Treatment of Squamous Cell Carcinoma from Posterior Maxilla with Wide Local Excision of the Tumor and Total Alveolectomy, Reconstruction with Buccal Fat Pad Advancement, Placement of Surgical Obturator, and an Ipsilateral Supraomohyoid Neck Dissection

1. Introduction

2. Supraomohyoid Neck Dissection

1. Incision
2. Platysma Flap Elevation
3. Posterior Elevation of the Neck Dissection
4. Anterior Border of the SCM
5. Dissection Level 2B
6. Dissection Level 2A and 3 Along the IJ Vein
7. Dissection on Level 1B on the Submandibular Region
8. Dissection of the Carotid Sheath
9. Dissection on Level 1A Anteriorly
10. Elevation of the Fibrofatty Tissue of the Strap Muscles
11. Dissection on Level 1B
12. Retraction of the Submandibular Gland Exposing the Lingual Nerve
13. Removal of the Specimen
14. Confirmation of Hemostasis
15. Confirmation of the Nerves' Integrity
16. Specimen Orientation on the Back Table
17. Drain Placements and Wound Closure

3. Excision of Squamous Cell Carcinoma from the Right Posterior Maxilla

1. Surgical Approach and Marking
2. Injection with Local Anesthesia
3. Beginning of Circumferential Dissection Around the Tumor
4. Extraction of Premolar Tooth Located Along the Linear Margin
5. Dissection of the Greater Palatine
6. Removal of the Soft Tissue Component of the Tumor
7. Orientation of the Soft Tissue
8. Specimens for Frozen Section
9. Posterior Partial Maxillectomy
10. Buccal Fat Pad Advancement for Repair
11. Suturing of Buccal Fat Pad

4. Immediate Surgical Obturator Placement and Adjustments

1. Addition of the Soft Tissue Reliner
2. Call with Pathologist
3. Obturator Fixation to Adjacent Teeth

5. Post-op Remarks