Maxillotomy

Maxillotomy is a maxillofacial surgical procedure involving a controlled division of the maxilla (upper jaw) to gain access to the maxillary region or to mobilize the maxilla for reconstruction. It is typically more limited in extent than a full maxillary osteotomy and is distinct from en bloc resections in that more surrounding anatomy may be preserved.

The procedure involves a planned osteotomy through the maxillary bone along specific lines, allowing removal of a segment or creation of an access window. Techniques vary by indication and can be performed on one or both sides, with attention to dental occlusion and the preservation of sensory nerves and surrounding structures. The operation is usually followed by stabilization and, when needed, reconstruction with grafts, implants, or dental rehab.

Indications include access for tumor or cyst resection in the maxilla or maxillary sinus, management of benign lesions, severe maxillary trauma requiring segmental mobilization, and reconstructive procedures after disease or injury. In some cases, maxillotomy serves as an alternative to more extensive resections or as a preliminary step before definitive reconstruction.

Risks and outcomes depend on planning and technique but commonly include bleeding, infection, nonunion or malunion of the osteotomized segments, sensory changes (for example in the infraorbital nerve distribution), occlusal disturbances, and cosmetic or functional impairment. Accurate imaging, meticulous surgical technique, and appropriate fixation are important for favorable results.

Historically, the term maxillotomy appears in older surgical literature; in contemporary practice, similar bone divisions are more often described as maxillary osteotomies or segmental resections, with emphasis on the extent of bone division and reconstruction.