Maxillectomy

A maxillectomy is an operation that involves removal of all or part of the maxillary bone. The maxilla forms the main structural framework for the midface and articulates with eight bones and forms part of several key structures including the oral cavity, nasal cavity, orbital cavity and the maxillary sinuses. Pathology arising in any of these structures can involve the maxilla. In this chapter, we discuss the indications, classification and techniques for performing a maxillectomy. Various access procedures are described for access to the maxilla depending on the location of the pathology and type of maxillectomy to be performed. These include transoral approach, lateral rhinotomy, transnasal, transfacial (Weber-Fergusson) and midface degloving. Mandibulotomy and transtemporal approaches are also briefly described. The head and neck surgeon should be able to perform each of these techniques where necessary knowing the limitations, advantages and disadvantages of each.