Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and partial maxillectomy (eg, locally aggressive or destructive lesion[s])
CPT4 code
Name of the Procedure:
Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and partial maxillectomy
Summary
In layman's terms, this procedure involves surgically removing a non-cancerous tumor or cyst located in the upper jaw (maxilla). The surgery requires creating an incision outside the mouth to access the jawbone and removing part of the upper jawbone to ensure all of the abnormal tissue is excised.
Purpose
This procedure addresses benign but locally aggressive or destructive tumors or cysts in the maxilla. The goal is to completely remove the abnormal growth to prevent further damage to the surrounding structures and to restore normal function.
Indications
- Presence of a benign but aggressive or destructive tumor or cyst in the maxilla.
- Symptoms such as pain, swelling, facial asymmetry, or difficulty with oral functions (e.g., chewing, speaking).
- Diagnostic imaging (X-rays, CT scans) indicating the need for surgical intervention.
Preparation
- Pre-procedure instructions may include fasting for a specific period before surgery.
- Medication adjustments, especially if the patient is taking blood thinners.
- Preoperative diagnostic tests such as blood work, imaging studies, and possibly a biopsy to understand the nature of the lesion.
Procedure Description
- The patient is placed under general anesthesia.
- An extra-oral incision is made to access the maxilla.
- Osteotomy (surgical cutting of bone) is performed to remove part of the upper jawbone.
- The benign tumor or cyst is excised completely.
- The surgical site is cleaned and closed with sutures.
- Reconstruction may be performed if necessary to restore the normal structure.
Tools and equipment include surgical saws, chisels, and other osteotomy instruments. Anesthesia ensures the patient remains unconscious and pain-free during the procedure.
Duration
The procedure typically takes 2 to 4 hours, depending on the complexity.
Setting
The procedure is performed in a hospital's operating room or surgical center.
Personnel
- Oral and maxillofacial surgeon.
- Surgical nurses.
- Anesthesiologist.
- Support staff.
Risks and Complications
- Common risks: bleeding, infection, swelling, and pain.
- Rare risks: nerve damage leading to numbness or loss of function, damage to adjacent teeth or structures, and complications from anesthesia.
- Management involves standard postoperative care, antibiotics if infection occurs, and follow-up visits.
Benefits
- Complete removal of the benign tumor or cyst.
- Alleviation of symptoms such as pain and swelling.
- Prevention of further damage to the jaw and surrounding structures.
Recovery
- Post-procedure care includes pain management with prescribed medications, instructions on oral hygiene, and avoiding hard foods.
- Expected recovery time is usually a few weeks to a few months, depending on the extent of surgery.
- Follow-up appointments are essential to monitor healing and any signs of recurrence.
Alternatives
- Watchful waiting with regular monitoring, if the lesion is not currently causing significant symptoms.
- Less invasive surgical options if applicable.
- Non-surgical therapies such as medication, although these are typically less effective for aggressive lesions.
Patient Experience
- During the procedure, the patient will be under general anesthesia and will not feel or be aware of the surgery.
- Post-procedure, the patient may experience some pain, swelling, and discomfort, which can be managed with medication and proper care.
- It is crucial to follow all postoperative instructions to ensure a smooth recovery and reduce the risk of complications.