Maxillary Resection Research Articles

Computer-aided prosthetic rehabilitation of a resected maxilla after mucormycosis using a quad zygomatic implant protocol with digital planning

The rehabilitation of patient function and esthetics is essential from a social and psychological point of view. After a maxillary resection, the supporting structures that help provide retention or stability to a removable prosthesis are lacking. An effective, functional, straightforward, comfortable, and esthetic prosthetic rehabilitation of a patient with a resected maxilla using a digital workflow is presented. The rehabilitation was done using a computer-aided design and computer-aided manufactured bar and clip-supported overdenture prosthesis over quad zygomatic implants.

Assessment of Acoustic and Nasalance Improvement in Maxillary Obturator Patients Using PRAAT Software: An In Vivo Study.

The purpose of this study was to evaluate the improvement in acoustic and nasalance in patients with maxillary obturators, using PRAAT software. The current study comprised a total of 16 patients who had acquired maxillary defects. Regardless of gender, the age range of these patients was 40-75 years old. The total number of patients were randomly divided into two groups (8 participants in each group) namely (A) Interim obturator group and (B) Definitive obturator group. Analysis was done using PRAAT software for two speech parameters namely nasalance and acoustic value. The first stage of speech analysis was completed without the use of an obturator, whereas the second stage involved inserting the obturator on the same day. The third stage occurred 2 months after the usage of the obturator. The data were recorded and statistically analyzed. In definitive obturator group, mean value for relative nasalance increases from before prosthesis (60.93 ± 3.34 db) to after 2 months of prosthesis (70.53 ± 2.24 db) while in interim group increased from 57.55 ± 4.31 db (before prosthesis) to 63.77 ± 3.66 db (after 2 months of prosthesis). This improvement was more marked with definitive obturator than interim obturator. The F2-F1 comparative mean value changed from before prosthesis to immediate after prosthesis in definitive group for /a/, /e/, and /u/ vowels was 9.77, 22, and 24.38, respectively. F2-F1 comparative mean changes from before prosthesis to after 2 months of prosthesis was 102, 75.75, and 87 for three vowels /a/, /e/, and /u/, respectively. Similarly, F2-F1 mean value in interim prosthesis group changes from before to after 2 months of prosthesis was 62.25, 27.62, and 1.75 for /a/, /e/, and /u/, respectively. On conclusion, the definitive obturators were well-tolerated by patients with major defects and the results show that maxillary resection significantly impairs speech and definitive obturator rehabilitation is effective in regaining nasalance and acoustic speech components. Speech disorders in maxillectomy patients are a significant clinical issue since the surgery results in hypernasality, which impairs a person's ability to understand their own speech. Either surgical techniques or prosthetic rehabilitation are used to correct these abnormalities. Certain people require prosthetics to fix their speech even after surgery. How to cite this article: Bhushan P, Thenumkal E, Khosla E, et al. Assessment of Acoustic and Nasalance Improvement in Maxillary Obturator Patients Using PRAAT Software: An In Vivo Study. J Contemp Dent Pract 2024;25(7):656-660.

NUT cancer of nasal cavity and sinuses: a case report and literature review

NUT Carcinoma（NC） is a rare malignant tumor of unknown origin, which is highly aggressive. It is characterized by chromosome rearrangement accompanied by NUTM1 gene. The pathological manifestations were sudden and focal squamous in poorly differentiated or undifferentiated carcinoma. NUTM1gene rearrangement can be used to diagnose NC. The prognosis of NUT cancer is poor. Clinically, there is no established treatment plan. treatment options mainly comprise surgery, radiotherapy and chemotherapy. A 74-year-old patient with NC of the nasal cavity and sinuses was reported. Her clinical presentation was right nasal congestion with facial swelling. Sinus CT and MRI showed soft tissue density in the right nasal cavity and maxillary sinus with bone destruction. After admission, the patient underwent nasal endoscopic biopsy, and the postoperative pathological FISH staining showed BRD4/NUT fusion t（15, 19）. The tumor was significantly reduced after two courses of sequential chemoradiotherapy. Two months later, the patient underwent a partial maxillary resection due to the rapid regrowth of sinusoidal mass, invading the hard palate. The patient died 2 months after surgery due to multiple organ failure resulted from tumor metastasis, with a survival time of 11 months. The clinical characteristics, diagnosis and treatment of this case were reported and related literature was reviewed.

