Maxillectomy
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Maxillectomy operation with pre and post op details.
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Maxillectomy
- 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)
- 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
Editor's Notes
- one of a pair of large bones (often referred to as one bone) that form the upper jaw and teeth, consisting of a pyramidal body and four processes: the zygomatic, frontal, alveolar, and palatine. The maxilla is a bone that forms the upper jaw, part of the roof of the mouth and some bones of the nose. It also holds the upper teeth.
- The diagnosis process is in order Biopsy: Histopathological findings on hard palate biopsy showing diffuse chorion infiltration by a poorly differentiated carcinoma with a focal microglandular growth pattern (hematoxylin and eosin stain, ×400).
- Doctor, Anaesthetist, Nurse, Speech Therapist, Dietitian, Physiotherapist and Pain Control Nurse Specialist
- Using some tissue taken from another part of your body (for example, your forearm, hip or lower leg) to rebuild the part that has been taken away. Another method involves filling the cavity (hole) with a skin, muscle and/or bone ‘flap’. This will be taken from another part of your body, for example, from your hip. Your surgeon will explain how this is done.
- For smaller tumours, the surgeon will reach the maxilla by making an incision in the roof of the mouth. This will leave a minor defect which can be left to heal or stitched closed. Larger tumours will be removed by cutting through the skin of the face, and this will leave a larger defect. There are two options to close this defect.
- Epiphora Watery eyes or an overflow of tears on the cheek is related to surgical swelling and is not uncommon following maxillectomy. As the swelling subsides, tearing generally also subsides.