Transsurgical Palatal Obturator for Maxillectomy Patients: A Preliminary Study of Swallowing and Oropharyngeal Geometry.

INTRODUCTION

Resection of malignancy through maxillectomy and subsequent maxillofacial prosthetics provides adequate swallowing function and rehabilitation. The aim of this study was to verify whether there is association between changes in swallowing and the oropharyngeal geometry in maxillectomy patients with and without using transsurgical palatal obturators (TPO).

METHODS

The study includes 7 maxillectomy patients, TPO users who underwent complementary radiotherapy. Outcome variables were investigated by acoustic pharyngometry (APh) and fiberoptic endoscopic evaluation of swallowing (FEES) to assess the oropharyngeal geometry and swallowing, respectively with and without TPO. Sociodemographic and clinical characteristics (postoperative radiotherapy, type of surgery, type of obturator, time elapsed between adaptation and the swallowing test) were evaluated. To compare with and without TPO conditions, Mann-Whitney test and Spearman's correlation coefficient were used.

RESULTS

Swallowing variables: early escape and nasopharyngeal reflux showed better results with TPO (p = 0.021 and p = 0.029, respectively) compared to swallowing without TPO. The oropharyngeal geometry was not statistically associated with swallowing changes.

CONCLUSION

Oropharyngeal measures by APh compared to the swallowing evaluation by FEES showed a correlation between early escape and longer length of the vocal tract in individuals with TPO. Swallowing in maxillectomy patients showed significant improvement with the use of transsurgical palatal obturator, related to the lack of early escape and absence of nasopharyngeal reflux.