Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제33권2호
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  • Pages.143-151
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  • 2007
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  • 2234-7550(pISSN)
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  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지

상악절제술 후 외과적 재건과 보철적 치료의 비교

ANALYSIS OF PROSTHODONTIC AND SURGICAL TREATMENT OF ACQUIRED PALATAL DEFECT AFTER MAXILLECTOMY

  • 권호범 (성균관대학교 의과대학 삼성서울병원 보철과) ;
  • 홍종락 (성균관대학교 의과대학 삼성서울병원 구강악안면외과)
  • Kwon, Ho-Beom (Departments of Prosthodontics Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Hong, Jong-Rak (Departments of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 발행 : 2007.04.30
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초록

One of the treatment methods for maxillary cancers or infections in maxilla is maxillectomy. Palatal defect can be resulted from this operation and it may cause functional problems with swallowing and speech, and psychological problems of patients. After maxillectomy, as rehabilitation, there can be two options. One is a prosthodontic treatment using obturator and the other is surgical reconstruction of defect with graft. As both methods have advantages and disadvantages, in determining treatment method after maxillectomy, various factors have to be considered. The purpose of this study is to compare the prosthodontic group to surgical group after maxillectomy with elapsed days prior to commencement of postoperative oral feeding, and to analyze the results of prosthodontic treatment and surgical treatment. During the period from March of 2000 to June of 2006, 74 patients were treatment by prosthodontic methods for maxillary defect. Among these patients, patients who had only velopharyngeal deficiency after surgery, whose data were incomplete, whose causes of palatal defect were not the treatment of diseases in maxilla, and who already had palatal defect due to previous surgery were excluded in this study. The patients who underwent maxillectomy for the treatment of diseases in the maxilla and were treated immediately after operation using surgical reconstruction or prosthodontic rehabilitation were included in this study. The records of 43 patients were reviewed to compare and to analyze the prosthodontic treatment and surgical reconstruction after maxillectomy. The median of days elapsed prior to commencement of postoperative oral feeding in the prosthodontic group was compared with data of surgical group. The data was analyzed using the Mann-Whitney test (${\alpha}$=.05). Days elapsed prior to postoperative oral feeding commencement in the prosthodontic group were less than those in the surgical group.

키워드

참고문헌

  1. Lang BR, Bruce RA: Presurgical maxillectomy prosthesis. J Prosthet Dent 1967;17:613-619 https://doi.org/10.1016/0022-3913(67)90133-3
  2. Desjardins RP: Early rehabilitative management of the maxillectomy patient. J Prosthet Dent 1977;38:311-318 https://doi.org/10.1016/0022-3913(77)90308-0
  3. Serafin D, Riefkohl R, Thomas I, Georgiade NG: Vascularised ribperiosteal and osteocutaneous reconstruction of the maxilla and mandible: an assessment. Plast Reconstr Surg 1980;66:718-727 https://doi.org/10.1097/00006534-198011000-00007
  4. Swartz WM, Banis JC, Newton ED, Ramasastry SS, Jones NF, Acland R: The osteocutaneous scapula flap for mandibular and maxillary reconstruction. Plast Reconstr Surg 1986;77:530-545 https://doi.org/10.1097/00006534-198604000-00003
  5. Psillakis JM, Grotting JC, Casanova R, Cavalcante D, Vasconez LO: Vascularised outer-table calvarial bone flaps. Plast Reconstr Surg 1986;78:309-317 https://doi.org/10.1097/00006534-198609000-00005
  6. Phillips JG, Peckitt NS: Reconstruction of the palate using bilateral temporalis muscle flaps: a case report. Br J Oral Maxillofac Surg 1988;26:322-325 https://doi.org/10.1016/0266-4356(88)90051-4
  7. Vuillemin T, Raveh J, Ramon Y: Reconstruction of the maxilla with bone grafts supported by the buccal fat pad. J Oral Maxillofac Surg 1988;46:100-106 https://doi.org/10.1016/0278-2391(88)90258-3
  8. Shestak KC, Schusterman MA, Jones NF, Janecska IP, Sekhar LN, Johnson JT: Immediate microvascular reconstruction of combined palatal and midfacial defects. Am J Surg 1988;156:252-255 https://doi.org/10.1016/S0002-9610(88)80285-X
  9. Ewers R: Reconstruction of the maxilla with a double musculoperiosteal flap in connection with a composite calvarial bone graft. Plast Reconstr Surg 1988;81:431-436 https://doi.org/10.1097/00006534-198803000-00021
  10. Earley MJ: Primary maxillary reconstruction after cancer excision. Br J Plast Surg 1989;42:628-637 https://doi.org/10.1016/0007-1226(89)90073-8
  11. Zarb GA: The maxillary resection and its prosthetic replacement. J Prosthet Dent 1967;18:268-281 https://doi.org/10.1016/0022-3913(67)90193-X
  12. Desjardins RP: Obturator prosthesis design for acquired maxillary defects. J Prosthet Dent 1978;39:424-435 https://doi.org/10.1016/S0022-3913(78)80161-9
  13. Beumer J, Curtis TA: Maxillofacial Rehabilitation, Prosthodontic and Surgical Considerations. St. Louis-Tokyo, Ishiyaku EuroAmerica, Inc.,. 1996
  14. Huryn JM, Piro JD: The maxillary immediate surgical obturator prosthesis. J Prosthet Dent 1989;61:343-347 https://doi.org/10.1016/0022-3913(89)90142-X
  15. Ali A, Fardy MJ, Patton DW: Maxillectomy--to reconstruct or obturate? Results of a UK survey of oral and maxillofacial surgeons. Br J Oral Maxillofac Surg 1995;33:207-210 https://doi.org/10.1016/0266-4356(95)90001-2
  16. Brown KE: Peripheral consideration in improving obturator retention. J Prosthet Dent. 1968;20:176-181 https://doi.org/10.1016/0022-3913(68)90143-1
  17. Aramany MA. Basic principles of obturator design for partially edentulous patients. Part I: Classification. J Prosthet Dent 1978;40:554- 557 https://doi.org/10.1016/0022-3913(78)90092-6
  18. Lapointe HJ, Lampe HB, Taylor SM: Comparison of maxillectomy patients with immediate versus delayed obturator prosthesis placement. J Otolaryngol 1996;25:308-312
  19. Birnbach S: Immediate surgical sectional stent prosthesis for maxillary resection. J Prosthet Dent 1978;39:447-450 https://doi.org/10.1016/S0022-3913(78)80165-6
  20. Jacob RF, Martin JW, King GE: Modification of surgical obturators to interim prostheses. J Prosthet Dent 1985;54:93-95 https://doi.org/10.1016/S0022-3913(85)80078-0
  21. Stark BS: Transitional prosthesis for dentulous hemimaxillectomy patients. J Prosthet Dent 1972;27:73-75.21 https://doi.org/10.1016/0022-3913(72)90175-8
  22. Ampil JP, Ellinger CW, Rahn AO: A temporary prosthesis for an edentulous patient following a maxillary resection. J Prosthet Dent 1967;17:88-91 https://doi.org/10.1016/0022-3913(67)90057-1
  23. Shifman A: A technique for the fabrication of the open obturator. J Prosthet Dent 1983;50:384-385 https://doi.org/10.1016/S0022-3913(83)80098-5
  24. Chevillard C, Rugina M, Bonfils P, Bougara A, Castillo L, Crampette L, et al.: Evaluation of calcium alginate nasal packing (Algosteril) versus Polyvinyl acetal (Merocel) for nasal packing after inferior turbinate resection. Rhinology 2006;44:58-61