The evaluation of the use of a delayed surgical obturator in dentate maxillectomy patients by considering days elapsed prior to commencement of postoperative oral feeding.
BACKGROUND
As a prosthodontic treatment for a maxillectomy patient in the initial postoperative period, immediate surgical obturators during surgery have been advocated to restore and maintain the patient's oral function to a reasonable level. However, these may fit poorly because they are fabricated using preoperative casts.


OBJECTIVE
The purpose of this study was to determine the comparative usefulness of a delayed surgical obturator.


METHODS
During the period from 2000 to 2004, 29 patients underwent prosthodontic treatment after maxillectomy. Twenty-three patients who were dentate postoperatively and were treated with polyvinyl acetal (Merocel) packing and a delayed surgical obturator were included in this study. Patients who were edentulous postoperatively, who were treated with an immediate surgical obturator or whose data were incomplete were excluded. The records of 23 patients were reviewed to determine the usefulness of using a delayed surgical obturator by counting days required to start postoperative oral feeding. The median of days elapsed prior to commencement of postoperative oral feeding was compared with data from a study by Lapointe et al (1996). In the Lapointe et al study, the median days elapsed prior to beginning a clear fluid diet was 2 in the group using immediate surgical obturators. The data were analyzed using the 1-sample Wilcoxon signed rank test (alpha=.05).


RESULTS
Days elapsed prior to commencement of postoperative oral feeding were less than those reported previously. Patients with Merocel packing began oral feeding, on average, 1.48 days after the maxillectomy. The median number of days elapsed prior to commencement of postoperative oral feeding was 1. This time was earlier than the 2 days for the Lapointe et al study (P=.0074). No major postoperative care complications occurred among the maxillectomy patients treated with a delayed surgical obturator.


CONCLUSIONS
Delayed surgical obturators were successful in terms of the postoperative care of dentate maxillectomy patients and did not increase patient discomfort during early rehabilitative management.
Park
Ki Tae
KT
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kwon
Ho Beom
HB
D000328:Adult; D000368:Aged; D004435:Eating; D005260:Female; D005557:Formaldehyde / Q000627:therapeutic use; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D012184:Retrograde Obturation / Q000379:methods*; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
D006490:Hemostatics; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D011142:Polyvinyl Alcohol