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Pages: 432-436
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Preoperative Planning for Simulation of Surgical Margins in Maxillectomy: a Systematic Review

Author: Jaspreet Singh Badwal, Bharat Kumar S, Saurabh Kumar Sinha

Category: JMSR Surgery


Purpose : To present the new developments in preoperative and intraoperative assessment of surgical margins in maxillectomy and highlight techniques developed for computerized simulation of surgical margins using different imaging modalities, by way of a systematic review.

Materials and Methods : An electronic search was conducted using the terms "maxillectomy", "surgical margins", "imaging" and "surgery" in combination with the following search strategy: Search block Maxillary Neoplasms - ("Maxilla"[Mesh] OR "Maxillary Neoplasms"[Mesh] OR "Maxillary Sinus Neoplasms"[Mesh] OR "Maxillary Sinus"[Mesh] OR maxillectomy*[tiab] OR maxilla resection*[tiab]); search block Margins of excision - ("Margins of Excision"[Mesh] OR surgical margin*[tiab] OR excision margin*[tiab] OR resection margin*[tiab] OR tumor-free margin*[tiab] OR line[tiab] AND resection [tiab] AND validation[tiab]); search block Maxillary cancer - (maxilla*[tiab] AND ("Neoplasms"[Mesh] OR neoplasm* [tiab] OR tumor [tiab] OR tumors[tiab] OR tumorous [tiab] OR tumour* [tiab] OR cancer* [tiab] OR lymphoma* [tiab] OR malignancy* [tiab] OR oncology* [tiab] OR carcinoma* [tiab]). Clinical studies up to June 2017 were retrieved from the electronic databases of PubMed, EMBASE and SCOPUS, which provided relevant information in relation to oncological disease managed with help of preoperative surgical simulation for maxillectomy and sinonasal cancer. References of the selected articles were further searched for important relevant studies. Apart from this, a search was conducted over Google Scholar to obtain related articles.

Results and Conclusion : Treatment planning for major surgical procedures involving surgical intervention for cancer of the maxilla, has greatly evolved over the last few decades. Preoperative planning and surgical simulation help to decrease the incidence of positive margins after a maxillectomy, making surgical treatment more accurate. Furthermore, surgical resections have been made possible for advanced sinonasal malignancies by reducing the morbidity of injury to adjacent critical vital structures.

Keywords: Imaging, Maxillectomy, surgery, surgical margins

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