Prosthodontic Rehabilitation of Speech, Mastication & Functional Occlusion in Maxillary Insufficiency & Mandibular Discontinuity Defects: A Review

Prosthodontic rehabilitation of patients undergoing ablative cancer procedures involves significant challenges and technicalities in the construction of a prosthesis like repeated prosthetic adjustments or remakes, and ultimately improving quality of life. Mandibular resection causes the mandible to deviate towards the defect, which causes loss of occlusion on the non-resected side, altered mandibular movements, cosmetic deformity, difficulty in swallowing, and impaired speech and articulation. Restoring speech, deglutition, mastication, and respiration in individuals who have undergone maxillary resection involving the maxillae, hard and soft palates, and paranasal sinuses is extremely difficult. It may not be feasible to surgically reconstruct in each case. In conjunction with physical therapy, prosthetic rehabilitation assists such patients in regaining form and function and improving their quality of life. It can be achieved by using obturators and mandibular guidance prosthesis, which could efficiently retrain the maxilla and mandible following surgical procedures to achieve a functional occlusal relation, enabling early progression leading to a permanent restoration that functions almost perfectly. This review's objective is to highlight the various rehabilitative prosthesis that can be used to correct maxillary insufficiency and mandibular discontinuity defects following tumour resections using the available information.

Guided placement of zygomatic implants in head and neck cancer patients: implant survival and patient outcomes at 1–3 years of follow-up

Zygomatic implants (ZI) are a valuable option for supporting an obturator prosthesis after maxillary resection. This study was performed to assess the clinical outcomes of a digitally validated guided technique for ZI placement, followed by immediate prosthetic obturation. The primary objective was to evaluate implant survival, while the secondary objective was to assess patient-reported quality of life post-rehabilitation. Twelve patients treated for head and neck cancer received a total of 36 ZI after ablative surgery. The mean duration of ZI follow-up was 30.1 months. The survival rate of ZI placed in non-irradiated patients was 100%, while it was 85% in irradiated patients. Patient-reported outcomes were evaluated using the Liverpool Oral Rehabilitation Questionnaire (LORQv3) and the University of Washington Quality of Life Questionnaire (UW-QOL v4). Most patients reported satisfactory outcomes in the oral function domain of the LORQv3 (mean score 17.7 ± 4.5; possible range 12–48, with lower scores indicating better outcomes). Regarding the UW-QOL v4, the swallowing and chewing domains had the highest scores (mean 97.5 ± 8.7 and 95.8 ± 14.4, respectively; maximum possible score of 100). In conclusion, this treatment approach improves function and quality of life after maxillary ablative surgery. However, irradiated patients showed a noticeable trend of higher implant failure, and this was influenced by tumour position and size impacting the radiation dose to the zygomatic bone.

Management of Edentulous Patients with Maxillary Substance Loss: A Case Report

Depending on the location and extent of the loss of substance following maxillary resection surgery, all functions of the masticatory apparatus may be adversely affected. Eating and communication are impaired, which has a negative impact on the patient's psychological state [1]. When reconstructive maxillofacial surgery is not possible, rehabilitation with a maxillofacial prosthesis is essential. It must restore functions (phonation, eating, breathing, etc.) and reintegrate the patient into his psychosocial environment by masking his disability [2]. To achieve these objectives, this prosthesis, like a conventional removable prosthesis, must meet the Housset triad (support - retention - stabilisation), but also the objective of tightness. We therefore speak of a "prosthetic tetrad in PMF" (Housset's triad completed by the objective of tightness) [3]. In the case of a completely edentulous arch with substance loss, the treatment becomes more complex due to the reduced support surface. The maxillofacial prosthodontist must therefore be extremely vigilant to ensure the success of this appliance. A wise choice of technique and impression material, as well as respect for the occlusal parameters (occlusal plane, vertical dimension, centric relation, etc.) will ensure prosthetic stability and integration [4]. In this article, we will focus on the peculiarities of the management and the different stages in the fabrication of a maxillofacial prosthesis for a patient with total edentulism and loss of maxillary substance.

