Palatal obturator in an edentulous patient with soft palate defect from tonsillar cancer
Prof. Myung-Joo Kim, Prof. Jai-Young Koak, Prof. Young-Jun Lim, Prof. Ho-Beom Kwon, Prof. In-Sung Yeo
Seoul National University
Objectives
Velopharyngeal insufficiency is an anatomical defect and has inability to separate nasal and oral cavity from defects in soft palate and velopharyngeal nervous/muscular systems. The ultimate purposes of this type of obturator are to provide patients the ability to control excretion through nasal cavity and to restore phonetic problems through air leakage during speech.
Materials and Methods
In this clinical case, the patient is 76-year-old male with a history of surgery in 2015 due to lymphatic cancer and 37 chemotherapies. The patient visited our department for fabrication of maxillary and mandibular dentures and complained of nasal regurgitation during swallowing and nasal emission during vocation.
Results
Sequentially, the mandibular and maxillary temporary dentures were fabricated, the later with soft palate obstructing component in the posterior area.
With the temporary dentures, the patient showed reduced nasality based on the nasometry test(without prosthesis;55, with prosthesis;31), then final prostheses were fabricated. Impression taking was done in closed technique using the temporary dentures and the obturator portion was compromised based on the temporary pros-thesis. After final delivery, the patient showed further decrease in nasality and a complete closure of velopharyngeal area was observed through the nasal endoscopy.
Conclusions
It is therefore presented in this particular case that the use of palatal obturator showed remarkable pronunciation and mastication improvements in patient with palatal defect from tonsillar cancer.