Abdel Fattah Hisham, Zaghloul Ashraf
The Deparments of Oro-Dental & Maxillofacial , National Cancer Institute, Cairo University.
J Egypt Natl Canc Inst. 2010 Dec;22(4):251-63.
After maxillectomy, prosthetic restoration of the resulting defect is an essential step because it signals the beginning of patient's rehabilitation. An obturator used to restore the defect should be comfortable, restore adequate speech, deglutition, and mastication, and is acceptable cosmetically, Success will depend on the size and location of the defect and the quantity and integrity of the remaining structures, in addition to pre-prosthetic surgical preparation of the defect sit. Preoperative cooperation between the surgeon oncologists and the maxillofacial surgeon may allow obturation of a resultant defect by preservation of the premaxilla or the tuberosity on the defect side and maintaining the alveolar bone adjacent to the defect of an abutment tooth. This study was carried out to evaluate the importance of Pre-prosthetic surgical alterations at the time of maxillectomy on the enhancement of the prosthetic prognoses as part of rehabilitation of the oral cancer patient. The present study was carried out on 66 cancer patient, 41 males 25 females ages ranging from 33 to 72 years, seeking treatment between 2003-2008 at The National Cancer Institute, Cairo university they underwent immediate prosthetic rehabilitation after maxillectomy surgery to remove the malignant tumor as apart of cancer treatment. Patients were divided into groups according to preprosthetic surgical preparation before prosthetic restoration. GROUP(A): Resection of maxilla followed by preprosthatic surgical preparation 24 cancer patients (13 males- 11 femals). GROUP(B): Resection of maxilla without any preprosthetic surgical preparation. 42 cancer patients (28 males and 14 females). Outcome variables measured included facial contour and aesthetic results, speech understandability, ability to eat solid foods, oronasal separation, socializing outside the home, and return-to-work status. Flap success and donor site morbidity were also studied. This study concluded that the cornerstone to improve the prosthetic restoration of the maxillary defect resulting maxillary resection as part of the treatment of maxillofacial tumor depend on the close cooperation between the prosthodontist and the surgeon, this can be achieved by combination of surgical and prosthetic technique which can be controlled by pre-prosthetic surgery during maxillect omy.
Maxillary re-construction- Pre-prosthetic surgery- Oral cancer.
上颌骨切除术后，对所形成的缺损进行修复是至关重要的一步，因为这标志着患者康复的开始。用于修复缺损的阻塞器应佩戴舒适，能恢复正常的言语、吞咽和咀嚼功能，且外观可接受。修复的成功与否取决于缺损的大小和位置、剩余结构的数量和完整性，以及缺损部位的修复前外科准备情况。外科肿瘤学家与颌面外科医生术前的合作，可能通过保留前颌骨或缺损侧的结节，并维持邻接基牙缺损处的牙槽骨，来封闭所形成的缺损。本研究旨在评估上颌骨切除时的修复前外科改变对改善口腔癌患者康复过程中修复预后的重要性。本研究对66例癌症患者进行，其中男性41例，女性25例，年龄在33至72岁之间，于2003年至2008年期间在开罗大学国家癌症研究所寻求治疗，他们在接受上颌骨切除手术以切除恶性肿瘤（作为癌症治疗的一部分）后立即进行了修复康复。患者根据修复前的外科准备情况分为几组。A组：上颌骨切除后进行修复前外科准备，24例癌症患者（13例男性 - 11例女性）。B组：上颌骨切除后未进行任何修复前外科准备，42例癌症患者（28例男性和14例女性）。测量的结果变量包括面部轮廓和美学效果、言语清晰度、进食固体食物的能力、口鼻分隔、外出社交情况以及重返工作状态。还研究了皮瓣成功率和供区并发症。本研究得出结论，作为颌面肿瘤治疗一部分的上颌骨切除术后，改善上颌骨缺损修复效果的关键在于修复医生与外科医生之间的密切合作，这可以通过手术和修复技术的结合来实现，而这可以在进行上颌骨切除时通过修复前手术来控制。
上颌骨重建 - 修复前手术 - 口腔癌
