Maxillectomy

What is a maxillectomy?

Maxillectomy is a procedure to remove all or part of your upper jawbone (maxilla). You may also receive reconstructive surgery to repair the area.

Why might I need a maxillectomy?

This condition treats cancers that start in or spread to your:

• Maxilla.
• Nose (nasopharyngeal cancer).
• Roof of your mouth (oral cancer).
• Sinuses (sinonasal tumors).

People who have invasive fungal sinusitis may also need a maxillectomy. You can develop this serious condition after inhaling certain types of fungus. It causes inflammation and loss of tissue in your sinus lining.

Is the maxilla the only structure that’s removed?

If the cancer has spread to nearby tissue, removing all or part of those structures may be necessary. This may involve your:

• Eye.
• Front area of your hard palate (roof of your mouth).
• Nerve that provides sensation to the skin under your eye.
• Orbit, bone around your eye (eye socket).
• Orbital floor, bone below your eye.
• Teeth attached to the section of maxilla removed.
• Tear duct.

What are the types of maxillectomy?

The type of maxillectomy you have depends on the tumor size and location. Surgical approaches include:

• Medial maxillectomy removes part of your maxilla nearest to your nose and adjoining teeth. This procedure is typically for tumors inside of your nose and doesn’t require reconstruction. Your surgeon accesses the tumor through an incision on the side of your nose. Another approach involves passing a long, thin tube (endoscope) through your nostril.
• Infrastructure maxillectomy removes the lower part of your maxilla, teeth and hard palate. An infrastructure maxillectomy leaves a hole in the roof of your mouth. Surgeons may take a flap of tissue from another area of your body to close it. Or you may require a special prosthetic to seal the hole.
• Suprastructure maxillectomy removes the upper part of your maxilla. It may also involve adjoining teeth, orbital floor, orbit, eye, tear duct and nearby nerve. Reconstruction is necessary to repair the missing structures. A human-made (prosthetic) eye can preserve a natural appearance, but it won’t restore vision.
• Subtotal (partial) maxillectomy removes part of your maxilla using one of the procedures above.
• Total maxillectomy removes your entire maxilla on one side of your face, along with your hard palate and orbital floor. It requires major reconstructive surgery and prosthetic devices.

What additional procedures might I need?

Additional procedures you may need with a maxillectomy include:

• Feeding tube placement to help you get nutrition.
• Dacryocystorhinostomy to route tears away from your eyes if the maxillectomy involved your tear ducts.
• Neck dissection to remove nearby lymph nodes if there’s a concern the cancer has spread.
• Tracheostomy if there’s a concern that swelling could affect your airway.
• Reconstructive surgery to restore facial features.

What are the benefits of a maxillectomy?

The procedure removes cancerous tissue, giving you a better chance for survival.

What are the risks of a maxillectomy?

Maxillectomy has many risks, including:

• Bleeding and bruising (hematoma).
• Blood clots.
• Droopy lower eyelid.
• Eustachian tube dysfunction.
• Infection.
• Numbness in your cheek from nerve damage.
• Watery eyes (epiphora).

What can I expect when recovering from a maxillectomy?

Your recovery depends on the type of maxillectomy. Initial recovery may include:

• Hospital stay of up to two weeks, especially if you have an extensive reconstruction.
• Medications for pain and to prevent blood clots and infection.
• Supplemental oxygen through the tracheostomy.
• Supplemental nutrition through a feeding tube.

What’s important to know about recovery after leaving the hospital?

After leaving the hospital you:

• Should avoid strenuous activity until you’re feeling better.
• Eat a diet of soft foods while the incision heals.
• Avoid hot food and beverages because parts of your mouth may remain numb while healing.

How long does it take to recover from a maxillectomy?

Recovery from a maxillectomy takes time. It could be months before you regain your ability to speak and swallow.

The length of your recovery depends in part on the type of maxillectomy:

• Medial maxillectomy is the least invasive type and may offer the quickest recovery.
• Infrastructure maxillectomy is more complex and may involve additional structures. These factors lead to a longer recovery time.
• Suprastructure and total maxillectomy are the most invasive and typically require the longest hospitalization. Your recovery at home will also be longer with these surgical approaches.

What is the outlook for people who have undergone a maxillectomy?

Many people successfully recover from a maxillectomy. Incisions often heal without complications.

But removing part of your jaw and nearby structures can bring unexpected changes. Once-simple tasks such as eating, speaking and swallowing can become challenging. Speech therapy can help you make the most of your abilities.

Your outlook depends on the type of head and neck cancer and its severity. Some of these conditions carry a poor prognosis, especially if they’re diagnosed in later stages.

When should I call my healthcare provider while recovering from a maxillectomy?

Contact your healthcare provider if you experience symptoms of potential complications, including:

• Abnormal swelling.
• Difficulty breathing.
• Fever, which could be a sign of infection.
• Pain that doesn’t respond to medications.

What other services might I need after a maxillectomy?

After surgery, follow-up care is necessary to ensure your recovery stays on track. You may need additional services from:

• Dietitians who help you get the nutrients you need even when it’s difficult to eat.
• Medical or radiation oncologists who coordinate other cancer treatments, including chemotherapy and radiation therapy.
• Prosthodontists and other dental specialists who restore your teeth and ability to chew food with special dentures.
• Speech therapists who help you relearn how to speak, swallow and eat.

A note from Cleveland Clinic

Maxillectomy is a surgical procedure to remove all or part of your upper jaw. Sometimes, it’s also necessary to remove nearby structures, such as the roof of your mouth, teeth, eye or bones that support your eye. This procedure can change your ability to speak, swallow, eat and see. It also gives many people better chances of surviving certain types of head and neck cancers.