ABSTRACT
A sobrevivência de pacientes com câncer de cabeça e pescoço vêm melhorando, entretanto, algumas deformidades podem ocorrer devido dos tratamentos cirúrgicos que geram mutilações bucomaxilofaciais como perda de dentes, estruturas do palato, língua ou assoalho, resultando em alterações na fonética, mastigação e deglutição. Nesses casos há a necessidade que seja realizado uma reabilitação protética buscando torná-los indivíduos com menos problemas sociais, psicológicos e físicos, visto que mais procedimentos cirúrgicos estão contra indicados para solucionar os efeitos colaterais gerados pelo tratamento das neoplasias. Esse tipo de reabilitação protética com prótese ou placa obturadora possibilita benefícios na fonética, facilita a convivência social e atividades nutricionais como alimentação e deglutição, permitindo ao paciente uma vida com menos constrangimentos. Este trabalho tem como objetivo relatar dois casos clínicos onde os pacientes foram submetidos a reabilitação com placa obturadora palatina feitos após cirurgias oncológicas. Os pacientes de gêneros diferentes e com comunicações buco-nasal similares receberam o mesmo planejamento reabilitador que foram confeccionadas a partir de um molde que foi enviado ao laboratório. Após a instalação foi possível verificar que houve sucesso no tratamento, notando uma melhora imediata comprovando a eficácia do método reabilitador(AU)
This paper relates two clinical cases where patients were recovered with a palatal splint made after oncological surgeries. Survival of patients and necks can occur, however, some deformities can occur during oral and maxillofacial treatment, such as the appearance of teeth, palate structures, mutilations or posterior jaws, leading to changes in aesthetics, surgery and swallowing. If the need to perform a prosthetic rehabilitation is necessary so that the results are seen with less problems, psychological and physical, that more procedures are performed so that the effects of neoplasms are contraindicated by the treatment. This type of prosthetic rehabilitation with prosthesis or obturator plate provides benefits in phonetics, facilitates social coexistence and nutritional activities such as eating and swallowing, allowing the patient a life with less constraints. Patients of different genders and with similar oral and nasal communications received the same rehabilitation plan that were made from a mold that was sent to the laboratory. After installation, it was possible to verify that the treatment was successful, noting an immediate improvement, proving the effectiveness of the rehabilitation method(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Palatal Obturators , Head and Neck Neoplasms , Esthetics , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/therapyABSTRACT
Objective:To summarize the case management of promoting the rehabilitation of oral and maxillofacial function of a patient with gingival cancer.Methods:The patient took the obturator prosthesis and orofacial myofunctional therapy to promote the rehabilitation of oral and maxillofacial function. The key points of nursing included: nursing of obturator prosthesis, orofacial myofunctional therapy, psychological nursing and evaluation of oral and maxillofacial function rehabilitation.Results:after one year of case management, the total score of the Chinese version of the obturator functioning scale was 18 points, the mouth opening was 4cm, and the speech distinctness was 98%. The quality of life of the patient was good.Conclusions:When the obturator prosthesis and orofacial myofunctional therapy are taken, all-round cooperation of the medical staff of different specialties from the perioperative period to the discharge follow-up should be strengthened in order to promote the rehabilitation of oral and maxillofacial function.
ABSTRACT
Total maxillectomy for patients with malignant lesions will often incapacitate the patient both functionally and aesthetically. An immediate surgical obturator prosthesis would be of utmost importance for patients in these critical situations to aid in deglutition, phonetics, respiration and effectively avoiding various post-surgical complications. This article emphasizes on utilizing circum-zygomatic wiring for retention of the immediate surgical obturator in cases of total maxillectomy or edentulous patients.
ABSTRACT
@#Unilateral maxillary defects are common clinical maxillofacial deformities. Because of their large area and the complexity of the maxillary structure, the distribution of pressure from dental prostheses and on the sustentacular tissue is usually uneven, which often results in pain or ulceration of the soft tissue and agomphiasis during the therapeutic process. Recently, the finite element method has been used to guide prosthesis design and implantation. This method is conducive to the restoration and stability of the dental prosthesis and the protection of the remaining tissue, which improves restoration quality and patient satisfaction. This paper summarizes the establishment of a three-dimensional finite element model of unilateral maxillary defects and its application in repairing unilateral maxillary defects with traditional prostheses, implant-supported prostheses and surgical flap transplantation combined with prostheses.
