Quality of Life After Major Removal: Maxillectomy, Mandibulectomy or Glossectomy

Introduction
Radical resective surgery often provides a cure in patients with oral and maxillofacial malignancy and is tolerated surprisingly well by dogs and cats. The quality of life provided by maxillectomy and mandibulectomy procedures is excellent. The multiple anesthesia episodes required for radiation therapy and the systemic sickness and multiple office visits required for chemotherapy are avoided. Combined therapy may be indicated, particularly for lesions with regional or distant metastasis.

Preoperative workup includes routine blood tests, blood type determination and cross-matching, coagulation profiles, buccal mucosa bleeding time, regional lymph node aspirates, and diagnostic imaging (thoracic radiographs, abdominal ultrasound, head computed tomography). The client must be informed about intra- and postoperative complications, follow-up care, long-term function and quality of life, and prognosis.

Maxillectomy
The practical limits for maxillectomy range from partial resection of the rostral upper jaw on one or both sides (rostral maxillectomy), a central or caudal portion of the maxilla (central or caudal maxillectomy), the entire dental arcade on one side including the palate to the midline (total maxillectomy) to the entire palate and both entire dental arcades. For more caudally located lesions that extend onto the side of the face, the bones forming the ventral and lateral limits of the orbit can be resected (partial orbitectomy). In cats the relatively small size of the skull and the short, tighter upper lip compared with that of dogs make radical maxillectomy far more challenging.  [...]