Name of the Procedure:

Excision of Malignant Tumor of Maxilla or Zygoma (also known as Maxillectomy or Zygoma Resection)

Summary

The excision of a malignant tumor of the maxilla or zygoma involves surgically removing cancerous tissue from the upper jawbone (maxilla) or cheekbone (zygoma). This procedure aims to eliminate cancer cells and prevent the spread of cancer to other parts of the body.

Purpose

This procedure addresses the presence of a malignant tumor in the maxilla or zygoma, which may be causing symptoms such as pain, swelling, or facial deformity. The primary goal is to completely remove the cancerous tissue, minimize the risk of recurrence, and alleviate any associated symptoms.

Indications

• Diagnosis of a malignant tumor in the maxilla or zygoma via imaging or biopsy
• Symptoms such as facial pain, swelling, or deformity
• Failure of other treatments such as radiation therapy or chemotherapy
• Patient eligibility based on overall health and ability to withstand surgery

Preparation

• Fasting for at least 8 hours prior to the procedure
• Adjusting or discontinuing certain medications as advised by the doctor
• Pre-operative imaging studies (e.g., CT scan, MRI) to determine the extent of the tumor
• Blood tests and other assessments to evaluate overall health

Procedure Description

1. Anesthesia: The patient is administered general anesthesia to ensure they are asleep and pain-free throughout the surgery.
2. Incision: An incision is made to access the tumor. The location and size of the incision depend on the tumor's size and position.
3. Resection: The surgeon carefully excises the tumor, along with some surrounding healthy tissue to ensure all cancer cells are removed.
4. Reconstruction: If necessary, reconstructive techniques, such as bone grafting or the use of prosthetic materials, are used to restore the structure and function of the affected area.
5. Closure: The incision is closed with sutures or staples, and a dressing is applied to protect the surgical site.

Duration

The procedure typically takes between 3 to 6 hours, depending on the complexity and extent of reconstruction required.

Setting

This surgery is usually performed in a hospital operating room.

Personnel

• Head and Neck Surgeon or Maxillofacial Surgeon
• Anesthesiologist
• Surgical Nurses
• Operating Room Technicians

Risks and Complications

• Infection
• Bleeding
• Nerve damage leading to numbness or weakness
• Facial asymmetry or deformity
• Difficulty chewing or speaking
• Recurrence of the tumor
• Complications related to anesthesia

Benefits

• Complete removal of the malignant tumor
• Prevention of cancer spread
• Relief from symptoms such as pain and swelling
• Improvement in facial structure and function with reconstructive surgery

Recovery

• Hospital stay of 3 to 7 days post-surgery
• Pain management with prescribed medications
• Instructions on wound care and dietary restrictions
• Follow-up appointments for monitoring healing and additional treatments if needed
• Full recovery may take several weeks to months, depending on the extent of surgery and reconstruction.

Alternatives

• Radiation therapy: Non-surgical option to shrink the tumor, often used in combination with surgery
• Chemotherapy: Systemic treatment that uses drugs to kill cancer cells, also often used in combination with surgery
• Palliative care: Focus on relieving symptoms and improving quality of life without curative intent

Patient Experience

Patients will be under general anesthesia during the procedure and will not feel any pain. Post-surgery, they may experience discomfort, swelling, and bruising in the facial area. Pain management strategies include medications and cold compresses. The medical team will provide detailed instructions for care at home and schedule follow-up visits to monitor recovery and address any concerns.