Maxillectomy operation with pre and post op details.

1. MAXILLECTOMY
ULVAN OZAD
(1)

2. MAXILLA
(2)

3. SURGICAL PROCEDURE PERFORMED
PARTIAL ANTERIOR
MAXILLECTOMY FOLLOWED BY
FITTING OF AN OBTURATOR
REMOVAL OF ANTERIOR
PART OF HARD PALATE
FROM MIDLINE(6TH TEETH)
REPLACEMENT FOR
DAMAGED AND REMOVED
MAXILLA

4. DIAGNOSIS
MEDICAL HISTORY
SIGNS AND SYMPTOMS
EXAMINATION OF MOUTH
X-RAY
CT SCAN / MRI SCAN
BIOPSY
(3)

5. SURGERY PROCEDURE
PRE-ASSESSMENT
UNDER GENERAL ANAESTHESIA
CANCEROUS TISSUE REMOVED
OBTURATOR PLACED

6. MAXILLECTOMY
PARTIAL
MAXILLECTOMY
(HEMI-
MAXILLECTOMY)
FULL
MAXILLECTOMY
MAXILLECTOMY IS THE REMOVAL OF DAMAGED PARTS IN
MAXILLA DUE TO CANCEROUS TISSUE BEING PRESENT AND
DAMAGING THE HARD PALATE
SIZE
SPREAD
(5)
EXTENDED
MAXILLECTOMY
(RADICAL
MAXILLECTOMY)
SIZE
SPREAD

7. PARTIAL MAXILLECTOMY
PART OF MAXILLA REMOVED LEAVING ONE OR
MORE BONY WALLS IN PLACE
(6)

8. TOTAL MAXILLECTOMY
REMOVAL OF THE WHOLE MAXILLA
(7)

9. EXTENDED MAXILLECTOMY
REMOVAL OF SURROUNDING TISSUE
TOGETHER WITH MAXILLA AS A RESULT OF
CANCER
(8)

10. (14)
ANATOMY OF MAXILLECTOMY

11. OBTURATOR
WHEN MAXILLA IS REMOVED, THERE WILL BE AN OPENING
BETWEEN MOUTH AND NOSE
OBTURATOR SEALS THE OPENING BETWEEN MOUTH AND
NOSE
FIRST, A TEMPORARY OBTURATOR IS PLACED IN SURGERY AND
WILL STAY FOR A FEW WEEKS
PLACING PERMANENT OBTURATOR MAY NEED ANAESTHESIA
ADVANTAGES: - PREVENT FLUID AND FOOD GOING INTO NOSE
- IMPROVE SPEECH AFTER OPERATION
- BETTER COSMETIC IMAGE
(4) (4)
(5) (11)

12. OTHER OPTIONS
REBUILD WITH TISSUE FROM ANOTHER
PART OF BODY (GRAFT)
CONSIDERATION FACTORS: AGE,
GENERAL HEALTH, TYPE OF TUMOUR
ADVANTAGES: AVOID OBTURATOR AND
PREVENT HOLES IN MOUTH
(11)

13. INCISION- WILL IT LEAVE A SCAR?
-CUT INTO THE SKIN ALONG THE SIDE OF NOSE, FROM
EYEBROW OR EYELIDS DOWN TO THE UPPER LIP
-MAKE A CUT INSIDE THE MOUTH UNDER UPPER LIP
(ADVANTAGE: NO BIG SCAR)
(9)
(10)
(10)

14. RISKS OF SURGERY
BLEEDING
INFECTION
POSSIBLE NERVE DAMAGE
FAILURE OF GRAFT

15. FUTURE PROBLEMS
SPEECH
SWALLOWING
PAIN
INFECTION
EATING/DRINKING
CHEEK NUMBNESS
LIP WEAKNESS
EPIPHORA
DOUBLE VISION
(5)

16. POST-OPERATION
HOSPITAL STAY UPTO 2 WEEKS
DIETICIAN APPOINTMENT AND ADVICE
MAY BE NEEDED
SPEECH AND LANGUAGE THERAPY MAY
BE NEEDED

17. THANK YOU
(16)

18. REFERENCES
(1): The Palatal Obturator, Dentist Portal, The Glossary of Prosthodontics Terms (2005), Volume 94, Issue 1, Pages 10-92 (July 2005),
Last accessed: 09 February 2011, http://dentista.pinoydental.com/content/view/101/67/
(2):Maxilla, Mosby's Medical Dictionary, 8th edition, 2009, Elsevier, Last accessed: 09 February 2011, http://medical-
dictionary.thefreedictionary.com/maxilla
(3): Figure 1, Colombo et al., BMC Cancer, 2005, Last accessed: 09 February 2011, http://www.biomedcentral.com/1471-
2407/5/117/figure/F1?highres=y
(4): Dental and oral complications, Oral cancer foundation, Last accessed: 09 February 2011,
http://www.oralcancerfoundation.org/dental/dental-complications.htm
(5): South Devon Healthcare, Patient Information, Last accessed: 09 February 2011,
http://www.sdhct.nhs.uk/patientcare/pil/23681.pdf?last_updated=13%252F11%252F2008
(6): Maxillofacial Prosthodontics, Last accessed: 09 February 2011, http://xiad.bravehost.com/Z/prosth.htm
(7): Pictures of Total Maxillectomy and Obturator, vBulletin, Last accessed: 09 February 2011,
http://www.all4dentist.com/showthread.php?555-Pictures-of-Total-Maxillectomy-and-Obturator, previously citated from:
http://www.ghorayeb.com/
(8): Squamous Cell Carcinoma - Maxillary Sinus, Head & Neck, Last accessed: 09 February 2011,
http://www.webpathology.com/image.asp?case=146&n=8
(9): Operations for nasal and sinus cancer, Cancer help UK, Last accessed: 09 February 2011, http://www.cancerhelp.org.uk/type/nasal-
cancer/treatment/surgery/operations-for-nasal-and-sinus-cancer#maxillary
(10): Anterior Subfrontal Approach - Tumor Removal: Treatment, Carrau et al, eMedicine, Last accessed: 09 February 2011,
http://emedicine.medscape.com/article/844449-treatment
(11): Information for people undergoing an operation to remove part of the upper jaw Queen victoria hospital, Last accessed: 09
February 2011, http://qvh.nhs.uk/assets/Maxillectomy
(12): Maxillectomy, Last accessed: 09 February 2011, http://www.latrobe.edu.au/hcs/resources/head-neck-
surgery/docs/maxillectomy.pdf
(13): Maxillectomy, Mount vernon cancer network, Last accessed: 09 February 2011,
http://www.ljmc.org/patient_information/PI63_Maxillectomy.pdf
(14): Essentials of Head and neck Oncology. Close et al, Page 132, 1998, Thieme
(15): Maxillectomy, The head+neck centre, Last accessed: 09 February 2011, http://www.rochesterhnc.com/Procedures/JC-
Maxillectomy.pdf
(16): Oral Surgeon Cartoons and Comics. CSL Cartoonstock, Last accessed: 09 February 2011,
http://www.cartoonstock.com/directory/o/oral_surgeon.asp