MAXILLECTOMY

ULVAN OZAD

(1)

MAXILLA

(2)

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

DIAGNOSIS

MEDICAL HISTORY SIGNS AND SYMPTOMS EXAMINATION OF MOUTH X-RAY CT SCAN / MRI SCAN BIOPSY

(3)

SURGERY PROCEDURE

PRE-ASSESSMENT

UNDER GENERAL ANAESTHESIA

CANCEROUS TISSUE REMOVED

OBTURATOR PLACED

MAXILLECTOMY

PARTIAL MAXILLECTOMY

(HEMI-MAXILLECTOMY)

FULL MAXILLECTOM

Y

MAXILLECTOMY IS THE REMOVAL OF DAMAGED PARTS IN MAXILLA DUE TO CANCEROUS TISSUE BEING PRESENT AND

DAMAGING THE HARD PALATE

SIZESPREAD

(5)

EXTENDED MAXILLECTOMY

(RADICAL MAXILLECTOMY)

SIZESPREAD

PARTIAL MAXILLECTOMY

PART OF MAXILLA REMOVED LEAVING ONE OR MORE BONY WALLS IN PLACE

(6)

TOTAL MAXILLECTOMY

REMOVAL OF THE WHOLE MAXILLA

(7)

EXTENDED MAXILLECTOMY

REMOVAL OF SURROUNDING TISSUE TOGETHER WITH MAXILLA AS A RESULT OF

CANCER

(8)

(14)

ANATOMY OF MAXILLECTOMY

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)

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)

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)

RISKS OF SURGERY

BLEEDING INFECTION POSSIBLE NERVE DAMAGE FAILURE OF GRAFT

FUTURE PROBLEMS

SPEECH SWALLOWING PAIN INFECTION EATING/DRINKING CHEEK NUMBNESS LIP WEAKNESS EPIPHORA DOUBLE VISION

(5)

POST-OPERATION

HOSPITAL STAY UPTO 2 WEEKS

DIETICIAN APPOINTMENT AND ADVICE MAY BE NEEDED

SPEECH AND LANGUAGE THERAPY MAY BE NEEDED

THANK YOU

(16)

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