2017 Volume 63 Issue 12 Pages 635-644
Partial maxillectomy is a common procedure for maxillary squamous cell carcinoma. In order to perform a partial maxillectomy safely, accurate knowledge of the clinical anatomy and precise radiological imaging of the tumor is important. Anatomically, maxilla is divided between the front and back according to the development of the primary palate and secondary palate. Furthermore, understanding of the anatomical positioning of the pterygopalatine fossa, infratemporal fossa, masticator space and buccal space is also needed. Currently i mage modality types such as panoramic radiographs, contrast-enhanced computed tomography, contrast-enhanced magnetic resonance imaging, or positron emission tomography are used to detect the extent of tumor infiltration. According to such evaluations, the therapeutic strategy for maxillary squamous cell carcinoma is determined. In cases of surgery, deciding whether to make an intraoral or extraoral incision is required. We use the Weber-Furgeson incision for extraoral operations. When performing a partial maxillectomy, sectional resection in consideration of the anatomical barrier according to extent of the tumor should be applied. On the other hand, chemo-radiotherapy is recommended for non-surgical indications of maxillary squamous cell carcinoma. Common treatment strategies by the national comprehensive cancer network(NCCN) clinical practice guidelines should be followed. Regarding reconstruction after partial maxillectomy, there are various opinions. A maxillary prosthesis, either free flap or osteocutaneous flap, is selected to improve oral functions. In conclusion, treatment for maxillary squamous cell carcinoma varies from tongue and mandible squamous cell carcinoma. Success in surgery can be achieved by taking advantage of a logical and detailed analysis, skilled techniques in surgery and proper selection of better instruments.
