Nuovo approccio clinico sulla fonetica in pazienti oncologici con protesi otturatoria

OBJECTIVES The maxilla plays an important role during chewing, swallowing and phonation. About 13,000 new cases of head and neck cancer are discovered in Italy every year. Prosthetic rehabilitation in edentulous patients with defects caused by maxillectomy is often difficult due to the absence of natural teeth, necessary to retain and support a post-operative obturator prosthesis. The main problems of an obturator prosthesis are weight, phonetics and retention. MATERIALS AND METHODS The definitive obturator prosthesis of a patient undergoing hemi-maxillectomy for squamous cell carcinoma was modified. The prosthesis was emptied to allow weight reduction and to improve phonetics by exploiting the principle of sound transmission of the tuning fork in a rigid body, subsequently with the use of the plaster model, acrylic resin and silicone the wall maintaining the sound box. RESULTS AND CONCLUSIONS The result of this procedure showed how the patient immediately wearing the prosthesis spoke well without having a nasal voice; the follow-up at 6 and at 12 months confirmed the patient’s satisfaction in being able to face a lifetime of normal relationship. CLINICAL SIGNIFICANCE The proposed treatment represents a valid solution to significantly improve the psychological behavioral aspects of hemi-maxillectomized cancer patients. Both traditional and digital prosthetic rehabilitation, maintaining all the advantages of the construction of a prosthesis, can undergo changes over time but only the traditional prosthesis can allow the adaptation of the sound in the chair. However, the precision of this type of work depends on each case and varies according to the complexity of the maxillectomy.