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MAXILLECTOMY
ULVAN OZAD
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MAXILLA
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SURGICAL PROCEDURE PERFORMED
PARTIAL ANTERIOR MAXILLECTOMY FOLLOWED BY
FITTING OF AN OBTURATOR
REMOVAL OF ANTERIOR PART OF HARD PALATE
FROM MIDLINE(6TH TEETH)
REPLACEMENT FOR DAMAGED AND REMOVED
MAXILLA
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DIAGNOSIS
MEDICAL HISTORY SIGNS AND SYMPTOMS EXAMINATION OF MOUTH X-RAY CT SCAN / MRI SCAN BIOPSY
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SURGERY PROCEDURE
PRE-ASSESSMENT
UNDER GENERAL ANAESTHESIA
CANCEROUS TISSUE REMOVED
OBTURATOR PLACED
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MAXILLECTOMY
PARTIAL MAXILLECTOMY
(HEMI-MAXILLECTOMY)
FULL MAXILLECTOM
Y
MAXILLECTOMY IS THE REMOVAL OF DAMAGED PARTS IN MAXILLA DUE TO CANCEROUS TISSUE BEING PRESENT AND
DAMAGING THE HARD PALATE
SIZESPREAD
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EXTENDED MAXILLECTOMY
(RADICAL MAXILLECTOMY)
SIZESPREAD
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PARTIAL MAXILLECTOMY
PART OF MAXILLA REMOVED LEAVING ONE OR MORE BONY WALLS IN PLACE
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TOTAL MAXILLECTOMY
REMOVAL OF THE WHOLE MAXILLA
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EXTENDED MAXILLECTOMY
REMOVAL OF SURROUNDING TISSUE TOGETHER WITH MAXILLA AS A RESULT OF
CANCER
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ANATOMY OF MAXILLECTOMY
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OBTURATOR WHEN MAXILLA IS REMOVED, THERE WILL BE AN OPENING
BETWEEN MOUTH AND NOSE OBTURATOR SEALS THE OPENING BETWEEN MOUTH AND
NOSE FIRST, A TEMPORARY OBTURATOR IS PLACED IN SURGERY AND
WILL STAY FOR A FEW WEEKS PLACING PERMANENT OBTURATOR MAY NEED ANAESTHESIA ADVANTAGES: - PREVENT FLUID AND FOOD GOING INTO NOSE
- IMPROVE SPEECH AFTER OPERATION
- BETTER COSMETIC IMAGE
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OTHER OPTIONS
REBUILD WITH TISSUE FROM ANOTHER PART OF BODY (GRAFT)
CONSIDERATION FACTORS: AGE, GENERAL HEALTH, TYPE OF TUMOUR
ADVANTAGES: AVOID OBTURATOR AND PREVENT HOLES IN MOUTH
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INCISION- WILL IT LEAVE A SCAR?
-CUT INTO THE SKIN ALONG THE SIDE OF NOSE, FROM EYEBROW OR EYELIDS DOWN TO THE UPPER LIP
-MAKE A CUT INSIDE THE MOUTH UNDER UPPER LIP (ADVANTAGE: NO BIG SCAR)
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RISKS OF SURGERY
BLEEDING INFECTION POSSIBLE NERVE DAMAGE FAILURE OF GRAFT
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FUTURE PROBLEMS
SPEECH SWALLOWING PAIN INFECTION EATING/DRINKING CHEEK NUMBNESS LIP WEAKNESS EPIPHORA DOUBLE VISION
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POST-OPERATION
HOSPITAL STAY UPTO 2 WEEKS
DIETICIAN APPOINTMENT AND ADVICE MAY BE NEEDED
SPEECH AND LANGUAGE THERAPY MAY BE NEEDED
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THANK YOU
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REFERENCES
(1): The Palatal Obturator, Dentist Portal, The Glossary of Prosthodontics Terms (2005), Volume 94, Issue 1, Pages 10-92 (July 2005), Last accessed: 09 February 2011, http://dentista.pinoydental.com/content/view/101/67/
(2):Maxilla, Mosby's Medical Dictionary, 8th edition, 2009, Elsevier, Last accessed: 09 February 2011, http://medical-dictionary.thefreedictionary.com/maxilla
(3): Figure 1, Colombo et al., BMC Cancer, 2005, Last accessed: 09 February 2011, http://www.biomedcentral.com/1471-2407/5/117/figure/F1?highres=y
(4): Dental and oral complications, Oral cancer foundation, Last accessed: 09 February 2011, http://www.oralcancerfoundation.org/dental/dental-complications.htm
(5): South Devon Healthcare, Patient Information, Last accessed: 09 February 2011, http://www.sdhct.nhs.uk/patientcare/pil/23681.pdf?last_updated=13%252F11%252F2008
(6): Maxillofacial Prosthodontics, Last accessed: 09 February 2011, http://xiad.bravehost.com/Z/prosth.htm (7): Pictures of Total Maxillectomy and Obturator, vBulletin, Last accessed: 09 February 2011,
http://www.all4dentist.com/showthread.php?555-Pictures-of-Total-Maxillectomy-and-Obturator, previously citated from: http://www.ghorayeb.com/
(8): Squamous Cell Carcinoma - Maxillary Sinus, Head & Neck, Last accessed: 09 February 2011, http://www.webpathology.com/image.asp?case=146&n=8
(9): Operations for nasal and sinus cancer, Cancer help UK, Last accessed: 09 February 2011, http://www.cancerhelp.org.uk/type/nasal-cancer/treatment/surgery/operations-for-nasal-and-sinus-cancer#maxillary
(10): Anterior Subfrontal Approach - Tumor Removal: Treatment, Carrau et al, eMedicine, Last accessed: 09 February 2011, http://emedicine.medscape.com/article/844449-treatment
(11): Information for people undergoing an operation to remove part of the upper jaw Queen victoria hospital, Last accessed: 09 February 2011, http://qvh.nhs.uk/assets/Maxillectomy
(12): Maxillectomy, Last accessed: 09 February 2011, http://www.latrobe.edu.au/hcs/resources/head-neck-surgery/docs/maxillectomy.pdf
(13): Maxillectomy, Mount vernon cancer network, Last accessed: 09 February 2011, http://www.ljmc.org/patient_information/PI63_Maxillectomy.pdf
(14): Essentials of Head and neck Oncology. Close et al, Page 132, 1998, Thieme (15): Maxillectomy, The head+neck centre, Last accessed: 09 February 2011,
http://www.rochesterhnc.com/Procedures/JC-Maxillectomy.pdf (16): Oral Surgeon Cartoons and Comics. CSL Cartoonstock, Last accessed: 09 February 2011,
http://www.cartoonstock.com/directory/o/oral_surgeon.asp