A Modified Classification for the Maxillectomy Defect

Background: At present no widely accepted classification exists for the maxillectomy defect suitable for surgeons and prosthodontists. An acceptable classification that describes the defect and indicates the likely functional and aesthetic outcome is needed.

Methods: The classification is made on the basis of the assessment of 45 consecutive maxillectomy patients derived prospectively from the database (September 1992) and retrospectively from 1989.

Results: The classification of the vertical component is as follows: Class 1, maxillectomy without an oro-antral fistula; Class 2, low maxillectomy (not including orbital floor or contents); Class 3, high maxillectomy (involving orbital contents); and Class 4, radical maxillectomy (includes orbital exenteration); Classes 2 to 4 are qualified by adding the letter a, b, or c. The horizontal or palatal component is classified as follows: a, unilateral alveolar maxillectomy; b, bilateral alveolar maxillectomy; and c, total alveolar maxillary resection.

Conclusion: This practical classification attempts to relate the likely aesthetic and functional outcomes of a maxillectomy to the method of rehabilitation.