恶性肿瘤术后上颌骨单侧缺损的赝复体修复

Prostheses for unilateral maxillary defects after malignant tumor surgery

目的:探讨赝复体修复在恶性肿瘤术后上颌骨单侧缺损患者口腔功能重建中的效果。方法:47例因恶性肿瘤行上颌骨单侧切除病例,于术后3周-4月进行中空式硬质树脂阻塞器赝复体修复,采用患者主观评价、洼田饮水试验、语音清晰度评判,以评价患者口腔功能重建效果,并随访6个月至2年。结果:佩戴赝复体后,患者自觉义齿的固位和稳定性良好、咀嚼功能改善、进食时无或仅有极少量鼻腔漏水、发音清晰、鼻音明显减轻;47例患者赝复体使用前后洼田饮水试验中,42例从Ⅳ级或Ⅴ级改善至Ⅰ级或Ⅱ级,差异具有统计学意义(P<0.001);佩戴赝复体前后语音清晰度分别为(44.5±14.2)%和(85.2±7.8)%,差异有统计学意义(P<0.05);赝复体的固位和稳定性良好,有效率91.5%。结论:赝复体可有效重建恶性肿瘤术后上颌骨单侧缺损患者的咀嚼、口咽封闭和语音功能,有利于提高患者术后生活质量和心理健康,是一种经济、有效、可行的修复重建方法。

Objective： To investigate the reconstructive effects of prostheses for unilateral maxillary defects resulting from malignant tumor surgery. Methods： 47 patients with unilateral maxillary defects were selected and restored with hollow obturator prostheses, 3 weeks to 4 months after procedure. Patients were evaluated with subjective assessment, water swallow test, and speech intelligibility score. Patients were followed up for half a year to 2 years. Results： After wearing of prosthesis, patients＇ masticatory efficiency, oropharyngeal closure, and better speech were significantly improved; Water swallow test indicated that 42 patients showed improved oropharyngeal closure （P〈0.001）; Significant difference （P〈0.05） was indicated between mean speech intelligibility score with and without prostheses （85.2± 7.8）% and （44.5± 14.2）%; The rate of good prosthetic retention and stability was 91.5%. Conclusion： Prosthetic restoration could restore mastication, oropharyngeal closure ftmctions and speech intelligibility of the patients with unilateral maxillary defects resulting from ma- lignant tumor surgery. It is an economical, effective and feasible way to improve quality of life and mental health after tumor resection.