Case report: Individual self-retaining palate-obturator epithesis to restore the palate after tumour resection

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

Publication History

Article published online:
10 June 2020