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Maxillectomy and its classification

R H Spiro1, E W Strong, J P Shah

  • 1Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA.

Head & Neck
|July 1, 1997
PubMed
Summary
This summary is machine-generated.

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A new classification system for maxillectomy procedures, categorizing them as limited (LM), subtotal (SM), or total (TM), is proposed. This system clarifies nomenclature and aids in describing surgical extent and approach for better reporting of maxillectomy outcomes.

Area of Science:

  • Head and Neck Surgery
  • Oncologic Surgery
  • Surgical Pathology

Background:

  • Maxillectomy nomenclature is varied and often confusing, with terms like radical, total, extended, subtotal, medial, partial, and limited in use.
  • This ambiguity complicates data analysis and comparison across different studies and institutions.

Purpose of the Study:

  • To propose and validate a simplified classification system for maxillectomy procedures.
  • To categorize 403 maxillectomies performed over a 10-year period into three distinct groups: limited (LM), subtotal (SM), and total (TM).

Main Methods:

  • A retrospective review of 403 maxillectomies conducted between 1984 and 1993.
  • Classification of procedures based on the extent of maxillary resection: LM (one wall of the antrum), SM (at least two walls including the palate), and TM (complete maxilla resection).

Related Experiment Videos

  • Analysis of tumor histology, site, and the incidence of complex reconstruction for each category.

    • Main Results:

    • Limited maxillectomy (LM) was performed in 57% of cases (230 patients), with various approaches based on tumor site and extent.
    • Subtotal maxillectomy (SM) and total maxillectomy (TM) were performed in 34% (135 patients) and 9% (38 patients), respectively.
    • Complex reconstruction was more frequent in TM cases (37%), and orbital exenteration occurred in 71% of TM patients.

    Conclusions:

    • The proposed classification of maxillectomy into LM, SM, and TM is clinically useful and feasible.
    • Accurate description requires specifying the resected portion of the maxilla for LM, the surgical access route, and any extension to adjacent structures for all maxillectomy types.