OPPORTUNITIES FOR TREATMENT WITH A TEMPORARY OBTURATOR MADE OF THERMOPLASTIC FOIL

Prosthetic treatment with a temporary obturator is an intermediate stage in the overall prosthetic rehabilitation of patients with maxillary resection. According to prevailing opinions, treatment with a temporary obturator should start around 2 weeks to 2-3 months after resection and to continue until the final completion of the healing processes in the defect. Due to the dynamic changes in the defect, this treatment stage is associated with many difficulties, requiring frequent correction of the obturator and up to 12-14 clinical visits on average. The aim of the research is to track the opportunity for fabrication of a temporary obturator of thermoplastic foil with vacuum forming apparatus and its efficiency for restoring speech and fluid intake in patients with maxillary resection. For the aim of the study we conducted a treatment of a 45-year-old patient operated a week ago for maxillary carcinoma. As a result, the left alveolar bone and a part of the hard palate with a diameter of 10 mm were resected, with teeth 13 to 23, 16 and 17 preserved. The defect was padded with gauze and an impression with an irreversible hydrocolloid impression material was taken. In the laboratory a grade 4 plaster working model was cast on which the borders of the palatal plate were outlined. For the frontal teeth, these were the cervical areas of the teeth, and for the distal - their equators. In the area of the defect and the missing teeth the border reached the transitional fold, and distally - the soft palate. The plate was made from foil of 1 mm diameter which was drawn onto the model with a vacuum forming apparatus and was cut along the indicated borders. The palatal plate - obturator successfully closed the comunication to the nasal cavity and restored the opportunity for fluid intake, which was the main problem for the patient. The use of a foil with a thickness of 1 mm provided stability and resistance of the construction. As a result of this, the necessary hermetic seal of the defect was achieved and the speech of the patient was normalised. The described treatment methodology with a temporary obturator allows the successful restoration of speech and fluid intake during the healing processes in the defect. The main advantages of the method are the fast and easy fabrication, the opportunity for multiple corrections and the short period of adaptation.

PROSTHETIC TREATMENT OF A PATIENT WITH RESECTION OF THE HARD PALATE WITH AN OBTURATOR WITH A SILICONE BASE

The most commonly used treatment method for maxillary resection patients is with an obturator, closing the communication between the oral and nasal cavity. Prosthetic methods and means with different types of materials are used for its fabrication. The purpose of the described clinical case is to track the opportunity for treatment of a patient with resection of the hard palate, with an obturator with a silicon base.The clinical case tracks the treatment of a patient with maxillary carcinoma. Preliminary alginate impressions were taken from the jaws. A custom tray with which a functional impression with a silicone material was taken, was fabricated for the mandible. The height and the central position of the mandible were determined with record bases with wax rims. The dentures were finished with heat cured resin. The upper denture was used as a custom tray for taking a functional impression of the prosthetic field with silicone cream material. After packing in the laboratory, the impression material was replaced with permanent soft relining material Molloplast B (Detax). The finished dentures were adjusted and articulated until bilaterally balanced occlusion was achieved. Treatment results showed good retention and stability of the prosthetic construction. Functional impression shaping and subsequent replacing with silicon material ensured a good and tight hermetic seal in the area of the defect. The use of permanent soft relining material allowed a trauma-free transmission of masticatory pressure and a stable connection with the plastic base of the obturator. The patient’s eating and speech as well as the fluid intake were successfully restored. The achieved results improved the quality of life of the patient and his self-esteem. Prosthetic treatment with an obturator with a silicon base provides good retention and stability of the prosthetic construction which allows successful restoration of the patient`s eating and speech.

Challenges in Managing Post-Radiation TMJ Pseudoankylosis.

This study demonstrates the outcomes of post-radiation temporomandibular joint (TMJ) pseudoankylosis management and its challenges. A rare maxillary squamous cell carcinoma was treated with subtotal maxillary resection. Subsequent radiation therapy, failure of free flap reconstruction, and 1 year of jaw hypomobility instigated TMJ pseudoankylosis with a maximal mouth opening (MMO) of less than 5mm. Bilateral coronoidectomy was done simultaneously with maxillary reconstruction, followed up with buccal fibrosis release and extensive jaw exercises. At 16 months of follow-up, the patient's MMO was 20mm. Although bilateral coronoidectomy released the attachment of the atrophic temporalis muscle, it did not correct the other causes of trismus, specifically the progressive fibrosis of masticatory muscles, loss of elasticity of the TMJ ligaments, and other soft tissue abnormalities. Radiotherapy-induced-trismus refractory to physical exercise may require further management to achieve satisfactory MMO.

