The Effect of Immediate Obturator Reconstruction after Radical Maxillary Resections on Speech and other Functions

Mehmet Dalkiz,Ahmed Dalkiz

doi:10.3390/dj6030022

Abstract

Objective: Maxillectomy often results in a high level of morbidity with significant psychological and functional implications for patients. The aims of the present study were to assess the effectiveness of the maxillary obturator as a speech rehabilitation aid, to examine the influence of dentition on speech intelligibility, to restore patients’ regular daily activity as soon as possible, and to maintain patients’ psychological well-being throughout the treatment. Patients and Methods: Forty-one palatomaxillary immediate obturator and definitive reconstruction patient treatments were reviewed at a clinic (Ankara, Turkey). Patients aged between 20 and 73 years with surgically acquired partial maxillary defects were included in this study. All patients were rehabilitated with immediate and definitive obturators. The patients were given immediate surgical obturators which were adjusted to the defect area with a tissue conditioner. By employing this procedure and relining with the tissue conditioner weekly, immediate obturators were used in the interim stage of the treatment. As interim obturators, prostheses were used for two to three months until healing and resorption were found satisfactory, after which the definitive obturators were fabricated. Results: The speech intelligibility test (SIT) was employed for the evaluation of the speech ability. Significant improvements were found in the mean speech intelligibility test score (SITS), from 0.02% in patients without prosthetic obturation to 94.10% in patients with immediate obturation on the second day, 95.60% in patients with immediate obturation on the 20th day, and 95.97% in patients with definitive obturation.

Highlights

Maxillofacial deformities can be congenital, acquired, and developmental [1,2,3,4,5]
41 patients with surgically acquired maxillary defects were divided into three groups: edentulous, partially edentulous, and dentulous
The lowest percentage mean SI score of 0.02% was recorded without prosthetic obturation, while this mean value increased to 94.10% on the second day and to 95.60% on the twentieth day of immediate obturation

Summary

Introduction

Maxillofacial deformities can be congenital, acquired, and developmental [1,2,3,4,5]. An obturator is a maxillofacial prosthesis that is used to close and maintain the integrity of the oral and nasal compartments that are altered because of a congenital, acquired, or developmental disease. Head and neck defects can be restored with the help of maxillofacial prosthetic rehabilitation to near-normal function and aesthetics. The prosthetic rehabilitation for maxillectomy patients aims at the separation of the oral and nasal cavities to allow adequate deglutition and articulation in order to restore the mid facial contour and to provide acceptable results [7,8]. The management of most head and neck neoplasms usually involves radical surgical resection, chemotherapy, and radiotherapy [9,10,11,12].

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Discussion

Conclusion