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Mandibulotomy Approach for Resection of Maxillary Tumours: A Clinical Review

  • Venkatesh Anehosur
  • Mohit Bindal
  • Niranjan Kumar
  • Chaitra Shetty
Review Article
  • 2 Downloads

Abstract

Purpose

The objective of this study was to assess the accessibility in the resection of maxillary tumours, resection margin status, and morbidity following maxillectomy through lip split with paramedian mandibulotomy approach.

Materials and Methods

A retrospective review of 20 consecutive patients who underwent maxillectomy with resection of primary tumours through lip split mandibulotomy approach with supraomohyoid neck dissection for maxillary tumours between 2008 and 2016. Patients details including the tumours site, extension and neck node involvement. were recorded. Resection technique, status of surgical resected margins was also discussed. Disease status was obtained from patients follow up records. Morbidity was assessed at mandibulotomy site in terms of infection, osteotomy healing, neural disturbance and mouth opening. The institutional research committee approval was taken for this study.

Results

All patients underwent adequate en bloc resection of the tumours, except in two patients in whom superior margins was positive. Osteotomy site healed well in our all patients except in one patient in whom there was infection at the osteotomy site during post radiation therapy. Minimal neural morbidity was encountered in four patients (three patients had lingual nerve hypothesia and two patients had inferior alveolar nerve hypothesia) which recovered in all four patients, over the 6th month post-operative period. Post-operative interincisal distance was satisfactory with a mean of 30.5 mm.

Conclusion

Mandibulotomy with lip split is considered to be an ideal approach to access tumours of maxilla and its adjacent structures, SOHND with level III clearance. This approach provide excellent accessibility for en bloc resection of operable maxillary tumours with good outcome of resultant scar and minimal morbidity.

Keywords

Infratemporal fossa Mandibulotomy Supraomohyoid neck dissection Maxillary tumours Mandible swing 

Notes

Acknowledgements

Authors would like to thank Dr. Niranjan Kumar, Medical Director, SDM craniofacial research centre Dharwad and Dr. Srinath Thakur, Principal, SDM College of Dental Sciences, Dharwad for the encouragement and facilities provided.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sector.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics Statement

Approval for this retrospective study was obtained from the Institutional Review Board and Ethical committee ( IRB. No. 2014/P/OS/25).

Informed Consent

Informed consent was obtained from all patients who were enrolled in this study.

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Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2018

Authors and Affiliations

  • Venkatesh Anehosur
    • 1
  • Mohit Bindal
    • 1
  • Niranjan Kumar
    • 2
  • Chaitra Shetty
    • 1
  1. 1.SDM Craniofacial Surgery and Research CentreSDM College of Dental Science and HospitalDharwadIndia
  2. 2.SDM College of Medical Science and HospitalDharwadIndia

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