2020 Volume 24 Issue 3 Pages 273-280
Patients who undergo wide removal of palatal tumor sometimes show dysphagia and speech disorder due to velopharyngeal incompetence, decreasing their quality of life. We report two cases of dysphagia and speech disorder resulting from palate resection, improved by a palatal and velopharyngeal obturator designed using a light-cure type rebase material.
One case was a 65-year-old male who underwent wide removal of a palatal tumor and reconstruction with a forearm flap at another hospital. In the surgery, he had lost a large part of the palate and the forearm flap covered only about half of the original palate. The oral cavity communicated with the nasal cavity on a broad scale. He complained of taking a long time to eat meals and difficulty in speaking.
To create a palate shape and improve the velopharyngeal function, we made a denture with an obturator using a light-cure type rebase material. The denture enabled him to chew foods, make a bolus of food, and transport the bolus to the pharynx naturally.
With this denture, his mealtimes were shortened and difficulty in speaking was improved, as confirmed by a speech clarity test from 30% (without the denture) to 67% (with the denture).
The other case was a 67-year-old female who underwent removal of the right side of the tongue, fauces and palatal tumor. After the surgery, a nasopalatal fistula and scar contracture was seen in the soft palate and she complained of regurgitation of foods to the nasal cavity and indistinct speech.
We made a denture with an obturator to obturate the defect of the palate, create the palatal shape and improve the velopharyngeal function. The obturator was made of a light-cure type rebase material to fill the space that the velum after surgery and pharyngeal constrictor were unable to close for velopharyngeal closure. The denture improved the shape of the palate and velopharyngeal closure. With the denture, no regurgitation was confirmed by videofluorography and improvement of indistinct speech was confirmed by a speech clarity test from 47% (without the denture) to 91% (with the denture).
