Three-dimensional printed definitive cast for a silicone obturator prosthesis: A clinical report.

For patients with head and neck cancer requiring a maxillectomy, obturator prostheses help with quality of life. These patients routinely require adjuvant oncologic treatments with significant adverse effects. Treatment sequelae can leave patients with difficulty speaking and swallowing, reduced salivary function, reduction in maximal incisal opening, and at risk of osteoradionecrosis. A 55-year-old African-American woman presented with significant trismus and reduction in maximal incisal opening after treatment for squamous cell carcinoma of the left maxillary sinus. She had received a left total maxillectomy with adjuvant chemotherapy and radiation treatments. With her reduced opening, she was no longer able to insert her interim obturator prosthesis, which caused difficulty speaking and nasal regurgitation. A cone beam computed tomography scan was made of the patient's maxillectomy defect. From the Digital Imaging and Communications in Medicine file, a definitive cast was 3-dimensionally printed to fabricate a flexible silicone obturator prosthesis. This treatment has allowed the patient to return to a functional quality of life and could help other patients in similar situations.

The Role of Maxillofacial Prosthetics for the Surgically Treated Patient at National Cancer Institute-Designated Comprehensive Cancer Centers.

OBJECTIVES/HYPOTHESIS: The current role of maxillofacial prosthetic care for head and neck cancer patients is not well understood. Additionally, perceived barriers for service provision are unknown. The purpose of this study was to evaluate the current role of maxillofacial prosthetic care at National Cancer Institute (NCI)-designated comprehensive cancer centers and to identify perceived barriers to care. STUDY DESIGN: Multicenter, cross-sectional survey of head and neck division leaders at NCI-designated comprehensive cancer centers. METHODS: Each head and neck division leader from the 47 NCI-designated comprehensive cancer centers was invited to participate. The main outcomes of this study were: 1) to evaluate the current role of maxillofacial prosthetics for the surgically treated head and neck cancer patient within NCI-designated comprehensive cancer centers and 2) to identify perceived barriers to care. Measured outcomes were obtained from an anonymous online survey and reported. RESULTS: Twenty-eight of the 47 head and neck service chiefs responded (60% response rate). Respondents expressed preference for prosthetic rehabilitation for hard palate/upper gum, auricular, and nasal defects. Local flap or free tissue transfer was preferred for lower gum and soft palate defects. Cost-related factors were among the most reported perceived barriers to maxillofacial prosthetic care. CONCLUSIONS: Maxillofacial prosthetics have an important role in the rehabilitation of the head and neck cancer patient. Perceived barriers for services exist, particularly as it relates to cost. Providers should be aware that these issues are likely to be more severe in regional or community centers. LEVEL OF EVIDENCE: NA Laryngoscope, 129:409-414, 2019.