Yonsei Med J.  2004 Aug;45(4):621-628. 10.3349/ymj.2004.45.4.621.

Surgical Outcome of Radical Maxillectomy in Advanced Maxillary Sinus Cancers

• Choi EC
• Choi YS
• Kim CH
• Kim K
• Kim KS
• Lee JG
• Kim GE
• Yoon JH

• KMID: 721412
• DOI: http://doi.org/10.3349/ymj.2004.45.4.621

Abstract

We investigated the surgical outcome of radical maxillectomy in advanced maxillary sinus cancers invading through the posterior wall and into the infratemporal fossa. Twenty-eight patients with maxillary sinus squamous cell carcinoma, who visited the Otorhinolaryngology Department at Severance Hospital from March, 1993 to February, 2001 and underwent the surgery, were analyzed retrospectively by reviewing clinical medical records and radiologic test results. The mean follow- up period was 78.8 months. (26 -162 months) Local recurrence, sites of local recurrence, and the 2-year disease-free survival rate were analyzed. Of the total 28 cases, 9 cases were T3, and 19cases were T4. Total maxillectomy was performed in 12 cases (42.9%) and radical maxillectomy in 16 cases (57.1%). Regardless of staging, radical maxillectomy was performed only when cancers invaded through the posterior wall and into the infratemporal fossa. When cancers only maginally or did not invade the posterior wall, total maxillectomy was performed. The 2-year disease-free survival rate was 75% for both total and radical maxillectomy, and the local recurrence rates were 8.3% and 18.7% respectively. All recurrence occurred at the posterior resection margin of the maxillectomy. We strongly recommend the use of radical maxillectomy in the cases of advanced maxillary sinus cancers invading the infratemporal fossa. Radical maxillectomy can provide sufficient safety margins and lower the local recurrence rate.

Keyword

Radical maxillectomy; total maxillectomy; infratemporal fossa

MeSH Terms

Adult
Aged
Carcinoma, Squamous Cell/mortality/pathology/*surgery
Disease-Free Survival
Female
Humans
Male
Maxilla/blood supply/*surgery
Maxillary Artery/surgery
Maxillary Neoplasms/mortality/pathology/*surgery
Maxillary Sinus/*surgery
Middle Aged
Neoplasm Recurrence, Local
Neoplasm Staging
Retrospective Studies
Survival Rate
Tomography, X-Ray Computed
Treatment Outcome