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Endoscopic-assisted total maxillectomy with precise surgical margins.

Masato Nagaoka1, Kazuhiro Omura1, Kazuhiro Nomura2

  • 1Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan.

Head & Neck
|November 7, 2022
PubMed
Summary

Endoscopic assistance improves the precision of total maxillectomy by allowing for better visualization of the posterior margin. This technique offers a precise surgical option without increasing operation time or blood loss.

Keywords:
accuracyendoscopemarginmaxillary cancerreconstruction

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Surgical Oncology
  • Endoscopic Surgery

Background:

  • Traditional open maxillectomy presents challenges in identifying the posterior margin due to deep anatomical location and pterygoid venous plexus bleeding.
  • Accurate identification of surgical margins is crucial for successful oncological resection in maxillectomy procedures.

Approach:

  • A novel endoscope-assisted total en bloc maxillectomy technique was developed and compared to conventional open maxillectomy.
  • Surgical outcomes were evaluated based on the precision of the remaining pterygoid process, operative time, and blood loss.

Key Points:

  • Endoscopic assistance resulted in a significantly shorter remnant pterygoid process, indicating enhanced precision in margin identification.
  • Operative time and blood loss were comparable between the endoscopic-assisted and conventional groups.
  • The pterygoid venous plexus bleeding, a common challenge, is better managed with endoscopic visualization.

Conclusions:

  • Endoscope-assisted total en bloc maxillectomy offers improved precision for identifying surgical margins.
  • This technique is a viable and reasonable alternative to conventional open maxillectomy without compromising operative efficiency.