Evaluation and comparison of retention and patient satisfaction with milled polyetheretherketone versus metal maxillary obturators

Statement of problemMetal and polyetheretherketone (PEEK) have been used to rehabilitate maxillary defects with obturators, each having advantages and disadvantages. However, patient satisfaction with the obturator retention of each material is unclear. PurposeThe purpose of this crossover clinical study was to compare retention and patient satisfaction between a milled cobalt chromium and a milled PEEK framework, each with a hollow bulb extension in polymethyl methacrylate (PMMA). Material and methodsTwenty patients who had received unilateral total maxillectomy and were treated in the prosthodontic department's maxillofacial clinic were enrolled in this crossover study. Each participant wore 2 different types of obturators for 6 months after insertion. Type CoCr received a milled cobalt chromium framework with a hollow bulb extension in PMMA first, and type Pk received a milled modified PEEK (BioHPP) framework with a hollow bulb extension in PMMA first. Patient satisfaction and retention force were measured immediately, at 3 months, and at 6 months after obturator insertions. The Fischer exact, chi-squared, and Monte Carlo tests were used to compare qualitative data. One-way ANOVA with the post hoc Tukey test was used for pair-wise comparison, and repeated measures ANOVA was used to compare before and after treatment at 3 and 6 months. ResultsNo significant difference was found between types in obturator insertion (P>.999), appearance of the upper lip (P>.999), mouth feeling (P=.301), pronunciation of words (P=.217), and talking in public (P=.589). A significant difference between types was found in speech after 6 months of obturator insertion (P=.016), swallowing liquids and food (P=.04), masticating foods (P=.007), appearance of clasps on anterior teeth (P=.002), satisfaction with appearance (P=.005), or avoidance of family events (P=.014) after 6 months of insertion. Types of obturators showed a statistically significant decrease in retention force with time (P<.001). ConclusionsAlthough the retention force was less with PEEK than with Co-Cr clasps engaging the same undercuts, this retention force was adequate for retaining removable partial dentures. Co-Cr clasps can be considered better than PEEK clasps because they engage the same undercuts regarding loss of retention with time. Quality of life in patients after maxillary resection could be improved by using maxillary obturators. Type Pk was better than type CoCr in terms of esthetics, but the retention of the PEEK obturator after 6 months decreased because of wear, leading to difficulty swallowing food or liquids, mastication, and speech.

All-in-one-piece type prosthesis combining an obturator, a facial prosthesis, and glasses for the rehabilitation of midfacial defect and its speech evaluation: A clinical report

This case report describes the use of an all-in-one-type prosthesis that combines an obturator, a facial prosthesis, and glasses in a 70-year-old man with a mid-facial defect caused by oral squamous cell carcinoma. The patient had undergone maxillary resection and postoperative recovery with an obturator; however, slurred speech, water leakage from the nose, and aesthetic issues persisted. The all-in-one-type prosthesis was designed to improve speech and aesthetics by connecting the obturator and facial prosthesis with a magnet and connecting the epithese to the glasses. The prosthesis was fabricated by a dental technician, who created a wax pattern of the epithese directly on the patient's face and used it to fabricate a custom-made epithelial prototype. The final prosthesis was fitted and adjusted for optimal position and comfort. The improvement in speech function was evaluated via formant analysis and nasalance evaluation and found to be satisfactory. (Int J Maxillofac Prosthetics 2023;6:20-24)

Managing Maxillofacial Defects with Hollow Closed Bulb Obturator Prosthesis

Maxillary resection surgery in response to tumour processes often results in loss of substance, leading to bucco-nasal or bucco-naso-sinus communication. The resulting consequences are significant, including difficulties with eating, with food and fluids leaking out, phonetic problems resulting in a nasal voice and incomprehensible speech. These problems are compounded by aesthetic problems such as sagging skin, asymmetry and facial disfigurement, particularly in cases where the facial tissues are affected. This article describes the case of a patient with maxillary bone loss associated with a deficit of jugal covering tissues. We decided to fabricate a cast metal partial denture with a hollow obturator, and we will detail the steps involved in its fabrication and describe the impression techniques used. Given the absence of a mandibular prosthetic corridor, we will also describe our approach to rehabilitating the mandibular arch to prevent food and fluid spillage through the jugal gap. In this context, our main objective was to ensure a watertight seal to guarantee optimal function.

A Study on Speech Analysis in Acquired Maxillary Defect Patients Treated with Maxillary Obturator.

