Pre-Prosthetic surgical alterations in maxillectomy to enhance the prosthetic prognoses as part of rehabilitation of oral cancer patient

UNLABELLED After maxillectomy, prosthetic restoration of the resulting defect is an essential step because it signals the beginning of patient's rehabilitation. An obturator used to restore the defect should be comfortable, restore adequate speech, deglutition, and mastication, and is acceptable cosmetically, Success will depend on the size and location of the defect and the quantity and integrity of the remaining structures, in addition to pre-prosthetic surgical preparation of the defect sit. Preoperative cooperation between the surgeon oncologists and the maxillofacial surgeon may allow obturation of a resultant defect by preservation of the premaxilla or the tuberosity on the defect side and maintaining the alveolar bone adjacent to the defect of an abutment tooth. This study was carried out to evaluate the importance of Pre-prosthetic surgical alterations at the time of maxillectomy on the enhancement of the prosthetic prognoses as part of rehabilitation of the oral cancer patient. The present study was carried out on 66 cancer patient, 41 males 25 females ages ranging from 33 to 72 years, seeking treatment between 2003-2008 at The National Cancer Institute, Cairo university they underwent immediate prosthetic rehabilitation after maxillectomy surgery to remove the malignant tumor as apart of cancer treatment. Patients were divided into groups according to preprosthetic surgical preparation before prosthetic restoration. GROUP(A): Resection of maxilla followed by preprosthatic surgical preparation 24 cancer patients (13 males- 11 femals). GROUP(B): Resection of maxilla without any preprosthetic surgical preparation. 42 cancer patients (28 males and 14 females). Outcome variables measured included facial contour and aesthetic results, speech understandability, ability to eat solid foods, oronasal separation, socializing outside the home, and return-to-work status. Flap success and donor site morbidity were also studied. This study concluded that the cornerstone to improve the prosthetic restoration of the maxillary defect resulting maxillary resection as part of the treatment of maxillofacial tumor depend on the close cooperation between the prosthodontist and the surgeon, this can be achieved by combination of surgical and prosthetic technique which can be controlled by pre-prosthetic surgery during maxillect omy. KEY WORDS Maxillary re-construction- Pre-prosthetic surgery- Oral cancer.