Management of acquired maxillary and hard palate defects
- Daniel Buchbinder, DMD, MD
Daniel Buchbinder, DMD, MD
- Professor and Chief Maxillofacial Surgery, Dept. of Otolaryngology Head and Neck Surgery
- Icahn School of Medicine at Mount Sinai, New York, NY
- Devin J Okay, DDS
Devin J Okay, DDS
- Division of Prosthodontics
- Mount Sinai Beth Israel
- Section Editors
- Bruce E Brockstein, MD
Bruce E Brockstein, MD
- Section Editor — Cancer of the Head and Neck
- Clinical Associate Professor of Medicine
- University of Chicago Pritzker School of Medicine
- Marvin P Fried, MD, FACS
Marvin P Fried, MD, FACS
- Section Editor — Head and Neck Surgery
- Professor and University Chairman, Department of Otorhinolaryngology - Head and Neck Surgery
- Montefiore Medical Center, Albert Einstein College of Medicine
Head and neck cancer and its treatment can cause significant difficulties in orofacial function and thus impair quality of life. When surgery results in a maxillary defect, morbidity can be due to nasal regurgitation (food, liquid, and sound) through the defect, loss of teeth and the inability to chew properly, malnutrition, impaired speech, and distortion of the facial appearance. Severe psychological issues can be a secondary consequence of these complications.
The approach to managing maxillary defects, including both the use of a prosthesis (obturator) and surgical reconstructive techniques, will be reviewed here. The management of soft palate and mandibular defects is discussed separately. (See "Mandibular and palatal reconstruction in patients with head and neck cancer".)
GOALS OF TREATMENT
The goal of treatment is to restore function (mastication, swallowing, speech) and a normal appearance to the face. This may be accomplished either through artificial closure of the defect using an obturator prosthesis or through surgical reconstruction of the defect.
To do this requires:
●Closure of the defect between the oral and nasal/sinus cavities
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