Anesthesia for maxillary, salivary gland, mandibular and temporomandibular joint surgery

The maxilla Introduction Surgery of the maxilla straddles the expertise of otorhinolaryngology and oromaxillofacial surgeons. This section of the chapter will focus on non-traumatic maxillary procedures and endoscopic maxillary sinus surgery. The maxilla is composed of two fused bones along the palatal fissure that form the upper jaw. The body of the maxilla is a component of three cavities - the roof of the mouth, the wall of the orbit and the floor and lateral wall of the nasal antrum. The maxillary sinus is housed in the body of the maxilla and is the largest of the paranasal sinuses [1]. Surgical procedure Maxillectomy surgery may encompass many variations - total maxillectomy with and without orbital exenteration, partial (subtotal) maxillectomy and limited maxillectomy. Limited maxillectomy is defined as surgery that removes one wall of the antrum. An example of a limited maxillectomy is a medial maxillectomy. Subtotal maxillectomy is defined as removal of two walls of the antrum. Total maxillectomy is defined as removal of the total maxilla [2]. Indications for maxillectomy include tumors of the palate, nasal cavity and sinus pathology, salivary gland pathology, fungal infection (mucormycosis), papilloma, angiofibroma and granulomatous disease. A maxillectomy may also be performed for skull base pathology [3]. Benefits of endoscopic maxillectomy include access to ethmoid and sphenoid sinuses, no external scarring, and no loss of bony nasal or anterior maxillary support structures [4].