlargement,” “distension,” “expansion,” and “dilation.” Results In total, 130 articles were found, of which 80 were broadly relevant to the topic. We ultimately included 38 articles that were closely related to the topic of interest. When the data were compiled, the following 7 lesions were found to have a relationship with mandibular canal widening: non-Hodgkin lymphoma, osteosarcoma, schwannoma, neurofibroma, vascular malformation/hemangioma, multiple endocrine neoplasia syndromes, and perineural spreading or invasion. Conclusion When clinicians encounter a lesion associated with mandibular canal widening, they should immediately consider these entities in the differential diagnosis. Doing so will help dentists make more accurate diagnoses and develop better treatment plans based on patients' radiographs.

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Radiolucent lesions of the mandible: a pattern-based approach to diagnosis

et al. 2013

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ObjectivesRadiolucent mandibular lesions seen on panoramic radiographs develop from both odontogenic and non-odontogenic structures. They represent a broad spectrum of lesions with a varying degree of malignant potential. The purpose of this review is to illustrate the characteristic imaging findings—as well as the clinical and histological features—of common and uncommon radiolucent lesions of the mandible.MethodsThis review article is based on the retrospective evaluation of 11,725 panoramic radiographs seen in our institution during the past 6 years. It provides a comprehensive, practical approach to the radiological interpretation of radiolucent lesions of the mandible. To facilitate the diagnostic approach, we have classified radiolucent lesions into two groups: lesions with well-defined borders and those with ill-defined borders.ResultsLesion prevalence, age of manifestation, location within the mandible, relationship to dental structures, effect on adjacent structures and characteristic findings at computed tomography (CT), cone beam CT (CBCT) and magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) are discussed. Pitfalls including malignant lesions mimicking benign disease and pseudo-lesions are equally addressed.ConclusionKnowledge of the characteristic imaging features of radiolucent mandibular lesions narrows the differential diagnosis and is crucial for the identification of those lesions, where biopsy is indicated for definitive histology.Teaching points• Panoramic X-rays, CT and MRI are essential for the work-up of radiolucent mandibular lesions.• Lesion borders, location within the mandible, relationship to dental structures and tissue characteristics on cross-sectional imaging are indispensable to narrow the differential diagnosis.• High-resolution CT and CBCT play a major role for the assessment of lesion margins and their relationship to important anatomic structures, such as the inferior alveolar nerve.• Although most radiolucent lesions with well-defined sclerotic borders are benign, MRI may reveal clinically unsuspected malignant disease.

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Unilateral widening of the inferior alveolar nerve canal: a rare anatomic variant mimicking disease

Cited by 8 publications

References 49 publications

Diagnostic imaging of a Rare Intraosseous Mandibular Schwannoma using Cone Beam Computed Tomography – A case report

Diagnostic imaging of a Rare Intraosseous Mandibular Schwannoma using Cone Beam Computed Tomography – A case report

Common conditions associated with mandibular canal widening: A literature review

Radiolucent lesions of the mandible: a pattern-based approach to diagnosis

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