Objective. Growth characteristics of amelohlastomas involving the inferior
alveolar nerve were examined to determine the most appropriate surgical man
agement of the nerve at the time of the surgical procedure.
Study design, Clinical and histopathologic examinations were performed on 2
2 resected mandibles in which the inferior alveolar nerve was lying adjacen
t to, or contained within, the tumor.
Results. Patterns of tumor involvement of the nerve bundle were evaluated w
ith respect to the presence of bone (11 patients) or connective tissue wall
(7 patients) between the tumor and the nerve bundle, and tumor infiltratio
n of perineural connective tissue (4 patients). Neither invasion into the n
erve sheath nor invasion into the nerve itself by the ameloblastoma was det
ected. Tumor infiltration of the tissue surrounding the nerve was identifie
d for the multicystic and solid types but not for the unicystic type. Prese
nce of bone or connective tissue wall between the tumor and the nerve bundl
e was dominant in the unicystic and plexiform ameloblastomas, whereas tumor
infiltration of the perineural tissue was frequently observed in ameloblas
tomas with the follicular pattern.
Conclusion. The preservation of the inferior alveolar nerve may be possible
in the management of the unicystic type of ameloblastoma. However, a more
radical approach is necessary for treatment of multicystic or solid tumors,
especially those exhibiting a follicular pattern.