Preoperative Planning and Reconstruction in Maxillectomy

Clinical Considerations

Preoperative imaging is essential for determining the extent of resection and reconstruction planning, according to the American Academy of Periodontology, with sinus septa present in approximately 30% of patients, which may complicate the surgical approach 1
Otorhinolaryngology consultation is recommended when medical history is positive for sinusitis symptoms, as suggested by the American Academy of Periodontology, with Schneiderian membrane perforation being the most common intraoperative complication during sinus procedures, occurring in approximately 19.5% of cases 2

Full thickness maxillectomy defects extending into the sinus (ClinRad stage III) can be reconstructed with myocutaneous flaps or osteomyocutaneous flaps, with the latter allowing for dental implantation, as recommended by the American Society of Clinical Oncology 3
Obturation with prosthetic appliance may be considered for patients who are poor candidates for microvascular surgery, according to the American Society of Clinical Oncology 3