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Review
. 2019 Sep;18(3):360-365.
doi: 10.1007/s12663-018-1164-6. Epub 2018 Oct 9.

Mandibulotomy Approach for Resection of Maxillary Tumours: A Clinical Review

Venkatesh Anehosur  1 , Mohit Bindal  1 , Niranjan Kumar  2 , Chaitra Shetty  1
Affiliations
Review

Mandibulotomy Approach for Resection of Maxillary Tumours: A Clinical Review

Venkatesh Anehosur et al. J Maxillofac Oral Surg. 2019 Sep.

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.

Keywords: Infratemporal fossa; Mandible swing; Mandibulotomy; Maxillary tumours; Supraomohyoid neck dissection.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Lip split and submandibular incision marking
Fig. 2
Fig. 2
Mandible osteotomy site marking with preservation mental nerve
Fig. 3
Fig. 3
Mandible swung and resection of primary tumour
Fig. 4
Fig. 4
Fixation of mandibulotomy site with miniplates
See this image and copyright information in PMC

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