Rehabilitation of Surgically Resected Soft Palate with Interim Velopharyngeal Obturator (original) (raw)
Related papers
Obturator prostheses following palatal resection: clinical cases
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2010
Malignant tumours of the upper gum and hard palate account for 1-5% of malignant neoplasms of the oral cavity; two thirds of the lesions which involve these areas are squamous cell carcinomas. Most of these carcinomas are diagnosed late, when they invade the underlying bone. The procedures of choice for removal are: alveolectomy, palatectomy, maxillectomy, which may be total or partial. Surgical reconstruction of the defect may be carried out using a wide range of microvascularized flaps: osteomuscolocutaneous of the internal iliac crest, an osteocutaneous flap of the fibula or scapula, fascia, or osteocutaneous radial flap, or a pedicled flap of temporal muscle. These flaps are supported by single or multiple obturator prostheses. Rehabilitation via palatal obturators is preferred in patients with a poor prognosis or in weak condition. Rehabilitation aims to: restore the separation between the oral and nasal cavities, enable the patient to swallow, maintain or provide mastication, ...
Enhancing quality of life: A hollow bulb obturator in palatal defect rehabilitation - A case report
International journal of oral health dentistry, 2023
The prosthodontic care for palatal defects is crucial for effectively closing oronasal communication in patients and enhancing various aspects of their oral health. This includes improving masticatory function, speech clarity, aesthetics, and overall comfort. Maxillary defects often arise as a result of surgical interventions for conditions like malformations, neoplasms, or traumatic injuries. In such cases, the primary objective of employing an obturator is to close the palatal defects that result from maxillectomy procedures, with the ultimate aim of enhancing both speech and masticatory function. This article presents a comprehensive case study highlighting the prosthetic rehabilitation of a maxillectomy defect resulting from osteosarcoma. The rehabilitation approach incorporates the use of a hollow bulb obturator, showcasing its transformative impact on the patient's masticatory function, speech clarity and aesthetics thus enhances the patient's quality of life. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Prosthetic Rehabilitation of a Congenital Soft Palate Defect
The Journal of Indian Prosthodontic Society, 2012
Obturator is derived from the Latin verb obturate which means to close or to shut off. This definition provides an appropriate description of the objective of obturation in patients with palatal defects. The obturator is often helpful in improving the speech of individuals with partial or total velar defects i.e. cleft of soft palate. Soft palate cleft is one of the most common cause of velopharyngeal incompetence, which is the functional inability of the soft palate to effectively seal with the posterior and or lateral pharyngeal walls. In maxillofacial prosthesis the clinician may have the responsibility for reestablishing palatopharyngeal integrity to provide the potential for acceptable speech. Here a case report has been presented in which palatal plate with a solid one piece pharyngeal obturator prosthesis has been used for rehabilitation of a dentulous patient having congenital soft palate defect using functional impression technique.
Rehabilitation of oncology patients with hard palate defects. Part 1: The surgical planning phase
Dental update, 2015
This article is the first in a series of three papers that will discuss the conventional non-implant retained prosthodontic rehabilitation of oncology patients with surgically acquired hard palate defects. In this first paper, the dental challenges posed by the oncology patients will briefly be discussed. The interface between the specialist restorative dentist and the maxillofacial surgeon when planning the conventional dental rehabilitation of an oncology patient with a hard palate defect will be discussed in detail. Clinical Relevance: To highlight the importance of the restorative dentistry/surgical interface when planning a treatment for a patient requiring a maxillectomy and conventional obturation.
Rehabilitation of maxillectomy defect with obturator prosthesis
The acquired defects of the palate are created commonly surgical intervention of benign or malignant neoplasms. The size and location of the defect influence the level of difficulty in prosthetic rehabilitation. Surgical intervention creates anatomic defect which forms communication among the oral cavity, nasal cavity and maxillary sinus. The goal of prosthodontist is to rehabilitate missing oral and extra oral structures with restoration of normal anatomic and physiologic function. Prosthetic rehabilitation with obturator restores the oral structures and also acts as barriers between communications among the cavities.
The International journal of prosthodontics
The restoration of speech after an extensive resection of the soft palate has been a challenge faced by both prosthodontists and surgeons. Few comparisons between prosthetic rehabilitations and surgical reconstructions of large soft palate defects exist in equally matched groups of patients. The purpose of this study was to evaluate speech outcomes in patients with soft palate defects that were rehabilitated with either a pharyngeal obturator or surgical reconstruction. Nine patients who were treated via prosthetic obturation were compared to nine patients who underwent surgical reconstruction of the oropharynx with a radial forearm free flap and a soft palate insufficiency repair modification. Speech intelligibility data, perceptual ratings of resonance, and aeromechanical measurements of velopharyngeal function were collected. There were no differences in any of the speech outcome measures between the two groups of patients. Future studies should focus on the patient's perspec...
International Journal of Prosthodontics and Restorative Dentistry, 2019
Soft palate is a part of the palate composed of muscles and mucous membrane. It divides oropharynx from the nasopharynx. Soft palate along with lateral and posterior pharyngeal walls create a three-dimensional muscular valve which is known as velopharyngeal (VP) sphincter. This VP sphincter allows normal breathing and prevents regurgitation of food and fluids in the nasal cavity. It is also required in other functions such as swallowing, blowing, sucking, whistling and sneezing. Any defect in the soft palate, i.e., structurally or neurologically will lead to VP defect due to which normal functions were impaired. Pharyngeal obturator prosthesis restores the congenital and acquired defects of the soft palate and allows adequate closure of palatopharyngeal sphincter. In the present case report, a male patient suffering from pleomorphic adenoma of the soft palate was operated leading to VP insufficiency. This patient was rehabilitated by pharyngeal obturator prosthesis for the improvement of quality of life of the patient.
Soft Tissue Management and Prosthetic Rehabilitation in a Tongue Cancer Patient
Case Reports in Dentistry, 2013
One major challenge in treating head and neck oncologic patients is to achieve an acceptable recovery of physiologic functions compatible with the complete tumor excision. However, after tumor resection, some patients present a surgically altered anatomy incompatible with prosthetic rehabilitation, unless some soft tissue correction is carried out. The aim of the present study is to describe the overall mandibular prosthetic rehabilitation of a postoncologic patient focusing on the possibility of soft tissue correction as a part of the treatment. A 72-year-old woman, who undergone a hemiglossectomy for squamous cell carcinoma several years before, was referred to our department needing a new prosthesis. The patient presented partial mandibular edentulism, defects in tongue mobility, and a bridge of scar tissue connecting one side of the tongue to the alveolar ridge. A diode laser (980 nm) was used to remove the fibrous scar tissue. After reestablishing a proper vestibular depth and ...