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Lateral lip-splitting approach for total and subtotal maxillectomy.
Jian Sun1, Yi Shen, Yan-Qiu Weng
1Department of Oral and Maxillofacial Surgery, the Ninth Affiliated Hospital, Shanghai Jiao Tong University, Shanghai, China. jianjian60@yahoo.com
Summary
The lateral lip-splitting approach for maxillectomy offers wide exposure and good functional outcomes, with patients reporting satisfactory results and preservation of facial nerve function. This technique is a viable option for complex oral surgeries.
Area of Science:
- Oral and Maxillofacial Surgery
- Surgical Oncology
- Reconstructive Surgery
Background:
- Maxillectomy is a complex procedure for tumors of the maxilla, palate, and gingiva.
- Surgical approach and reconstruction significantly impact functional and aesthetic outcomes.
- Preservation of facial nerve function is crucial for patient quality of life.
Purpose of the Study:
- To evaluate the postoperative outcomes of maxillectomy using the lateral lip-splitting approach.
- To assess functional results, patient satisfaction, and oncological control.
- To determine the efficacy and safety of this surgical technique.
Main Methods:
- Retrospective review of 36 patients undergoing total or subtotal maxillectomy via lateral lip-splitting.
- Dissection and preservation of the marginal mandibular branch of the facial nerve.
- Reconstruction with free vascularized flaps in 17 patients; postoperative radiotherapy in 26 patients.
- Postoperative assessment included patient self-assessment (questionnaire) and examiner's evaluation of facial nerve function.
Main Results:
- Complete tumor removal with adequate margins was achieved in most cases.
- Average mouth opening was 3.81 cm, with most patients reporting good or fair functional and aesthetic outcomes.
- High scores were reported in examiner's evaluation of facial nerve function.
- Five-year survival and local control rates for malignant tumors were 76.7% and 85.8%, respectively.
Conclusions:
- The lateral lip-splitting approach provides wide surgical exposure for maxillectomy.
- This technique leads to satisfactory functional results and inconspicuous scarring.
- Preservation of facial nerve function is a key advantage, making it an acceptable optional approach.
