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Mandibulotomy Approach for Resection of Maxillary Tumours: A Clinical Review.
J Maxillofac Oral Surg 2019; 18(3):360-365JM

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.

Authors+Show Affiliations

1SDM Craniofacial Surgery and Research Centre, SDM College of Dental Science and Hospital, Dharwad, Karnataka India.1SDM Craniofacial Surgery and Research Centre, SDM College of Dental Science and Hospital, Dharwad, Karnataka India.2SDM College of Medical Science and Hospital, Dharwad, Karnataka India.1SDM Craniofacial Surgery and Research Centre, SDM College of Dental Science and Hospital, Dharwad, Karnataka India.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31371874

Citation

Anehosur, Venkatesh, et al. "Mandibulotomy Approach for Resection of Maxillary Tumours: a Clinical Review." Journal of Maxillofacial and Oral Surgery, vol. 18, no. 3, 2019, pp. 360-365.
Anehosur V, Bindal M, Kumar N, et al. Mandibulotomy Approach for Resection of Maxillary Tumours: A Clinical Review. J Maxillofac Oral Surg. 2019;18(3):360-365.
Anehosur, V., Bindal, M., Kumar, N., & Shetty, C. (2019). Mandibulotomy Approach for Resection of Maxillary Tumours: A Clinical Review. Journal of Maxillofacial and Oral Surgery, 18(3), pp. 360-365. doi:10.1007/s12663-018-1164-6.
Anehosur V, et al. Mandibulotomy Approach for Resection of Maxillary Tumours: a Clinical Review. J Maxillofac Oral Surg. 2019;18(3):360-365. PubMed PMID: 31371874.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mandibulotomy Approach for Resection of Maxillary Tumours: A Clinical Review. AU - Anehosur,Venkatesh, AU - Bindal,Mohit, AU - Kumar,Niranjan, AU - Shetty,Chaitra, Y1 - 2018/10/09/ PY - 2018/05/25/received PY - 2018/10/03/accepted PY - 2020/09/01/pmc-release PY - 2019/8/3/entrez PY - 2019/8/3/pubmed PY - 2019/8/3/medline KW - Infratemporal fossa KW - Mandible swing KW - Mandibulotomy KW - Maxillary tumours KW - Supraomohyoid neck dissection SP - 360 EP - 365 JF - Journal of maxillofacial and oral surgery JO - J Maxillofac Oral Surg VL - 18 IS - 3 N2 - 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. SN - 0972-8279 UR - https://www.unboundmedicine.com/medline/citation/31371874/Mandibulotomy_Approach_for_Resection_of_Maxillary_Tumours:_A_Clinical_Review DB - PRIME DP - Unbound Medicine ER -
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