Rehabilitation of Surgically Resected Soft Palate with Interim Velopharyngeal Obturator

Rehabilitation of surgical resection defects is always a challenging clinical scenario. These defects pose a major physiological and psychological threat not only to the patients, but to the entire family. A multidisciplinary team approach, thorough investigation, long term follow up, proper counselling and sympathetic attitude may help to bring these suffering patients back to normal life stream. Recent advancements in Dental Materials, CAD CAM, Laser Technology and Ossseo integrated Implants have revolutionized the treatment outcomes. However in certain clinical case scenarios, conventional prosthodontic principles and routinely available materials are still the gold standards. This case report presents the prosthodontic rehabilitation of soft palate after surgical resection due to adenoid cystic cell carcinoma. either can be a metal framework or all plastic (acrylic) prosthesis [9]. In each case the patient will require some functional adjustments to the prosthesis as this is an area that moves every time the patient speaks or swallows. Adjustment of these prostheses is a fine balance between swallowing and speaking. If the valve is closed too tightly then swallowing is very good but speaking will sound as if the patient has a cold or stuffy nose (hypo nasality). If the valve is left more open then speech will sound better but food/liquid leakage when swallowing may be increased. In addition, healing from surgery or radiation treatment will alter this area and require frequent adjustments until all healing is completed [9]. These obturators can have mobile distal extensions or bulbs with a flexibility to have synchronized movements during functional opening and closure of the adjacent soft tissues around a customized hinged joint. However, fixed or stable distal extensions with balanced functional adjustments are more recommended as these are less complicated, easily fabricated and adequately functional for successful outcomes. Caring for the prosthesis is relatively easy. Simply brushing the prosthesis or rinsing with soap and water when cleaning the teeth is adequate. Effervescent partial denture cleaning tablets can be used as well when the prosthesis is soaking while the patient is sleeping. These prostheses aid in improving a complex muscular valve dysfunction. With patience and time these prosthetic devices can be fine-tuned to be very functional and comfortable [9].