The value of transmandibular approach to total maxillectomy in the management of T3-T4 carcinoma of the maxillary sinus.

Surgical excision of the maxilla either as a primary procedure or after radiotherapy continues to play an important role in the management of carcinoma of the maxillary sinus. A majority of these cancers are seen in T3-T4 stage. Recurrence at the infratemporal fossa has been recognized as a major cause of failure. Although the importance of inclusion of the pterygopalatine fossa in the field of excision has been recognized, there is no uniform approach for en bloc removal of the pterygopalatine fossa. Transmandibular approach has been described for purpose and practiced at the Bangalore Institute of Oncology for the past 8 years with success. This paper presents the technique used, its benefits and the results obtained.