OBJECTIVE: To investigate the clinical efficacy of a modified paramedian lower lip-submandibular approach for maxillary (subtotal) total resection. METHODS: Eleven patients of maxillary tumors underwent maxillary (subtotal) total resection through the modified paramedian lower lip-submandibular approach. Clinical follow-up visits were conducted to evaluate appearance restoration, facial nerve functional status, parotid gland functional status, and orbital region complication. RESULTS: During the follow-up period of 6-36 months, the appearance of all 11 patients recovered well. All cases presented hidden scars. No facial nerve and parotid duct injury, lower eyelid edema, lower eyelid ectropion, or epiphora in all cases was observed. CONCLUSIONS Applying modified paramedian lower lip-submandibular approach to maxillary (subtotal) total resection effectively reduces incidence of orbital region complications including lower eyelid edema, lower eyelid ectropion, and epiphora, which often occur to traditional approach. The modified approach produces more subtle scars than other methods and should be applied to treatment of maxillary (subtotal) total resection.
Facial Nerve ; Humans ; Lip ; Maxilla ; Maxillary Neoplasms ; Surgical Flaps

OBJECTIVES: Endoscopic prelacrimal medial maxillectomy (EPMM) was previously reported to treat maxillary inverted papilloma. This study aimed to compare prelacrimal recess approach with the conventional Caldwell-Luc approach (CLA) to remove benign maxillary sinus tumors and to evaluate the usefulness of this approach based on our experience. METHODS: Ten patients who underwent EPMM at our hospital from January 2013 to December 2017 were reviewed. We also reviewed 30 patients who underwent benign maxillary sinus tumor resection via CLA during the same period. From medical records, postoperative pathological results, complications due to surgery, and recurrence rate were evaluated. RESULTS: There were eight inverted papilloma, one ameloblastoma, and one ossifying fibroma in the EPMM group. In the CLA group, all 30 cases were inverted papilloma. There were no cases of failure at gross total removal during surgery, and no recurrences were observed during follow-up in either groups. Mean follow-up period was 13.0 months in CLA group and 10.8 months in EPMM group. Regarding postoperative complications, 11 patients of the CLA group (37%) and three patients of the EPMM group (30%) had numbness around the cheek and upper lip area after surgery (P=0.715). In the CLA group, there were eight patients who had numbness lasting more than 3 months after surgery, and two patients had numbness for more than 1 year. However, facial numbness disappeared within 3 months in all patients in the EPMM group, in which epiphora was not observed. CONCLUSION: EPMM is the effective surgical approach for resecting benign maxillary sinus tumor compared with CLA. Although facial numbness was reported in EPMM, the duration of numbness was shorter than CLA.
Ameloblastoma ; Cheek ; Endoscopy ; Fibroma, Ossifying ; Follow-Up Studies ; Humans ; Hypesthesia ; Lacrimal Apparatus Diseases ; Lip ; Maxillary Sinus Neoplasms ; Maxillary Sinus ; Medical Records ; Papilloma, Inverted ; Postoperative Complications ; Recurrence

Prosthetic rehabilitation of an edentulous patient who has a maxillary defect is difficult to achieve for many clinicians. The maxillary defect causes leakage of air during pronunciation and compromises denture stability, support and retention by reducing denture-bearing area and breaking peripheral seal. In these patients, the sizes and shapes of defects are very important factors which attribute to prognosis of maxillary obturators. This case report shows the prosthetic rehabilitation of the patient who had maxillectomy on the right maxillary sinus because of squamous cell carcinoma. The patient had a stepwise treatment protocol which started with pre-operative dental examination and followed by surgical, interim and definitive obturation phase. In this case, an acceptable level of retention could be obtained due to well-defined static defects and the preserved premaxillae and the patient was satisfied with the result of the treatment in the aspect of function and esthetics.
Carcinoma, Squamous Cell ; Clinical Protocols ; Denture Retention ; Esthetics ; Humans ; Maxillary Sinus ; Mouth Neoplasms ; Prognosis ; Rehabilitation

