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Case Reports in Dentistry
Volume 2016 (2016), Article ID 3010934, 4 pages
Case Report

Mandibular Canal Widening and Bell’s Palsy: Sequelae of Perineural Invasion in Oral Cancer

1Department of Oral and Maxillofacial Surgery, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, India
2K.S. Hegde Charitable Hospital, Mangalore, India
3Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal University, Manipal, India

Received 15 July 2016; Revised 10 November 2016; Accepted 14 November 2016

Academic Editor: Paolo Giacomo Arduino

Copyright © 2016 Gopinath Thilak Parepady Sundar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Perineural invasion is an underrecognized route of metastatic spread along the nerve bundles within the nerve sheath into the surrounding tissues. It hinders the ability to establish local control as tumour cells can traverse along nerve tracts well beyond the extent of any local invasion rendering them inoperable and unresectable. Perineural invasion is a marker of poor prognosis. Oral submucous fibrosis with oral cancer constitutes a clinicopathologically distinct disease. Our case highlights an enigmatic presentation of oral submucous fibrosis and its coexistence with oral cancer presenting with unusual neurological disturbance of the inferior alveolar nerve and facial nerve and diffuse widening of the mandibular canal. The objective of this case report is to enumerate the significance of perineural invasion in determining the course of the disease and necessitate the need for future studies that can shed light on molecular mediators and pathogenesis of perineural spread.