Perineural tumour spread in Head and Neck Lesions

Perineural spread (PNS) is said to occur in about 2,5–5% of all patients with head and neck malignancy. It is associated with a 3-fold increase of local recurrences and a 30% decrease of 5 years survival. About 30–60% of patients are reported to be clinically asymptomatic. On high resolution MRI imaging abnormal enhancement along cranial nerves with or without nodular thickening and with or without skip lesions is the hallmark for PNS. The most commonly affected cranial nerves are the trigeminal nerve (maxillary and mandibular nerves) and the facial nerve; less commonly the hypoglossal nerve is involved. In abou…