Introduction Large defects of the hard and soft palate, e.g. after radical tumour resection, lead
to complaints concerning the articulation and the swallowing. If a surgical closure
by flap techniques is not possible, epitheses can be used to reconstruct such defects.
Tooth-fixed obturator prostheses made of plastic +/- metal are commonly used, but
they are difficult to fix and insert for far dorsally located defects.
Casuistry We report a case in which an individual self-retaining silicone palate-obturator
epithesis was successful.
A 64-year-old female patient presented with a large posterior defect of the palate
after radical tumour resection because of SCC after a long period of suffering. She
had multiple frustrating obturator adaptations with severe pain and sepsis caused
by flap necrosis. Also, she suffered from swallowing difficulties, nasal speech and
tubal ventilation disorders.
An epithesis was adapted, which was hollow inside, flexible and formed the nasopharynx
through a channel. The epithesis was self-retainingly anchored by tongue-like components
in the recessus pharyngeus and on the nasal floor as well as support on the rear wall
of the pharynx. The epithesis was inserted under inpatient conditions due to the risk
of dislocation with aspiration. There was no dislocation at any time in the course
of the study.
Conclusion During swallowing the epithesis showed a sufficient closure of the nasopharynx. The
articulation was significantly improved. Thus, the above mentioned epitheses are an
option to close pronounced defects of the palate if this is not surgically possible.
Poster-PDF
A-1836.PDF
