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Lateral Molar Approach-Driven Transoral Endoscopic Procedure for Benign Infratemporal Fossa Tumor Resection
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Transmandibular approach to total maxillectomy.

R M Tiwari1

  • 1Bangalore Institute of Oncology, No. 44-45/2, II Cross, Raja Rammohan Roy Extension, 560 027 Bangalore.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|November 3, 2012
PubMed
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The transmandibular approach to total maxillectomy offers improved oncological outcomes for advanced maxillary cancer by resecting tumors en bloc with the pterygopalatine fossa. This method addresses limitations of the transfacial approach, potentially reducing recurrence rates.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Head and Neck Cancer

Background:

  • Transfacial total maxillectomy has been used for over a decade to treat maxillary cancer.
  • Its effectiveness for advanced T(3)-T(4) tumors with posterior extension is limited, often preventing radical oncological resection.
  • High recurrence rates in the infratemporal fossa and stagnant survival rates with radiotherapy highlight the need for improved surgical techniques.

Purpose of the Study:

  • To present early experience with the transmandibular approach for total maxillectomy.
  • To evaluate the potential of this approach in achieving oncologically radical resections for advanced maxillary tumors.
  • To address the shortcomings of the transfacial approach in managing extensive maxillary cancers.

Main Methods:

Keywords:
CarcinomaTotal MaxillectomyTransmandibular

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  • The study involves the transmandibular approach for total maxillectomy.
  • This technique facilitates en bloc resection of the maxilla along with the pterygopalatine fossa.
  • Early clinical experience with this surgical method is detailed.

    • Main Results:

    • The transmandibular approach allows for the inclusion of the pterygopalatine fossa in the resection specimen.
    • This facilitates a more comprehensive removal of tumors with posterior extension.
    • Early data suggests this approach may overcome limitations of the transfacial route.

    Conclusions:

    • The transmandibular approach to total maxillectomy is a promising technique for advanced maxillary cancer.
    • It enables en bloc resection of the maxilla and pterygopalatine fossa, improving oncological control.
    • Further studies are warranted to confirm survival benefits and recurrence reduction.