Maxillectomy with orbital exenteration is an extensive procedure reserved for aggressive tumors of the maxillary sinus, infratemporal fossa, or orbit that infiltrate the bony walls and orbital contents. A partial maxillectomy spares uninvolved orbital floor and walls; total maxillectomy removes the entire maxilla; orbital exenteration entails en bloc removal of the globe, orbital fat, and sometimes eyelid tissues when malignancy invades orbital structures.
Dr. Singhavi first obtains contrast-enhanced CT/MRI to delineate tumor extent and orbital involvement, supplemented by ophthalmologic evaluation. For lesions isolated to the maxilla without orbital invasion, he performs a partial maxillectomy via a Weber–Ferguson or infraciliary incision. If the tumor extends into the orbital floor but spares the globe, he removes only the involved orbital bone and reconstructs with titanium mesh or calvarial bone grafts. In cases of deep orbital invasion, he plans a total maxillectomy with orbital exenteration—using extended bicoronal incisions for optimal access. Intraoperative margin assessment and frozen sections guide the extent of resection. Reconstruction is coordinated with microvascular teams: radial forearm free flaps or anterolateral thigh flaps recreate midfacial volume, orbital architecture, and external skin cover. Custom ocular prosthesis fitting begins after soft-tissue healing.
Dr. Singhavi’s integrated approach achieves uncompromised oncologic clearance of advanced maxillary and orbital tumors. By tailoring the resection to each patient’s disease, he preserves ocular function whenever safe, reducing the need for exenteration. When exenteration is unavoidable, immediate free-flap coverage prevents cavity contracture, facilitates prosthetic rehabilitation, and restores facial symmetry. Patients experience robust local control, reduced hospitalization due to single-stage reconstruction, and a clear pathway to adjuvant therapies. Overall, this comprehensive protocol ensures durable disease management, optimizes cosmesis, and accelerates psychological adaptation to facial changes.