The aim of the present study was to assess the speech analysis in acquired maxillary defect patients treated with maxillary obturator. Total of 16 patients were considered in the study. The age group of these patients ranged from 40 to 75 years with a mean age of 59.5 years, irrespective of their gender. The surgical obturator was fabricated using self-cure acrylic. The surgical obturator was delivered immediately after surgery. After a healing period of about 2 weeks, the surgical obturator was replaced by an interim prosthesis. This was processed with the help of heat-cure polymethylmethacrylate. The total number of patients was divided into two groups, namely, (A) Definitive obturator group and (B) Interim obturator group. The speech intelligibility (SI), was analyzed. The mean scores for SI before prosthesis in definitive and interim groups were 19.13 ± 3.22 and 19.87 ± 1.72, respectively. This was increased after prosthesis insertion to 24.38 ± 1.30 and 22.37 ± 1.18, which further increased after adaptation period of 2 months to 28.75 ± 1.28 and 24.62 ± 1.59 in two groups. The present study concluded that speech was severely affected by maxillary resection and that rehabilitation with maxillary obturator was successful in restoring these aspects of speech.

An obturator prosthesis for a 4-year-old child following treatment of a juvenile trabecular ossifying fibroma with a maxillary resection

Juvenile trabecular ossifying fibroma (JTOF) is a benign fibro-osseous lesion that usually occurs in the maxilla or mandible. Individuals with JTOF of the maxilla will most commonly require a resection that can result in a significant palatal defect. Appearance and articulatory, masticatory, and deglutitory functions can be restored with a clasp-retained obturator. Providing a prosthetic obturator with adequate retention in situations where the teeth cannot accommodate clasps because of insufficient eruption can be challenging. This article describes a technique that has been developed for such instances—in this situation, a 4-year-old child who had undergone a maxillary resection because of a JTOF.

Vascular Pedicle Ossification After Jaw Reconstruction With Fibular Free Flap.

Ossification of vascular pedicle in free fibular flap for jaw reconstruction was a rare complication. The aim of our study is to evaluate its consequence and propose our clinical experience with surgical management and outcomes of this complication. Our study includes patients who underwent jaw reconstruction with free fibular flap from Jan 2017 to Dec 2021. Patients were included only they had at least one computed tomography scan in follow-up period. Among 112 cases included in our study, 3 cases were observed of abnormal ossification along vascular pedicle who underwent maxilla (two patients) or mandibular (one patient) resection. Two patients who received maxilla resection present a progressive reduction in mouth opening after surgery, and CT scans showed calcified tissue around pedicle. Surgical revision was performed in one patient. Our experience show that periosteum preserves its osteogenic capability which allows the possibility of new bone formation along the vascular pedicle. Another important factor is mechanical stress. From our experience, it was necessary to remove periosteum from vascular pedicle only when mechanical stress of vascular pedicle were high, in order to avoid complication of vascular pedicle calcification. Surgical excision of calcification may be necessary only with clinical symptom. We believe this study could aid in understanding of pedicle ossification and contribute towards prevention and treatment of pedicle ossification.

Brown Tumors of the Jaws: A Retrospective Study.

(1) Describe the clinical spectrum, imaging features, management, and outcome of brown tumors (BT) of the jaws. (2) Determine via a literature review the facts and controversies around the characteristics and management of this lesion. Our study was approved by the institutional committee of Sahloul University Hospital in accordance with the ethical standards of the Declaration of Helsinki. Sixteen patients with BT in the context of a primary, secondary, and tertiary hyperparathyroidism were treated and followed up during their recovery. This study reports 16 patients with a mean age of 48 years old. Brown tumor lesions were associated with primary hyperparathyroidism in 6 cases (38%), secondary hyperparathyroidism to chronic kidney failure in 5 cases (31%), and tertiary hyperparathyroidism in the context of a long lasting CRI in 5 cases. Their location was maxillary in 7 cases, mandibular in 5 cases, and bimaxillary in 4 cases. The treatment consisted of parathyroidectomy in 13 patients, maxillary resection in 3 cases, and vitamin D treatment in 2 cases. Favorable outcomes, characterized by tumor regression, were reported in 9 cases, whereas unfavorable evolution was observed among 7 patients. Parathyroidectomy is the gold standard treatment for primary hyperparathyroidism. It resulted in a total regression in all our cases. Regarding secondary hyperparathyroidism, blood screening and chronic renal insufficiency follow-up are critically valuable to detect this condition at an early stage, hence increasing the success rate of brown tumor regression. Our secondary and tertiary hyperparathyroidism results were miscellaneous; although it is important to emphasize the importance of the chronic renal insufficiency management to ensure a success. Brown tumors should be included in the differential diagnosis of giant cell lesions. Parathyroidectomy is usually sufficient to induce the total regression of the lesion in primary hyperparathyroidism cases. A more delicate approach is needed regarding secondary hyperparathyroidism. Meticulous control of chronic renal insufficiency is mandatory in addition to parathyroidectomy.