Osseointegrated implants are now commonplace in contemporary dentistry. However, a number of complications can occur around dental implants, including peri-implantitis, maxillary sinusitis, osteomyelitis, and neoplasms. There have been several reports of a malignant neoplasm occurring adjacent to a dental implant. In this report, we describe 2 such cases. One case was that of a 75-year-old man with no previous history of malignant disease who developed a solitary plasmacytoma around a dental implant in the left posterior mandible, and the other was that of a 43-year-old man who was diagnosed with squamous cell carcinoma adjacent to a dental implant in the right posterior mandible. Our experiences with these 2 cases suggest the possibility of a relationship between implant treatment and an inflammatory cofactor that might increase the risk of development of a malignant neoplasm.
Adult ; Aged ; Carcinoma, Squamous Cell ; Dental Implants ; Dentistry ; Humans ; Mandible ; Maxillary Sinus ; Maxillary Sinusitis ; Mouth Neoplasms ; Osteomyelitis ; Peri-Implantitis ; Plasmacytoma

Retention cyst of the maxillary sinus is a benign lesion produced from obstruction of a seromucous gland or duct. It is mostly asymptomatic but sometimes is accompanied by facial pain, headache, nasal obstruction, and other symptoms. However, there are some debates on whether the symptoms are directly related with retention cyst. These cysts typically do not require treatment. However, when accompanied by symptoms, treatment can be administered for diagnostic and therapeutic purposes. We report a case in which facial pain is caused by a maxillary retention cyst suspended from an infraorbital nerve.
Facial Pain ; Headache ; Maxillary Sinus ; Nasal Obstruction ; Paranasal Sinus Neoplasms

Pentastomiasis, a zoonotic parasite infection, is typically found in the respiratory tract and viscera of the host, including humans. Here, we report for the first time an extremely rare case of intraosseous pentastomiasis in the human maxilla suffering from medication related osteonecrosis of the jaw (MRONJ). A 55-year-old male had continuously visited the hospital for MRONJ which had primarily developed after bisphosphonate and anti-neoplastic administration for previous bone metastasis of medullary thyroid cancer. Pain, bone exposure, and pus discharge in the right mandible and left maxilla were seen. Osteolysis with maxillary cortical bone perforation at the left buccal vestibule, palate, nasal cavity, and maxillary sinus was observed by radiologic images. A biopsy was done at the left maxilla and through pathological evaluation, a parasite with features of pentastome was revealed within the necrotic bone tissue. Further history taking and laboratory evaluation was done. The parasite was suspected to be infected through maxillary open wounds caused by MRONJ. Awareness of intraosseous pentastomiasis should be emphasized not to be missed behind the MRONJ. Proper evaluation and interpretation for past medical history may lead to correct differential diagnosis and therapeutic intervention for parasite infections.
Biopsy ; Bone and Bones ; Diagnosis, Differential ; Humans ; Jaw ; Male ; Mandible ; Maxilla* ; Maxillary Sinus ; Middle Aged ; Nasal Cavity ; Neoplasm Metastasis ; Osteolysis ; Osteonecrosis ; Palate ; Parasites ; Pentastomida ; Respiratory System ; Suppuration ; Thyroid Gland* ; Thyroid Neoplasms* ; Viscera ; Wounds and Injuries

Ablative surgery for oral cancer treatment results in tissue defect. Large tissue defect requires free flap reconstruction that requires long operation time. Maxillectomy involves the teeth and maxilla that separates the maxillary sinus and nasal cavity from oral cavity. Resection of the maxilla causes oro-antral or oro-nasal fistula, which results in difficulty while chewing and swallowing. Regurgitation of the ingested food into the maxillary sinus or nasal cavity makes it difficult for a patient to digest. Obliteration of the fistula is the most important part of dental prosthesis in patients who underwent maxillectomy. Local flap is indicated when the fistula is less than 10mm, however, larger sized defects are closed with free flap or obturator. The decision of treatments should be based on patient's general condition, risk of recurrence, size of the defect and financial aspect.
Aphasia ; Deglutition ; Dental Prosthesis ; Fistula ; Free Tissue Flaps ; Humans ; Mastication ; Maxilla ; Maxillary Sinus ; Mouth ; Mouth Neoplasms* ; Nasal Cavity ; Recurrence ; Tooth

