Benefits of maxillectomy with internal dissection of the masticator space by transmandibular approach in the surgical management of malignant tumours of the upper gingiva and hard palate: a clinical review of 10 cases

Int J Oral Maxillofac Surg. 2014 Nov;43(11):1319-25. doi: 10.1016/j.ijom.2014.06.006. Epub 2014 Jun 30.

Abstract

The aim of this study was to review patients with tumours extending to the posterior portion of the upper gingiva and hard palate, and to evaluate the postoperative outcomes. Ten consecutive patients with tumours in the upper gingiva and hard palate, who underwent maxillectomy with internal dissection of the masticator space by the transmandibular approach, were reviewed retrospectively. Among the 10 patients, the pathological diagnosis was squamous cell carcinoma in seven, adenoid cystic carcinoma in one, malignant melanoma in one, and osteosarcoma in one. Loco-regional control was achieved in eight of nine patients (88.9%). Three patients had residual moderate trismus. Cosmetic issues were not noted in any patient. En bloc resection of the maxilla with the internal portion of the masticator space and neck through the parapharyngeal space by the transmandibular approach is a useful and satisfactory technique for the excision of a tumour with involvement of the posterior portion of the upper gingiva and hard palate.

Keywords: masticator space; maxillectomy; oral malignant tumour; transmandibular approach.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gingival Neoplasms / pathology
  • Gingival Neoplasms / surgery*
  • Humans
  • Lymphatic Metastasis
  • Male
  • Maxillary Neoplasms / pathology
  • Maxillary Neoplasms / surgery*
  • Middle Aged
  • Neck Dissection
  • Neoplasm Staging
  • Palate, Hard / pathology
  • Palate, Hard / surgery*
  • Postoperative Complications
  • Retrospective Studies
  • Surgical Flaps
  • Survival Rate