The definitive obturator prosthesis, usually fabricated 4 to 6 months after all cancer therapy is completed, should extend maximally along the lateral wall of the defect.25 The higher the lateral extension of the bulb, the greater is the increase in lateral stability of the prosthesis.26 When the definitive obturator prosthesis is completed, speech and swallowing are restored to normal limits (Figures 20-8 and 20-9). The patient is
Figure 20-7. A, Preoperative squamous cell carcinoma—posterior alveolar ridge. B, Surgical obturator ligated to non-resected alveolus and palate with 24-gauge stainless steel wires.C, Immediate postoperative partial maxillectomy defect.
recalled periodically for adjustments and examination for recurrent disease by the multidisciplinary surgical team. Home-care instructions and cleaning (irrigation) of the defect area are essential.
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