Palatomaxillary Obturation and Facial Prosthetics in Head and Neck Reconstruction

Abstract

Rehabilitation of head and neck defects following trauma, oncologic resection, or congenital malformation is a challenging task. Not only is the restoration of three-dimensional form necessary for acceptable cosmesis, but simultaneous restoration of functional speech and swallow is also essential for optimal reconstruction outcomes. While advances in free tissue transfer have allowed surgical reconstruction of head and neck defects once considered inoperable and associated with poor quality of life, not all patients are ideal surgical candidates. As such, nonsurgical solutions to both functional and cosmetic restoration remain a necessary alternative option. Facial prostheses and palatomaxillary obturators have evolved with increasingly biocompatible materials as well as retention systems to address significant defects that challenge the limits of surgical reconstruction.

Vascularized Composite Allograft Versus Prosthetic for Reconstruction After Facial and Hand Trauma

“…Nasal, orbital, auricular, and upper lip prostheses have been shown to provide adequate cosmetic and functional results for patients 88,89 . A study that compared pretreatment and posttreatment quality of life for 82 patients with facial prostheses found that implant-retained prostheses were associated with significantly increased patient quality of life 90 .…”

“…87 Functional Outcomes -Face Nasal, orbital, auricular, and upper lip prostheses have been shown to provide adequate cosmetic and functional results for patients. 88,89 A study that compared pretreatment and posttreatment quality of life for 82 patients with facial prostheses found that implant-retained prostheses were associated with significantly increased patient quality of life. 90 A recent Dutch study looking at the long-term (14 years) quality of life for patients with facial prostheses showed high satisfaction scores with regard to comfort, color, and anatomic fit and form.…”

A statistical shape model for estimating missing soft tissues of the face in a black South African population

“…The surgical reconstruction of ear 14 and nose 15 defects also presents unique challenges. Successfully addressing defects of these features by accurately replicating their intricate three‐dimensional geometry requires complex surgical techniques and the availability of appropriate donor tissues 16,17 …”

“…Successfully addressing defects of these features by accurately replicating their intricate three-dimensional geometry requires complex surgical techniques and the availability of appropriate donor tissues. 16,17 Over the past two decades, facial transplantation has emerged as an effective treatment for patients burdened with extensive facial disfigurement, particularly when autologous strategies fail to restore optimal facial form and function. This approach, however, is still not widely performed and has stringent criteria to be met before consideration.…”