ABSTRACT
PURPOSE: To longitudinally assess the quality of life in maxillectomy patients rehabilitated with obturator prosthesis. MATERIALS AND METHODS: Thirty-six subjects were enrolled in the span of 16 months, out of which six were dropouts. Subjects (age group 20-60 years) with maxillary defects, irrespective of the cause, planned for definite obturator prosthesis, were recruited. The Hindi version of European Organization for Research and Treatment of Cancer, Head and Neck version 1 of Quality of Life Questionnaire was used before surgical intervention and one month after definitive obturator. Questionnaire includes 35 questions related to the patient's physical health, well being, psychological status, social relation and environmental conditions. The data were processed with statistical package for social science (SPSS). Probability level of P<.05 was considered statistically significant. RESULTS: The quality of life after rehabilitation with obturator prosthesis was 81.48% (+/-13.64) on average. On item-level, maximum mean scores were obtained for items problem with teeth (1.87 +/- 0.94), pain in mouth (1.80 +/- 0.92), trouble in eating (1.70 +/- 0.88), trouble in talking to other people (1.60 +/- 1.22), problems in swallowing solid food (1.57 +/- 1.22) and bothering appearance (1.53 +/- 1.04); while minimum scores were obtained for the items coughing (1.17 +/- 0.38), hoarseness of voice (1.17 +/- 0.53), painful throat (1.13 +/- 0.43), trouble in having social contacts with friends (1.10 +/- 0.40) and trouble having physical contacts with family or friends (1.10 +/- 0.31). CONCLUSION: Obturator prosthesis is a highly positive and non-invasive approach to improve the quality of life of patients with maxillectomy defects.
Subject(s)
Humans , Cough , Deglutition , Eating , Friends , Head , Hoarseness , Longitudinal Studies , Mouth , Mouth Neoplasms , Neck , Patient Dropouts , Pharynx , Prostheses and Implants , Quality of Life , Social Sciences , Tooth , Surveys and QuestionnairesABSTRACT
A prótese bucomaxilofacial permite a reabilitação de pacientes que sofreram algum tipo de mutilação facial. A reabilitação protética e utilização de obturadores maxilares após maxilectomia com comunicação das cavidades bucal e nasal possibilitam uma adequada condição de deglutição e fala, garantindo uma melhor qualidade de vida e reintegração social de portadores de sequelas cirúrgicas. O carcinoma mucoepidermoide (CME) é a neoplasia maligna de glândula salivar mais frequentemente encontrada na cavidade bucal, principalmente no palato e região parotídea. Já o carcinoma escamocelular (CEC) é uma das neoplasias malignas mais comuns na cavidade bucal, predominando na região de língua e assoalho, sendo rara na região de seio maxilar. Ambos os carcinomas apresentam-se frequentemente como um aumento de volume assintomático de evolução reativamente lenta, sendo a excisão cirúrgica com margem de segurança o tratamento de escolha. O objetivo deste artigo é relatar dois casos clínicos de reabilitação com prótese obturadora maxilar, após cirurgia oncológica para tratamento de CME e CEC em palato e seio maxilar respectivamente, seguido de comunicação buconasosinusal. A prótese possibilitou não apenas a devolução da estética mas também da função, permitindo a reintegração social do paciente.
A maxillofacial prosthesis allows the rehabilitation of patients who have suffered some type of facial mutilation. Prosthetic rehabilitation and the use of maxillary obturators after maxillectomy, with communication of the oral and nasal cavities, provide a suitable condition for swallowing and speech, ensuring a better quality of life and social reintegration of patients with surgical sequelae. Mucoepidermoid carcinoma (MEC) is a malignant neoplasm of the salivary gland most often found in the oral cavity, especially on the palate and in the parotid region. For its part squamous cell carcinoma (SCC) is one of the most common malignancies in the oral cavity, predominantly in the region of the tongue and floor. It often presents as an asymptomatic bulging with a relatively slow progression, for which surgical excision, with a margin of safety, is the treatment of choice. The purpose of this paper is to report two cases of rehabilitation with a maxillary obturator prosthesis after oncologic surgery for treatment of MEC and SCC on the palate and a maxillary sinus, respectively, followed by buconasosinusal communication. The prosthesis allowed not only the recovery of an aesthetically pleasing appearance but also of function, making possible the patient's social reintegration.
ABSTRACT
Face is the forefront of aesthetics. Surgical resection of the maxillae and facial structures for treatment of cancer, trauma, congenital deformities or infection causes maxillofacial defect that has serious impact on the individual’s esthetic and has great psychological trauma of social outcast. When the presented defect is extensive and supporting structures is lacking, the rehabilitation and restoring functions is a challenging task. Rehabilitation becomes even more difficult when the problems at defect site are associated with the complications. An attempt has been made to rehabilitate of a patient at terminal stage having extensive maxillofacial defect with inoperable carcinoma, infections, and restricted mouth opening.
ABSTRACT
Objective:To evaluate speech outcomes following prosthetic obturation of maxillary defects.Methods:The speech intelligibility(SI)of 21 patients with maxillary defects with and without prostheses was measured postoperatively.In addition,the acoustic characteristics of vowels of 21 individuals were analyzed with and without an obturator in place by sound spectrograph.Results:Following the placement of maxillary obturator prostheses,there was significant improvement in SI.The mean SI score of the patients without and with the prosthesis was(23.2?7.4)% and(81.8?9.4)% respectively(P