Prosthetic Rehabilitation of Patients with Maxillary Defects Post Mucormycosis: Case Series

Mucormycosis has emerged as an epidemic within a pandemic of COVID 19 in India. It has emerged especially during second wave of COVID 19. Four major factors which are critical for the treatment of mucormycosis are rapidity of diagnosis, reversal of underlying predisposing factors (if possible), appropriate surgical debridement of infected tissue and appropriate antifungal therapy. Patient with maxillary resection present a challenging situation for the prosthodontist. Prosthetic rehabilitation is often difficult to achieve in such cases due to absence of many teeth and lack of favorable tissue undercuts. Obturator prosthesis should recreate the partition between oral and nasal cavities to restore oral function and esthetics. This case series presented the prosthodontic management of patients with hemimaxillectomy and premaxillary resection secondary to mucormycosis using maxillary interim obturator.

Application of Augmented Reality to Maxillary Resections: A Three-Dimensional Approach to Maxillofacial Oncologic Surgery.

In the relevant global context, although virtual reality, augmented reality, and mixed reality have been emerging methodologies for several years, only now have technological and scientific advances made them suitable for revolutionizing clinical care and medical settings through the provision of advanced features and improved healthcare services. Over the past fifteen years, tools and applications using augmented reality (AR) have been designed and tested in the context of various surgical and medical disciplines, including maxillofacial surgery. The purpose of this paper is to show how a marker-less AR guidance system using the Microsoft® HoloLens 2 can be applied in mandible and maxillary demolition surgery to guide maxillary osteotomies. We describe three mandibular and maxillary oncologic resections performed during 2021 using AR support. In these three patients, we applied a marker-less tracking method based on recognition of the patient's facial profile. The surgeon, using HoloLens 2 smart glasses, could see the virtual surgical planning superimposed on the patient's anatomy. We showed that performing osteotomies under AR guidance is feasible and viable, as demonstrated by comparison with osteotomies performed using CAD-CAM cutting guides. This technology has advantages and disadvantages. However, further research is needed to improve the stability and robustness of the marker-less tracking method applied to patient face recognition.

A digital workflow for fabricating an interim obturator after partial maxillary resection

This article describes a digital workflow for fabricating an interim obturator after partial maxillectomy which utilizes the radiopacity of iodoform gauze, a common surgical packing material, to simulate postoperative oronasal defect cavities through a computer-aided design and computer-aided manufacturing (CAD-CAM) workflow and to generate the interim obturator by 3-dimensional printing. This technique may serve as a promising alternative technique for the fabrication of an interim obturator and, in particular, benefit patients who have not seen a prosthetic specialist before surgery and present without a surgical obturator.

Prognostic Analysis of Individualized Treatments of Malignant Tumors Primary From Maxillary Sinus.

To investigate the prognosis and quality of life for primary malignant maxillary sinus tumors. This was a retrospective analysis. 164 patients diagnosed with primary malignant maxillary sinus tumors between 2005 and 2018 were recruited. Patients were treated according to the pathological type and the lesion range. Prognostic differences of different pathological types, surgical resection methods, repair methods, treatment methods, and different local recurrence sites were analyzed. Survival analysis and prognostic factors analysis were performed. Overall survival (OS) rate was 74.7% at 3 years, 60.5% at 5 years, and 45.8% at 10 years. Disease-free survival (DFS) rate was 67.2% at 3 years, 45.6% at 5 years, and 30.8% at 10 years. There was significant difference in OS rate among different pathological types (χ2 = 14.18, P < 0.05). The order of 5-year OS rate was as follows: malignant transformation of inverted Papilloma (77.7%) > adenoid cystic carcinoma (74.1%) > squamous cell carcinoma (48.4%) > sarcoma (22.1%). The order of disease-free survival was as follows: total maxillary resection > subtotal maxillary resection > endoscopic nasal tumor resection ≥enlarged maxillary resection, the 5-year DFS rate were 68.6%, 53.5%, 46.2%, and 42.9%, respectively. The OS of postoperative radiotherapy was significantly better than that of preoperative radiotherapy (χ2 = 7.16, P < 0.05). There was significant difference in OS between recurrent and non-recurrent patients (χ2 = 68.57, P < 0.05). The pathological type and the timing of radiotherapy are independent prognostic factors for primary malignant tumor of maxillary sinus. In addition, different local surgical resection methods are independent factors affecting the recurrence rate.