A 59-year-old man was admitted to the Department of Ear, Nose and Throat with a complaint of six-month history of left facial numbness and toothache. There was no special previous medical history in addition to smoking. No obvious abnormality in routine electrocardiogram, chest X-ray, abdominal B ultrasound were found. (1) CT scans showed heterogeneous shadows in maxillary sinus with the lesions on the left max- illary bone and evidently destruction of alveolar bone. The histopathological examination revealed bone tissue which was partly covered by an intact adenocarcinoma cell. (2) Immunohistochemical staining foe CK7, CD117, thyroid transcription factor-1, and novel aspartic proteinase A were positive and thus compatible with metastatic lung adenocarcinoma. (3) Chest CT scans showed a 1 cm x 2 cm mass on the superior lobe of the left lung, with destruction of sternum and rib, confirming that the lesions in the paranasal sinuses were lung cancer metastases. Therefore, this patient conclusively diagnosed as lung adenocarcinoma with multiple bone metastases.
Adenocarcinoma ; diagnosis ; pathology ; Adenocarcinoma of Lung ; Bone Neoplasms ; secondary ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Male ; Maxillary Sinus ; pathology ; Middle Aged ; Nose Neoplasms ; secondary

A 70 years old male patient complained a sense of swelling on right facial, mild pain, and the obstruction of right nasal, no complain of facial numbness and toothache. Physical examination showed the slight bulging on right facial with mild tenderness, purulent nasal secretions on the right middle nasal meatus, and no significant neoplasm. CT scan showed that soft density tissue in the right maxillary sinus,and the high density tissue in some period. Postoperative diagnosis: carcinoma of maxillary sinus with fungal sinusitis.
Aged ; Carcinoma ; complications ; diagnosis ; Humans ; Male ; Maxillary Sinus ; microbiology ; pathology ; Mycoses ; complications ; Nose Neoplasms ; complications ; diagnosis ; Sinusitis ; microbiology

OBJECTIVE: A retrospective analysis of the clinical efficacy on the surgery of maxillary sinus diseases via the endoscopic lateral nasal wall incision, and a discussion on the clinical application of this approach. METHOD: Eighteen cases of the maxillary sinus diseases diagnosed on the basis of the preoperative nasal endoscopy, CT scan or MRI, and pathologic finding. Among 13 patients underwent routine lateral nasal wall incision approach, including 4 of maxillary sinus hemorrhagic and necrotic polyps, 4 of maxillary sinus cyst, and 3 of the maxillary sinus fungal infection. Five patients underwent lateral nasal wall resection approach and thorough maxillary sinus lesions resection by nasal endoscope, including 3 of inverted maxillary sinus papilloma, a nasal sinus bone giant cell tumor and a spindle cell tumor. Patients were followed up for more than half a year, and the postoperative efficacy were observed. RESULT: The surgical cavity of the lateral nasal wall incision approach have luminal epithelium, well shapes of inferior turbinate, no recurrence of the lesion, and the lateral nasal wall resection patients with well luminal epithelium, without recurrence. All patients had no complications such as numbness, tears, etc. CONCLUSION Endoscopic incision of lateral nasal wall keep the nasolacrimal duct and inferior turbinate, help remove the entire sinus cavity lesion and retain the physiological function of the nasal cavity. Resection of the lateral nasal wall can reveal an ideal vision approach, which perform certain clinical value for the treatment of the inverted maxillary sinus papilloma and sinus cancer.
Cysts ; surgery ; Dissection ; methods ; Endoscopy ; Humans ; Magnetic Resonance Imaging ; Maxillary Sinus ; surgery ; Maxillary Sinus Neoplasms ; surgery ; Maxillary Sinusitis ; microbiology ; surgery ; Nasal Cavity ; surgery ; Papilloma, Inverted ; surgery ; Retrospective Studies ; Tomography, X-Ray Computed