Simini Boards Cast

Chapter 89 - Part C: Maxillectomy Isn’t Mandibulectomy: Why the Upper Jaw Fails Differently

Simini Podcasts Season 1 Episode 81

In this BoardsCast episode, we continue Tobias Chapter 89 - Mandibulectomy and Maxillectomy by breaking down a critical but often misunderstood reality:
maxillectomy is not mandibulectomy.
The upper jaw functions differently, carries load differently, fails differently, and requires an entirely separate mental model for planning and reconstruction.

Unlike the mandible — a mobile, curved beam with bilateral musculature — the maxilla is a fixed structural platform integrated with the nasal cavity, sinuses, orbit, and hard palate. Resections here change airway dynamics, occlusion, cosmetic appearance, and skull biomechanics in ways mandibular surgery simply does not.

You’ll learn:

  • Why maxillary mechanics are fundamentally different from mandibular mechanics
  • How defects destabilize nasal airflow, sinuses, and palatal support
  • Why cosmetic distortion is predictable — and unavoidable
  • How bone invasion patterns differ between mandible and maxilla
  • What determines postoperative function (and dysfunction)
  • Why reconstruction is about partitioning, not load-bearing
  • High-yield board patterns involving SCC, fibrosarcoma, melanoma & acanthomatous lesions in the maxilla

If mandibulectomy is about load dynamics, maxillectomy is about anatomical compartments — and understanding those differences is the key to success.

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