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The journal «ONCOSURGERY» 2013, Vol.5, No 4

Current tactics for multimodality rehabilitation in patients with acquired maxillary defects

Malginov NN1, Reshetov IV2, Korzhov IS1

1) Moscow State Medical and Stomatological University, Department of dental orthopedics of ecto- and endoprosthesis on Faculty of post-graduate education,
2) PA Herzen Moscow Cancer Research Institute,
Moscow, Russia
Contact: Korzhov IS, e-mail:

Current approaches for rehabilitation of patients with acquired maxillar defects are represented in the article.

Material and methods: we analyzed 50 literary sources, 25 of them belong to Russian authors , the rest 25 were foreign. The earliest one was dated by 1946, the latest – 2013.

Results: rehabilitation of patients with acquired maxillary defects is the topical issue in medicine. It is illustrated by constantly increasing incidence rate of this pathology of different genesis among world population. For etiology cancer disease are at the first place – near 610 thousands per 2.7 billion of total number of cancer patients. Malignant tumors of middle face account for 2-6% of all human cancer. Of them the incidence of maxillary malignant tumors is – 28%, benign tumors – 7.69%, tumor-like lesions – 1%, inflammatory disease – 1%. According to cancer, midface defects are caused by injuries of different origin: civilian trauma accounts for 70.1% of cases, fall from a height – 19.4%. The majority are men (72.3%), 74.8% of them are of working age from 20 to 50 years old. Additionally, the rate of inherited maxillary and facial pathology interrupting maxillary continuity may increase. A lot of classifications of defects are specific and do not meet requirements of current medicine.

Additionally the single protocol for patient management is absent although studies are ongoing. In fact subdivisions of Health Care performing surgical care and subdivisions for following rehabilitation are isolated from each other. Recently this situation changes for the collaboration of specialized medical institutions dealing with targeted rehabilitation of patients with acquired maxillary defects of different origin.

Conclusion: nowadays multimodality and continuity treatment of patients with this pathology is extremely rare despite explosive development of medical sciences. As such, multidisciplinary collaboration is the possible way for creation of single organized protocol for management of patients with acquired maxillary defects.

KEY WORDS: acquired maxillary defect, postresection prosthesis, obturator, multimodality rehabilitation, resection of maxilla.

References

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  9. Churkin AYu. New aspects of fabrication and application of immediate prosthesis for repair of defects after maxillary resection. Systemnyi analiz I upravleniye v biomedicinskikh sistemakh, 2010; 9: 1: 77-82.
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  39. Karunagaran S, Markose SC, Paprocki GJ. Management of the maxillary cancer patient – what the general dentist should know. J Tennessee Dental Association, 2013; 1(93): 40-6.
  40. Patil PG, Patil SP. Fabrication of a hollow obturator as a single unit for management of bilateral subtotal maxillectomy. J Prosthodont, 2012; 21(3): 194-9.
  41. Elangovan S, Loibi E. Two-piece hollow bulb obturator. Indian J Dent Res, 2011; 22: 486-8.
  42. Pravinkumar Gajanan, Smita Pravinkumar. A hollow definitive obturator fabrication technique for management of partial maxillectomy. J Adv Prosthodont, 2012; 4: 248-53.
  43. Zhulev EN, Arutyunov SD, Lebedenko IYu. Maxillo-facial orthopedical dentistry: Textbook for doctors. М.: LLC «Medicinskoe informacionnoe agentstvo». 2008. 160.
  44. Saurav Banerjee, Surender Kumar, Amit Bera, et all. Magnet retained intraoral-extra oral combination prosthesis: a case report. J Adv Prosthodont, 2012; 4: 235-8.
  45. Brusov AB, Orlovskiy IP. Ectoprsthesis for defects and deformations of midfacial region using silicone elastomers. Stomatologiya, 2010; 3: 52-56.
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  51. Yusupova ZKh. Multimodality rehabilitation of patients with postoperative maxillary defects of tumor and other origins: PhD dissertation. Dushanbe, 2005; 147.
  52. References Galonskiy VG, Radkevich AA, Kazantseva TV. Immediate orthopedics efforts after resection of maxilla. Siberian medical journal, 2009; 4: 59-62.
  53. Yusupova ZKh. Multimodality rehabilitation of patients with postoperative maxillary defects of tumor and other origins: PhD dissertation. Dushanbe, 2005, 147.
  54. J Ferlay, E Steliarova-Foucher, J Lortet-Tieulent, et all. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer 49. Europe, 2013; 1374-1403.
  55. Andryukhina VV, Nikitin AA, Stuchilov VA, et all. Cryosurgical, cryolaser and surgical treatment for basal cell carcinoma of maxilla-facial region and neck. Materials of first congress of Head and Neck Tumor Specialists Society, 2012; 8-9.
  56. Malignant neoplasms in Russia in 2011 (incidence and mortality): Textbook. Edited by VI Chissov, VV Starinskiy, GV Petrova. М.: FGBU «MNIOI im PA Herzena» Minzdrava Rossii, 2013; 289.
  57. Christoforando DYu. Analysis of incidence, diagnostics and treatment of combined cranio-facial injury. Meditsinskiy vestnik Severnoguo Kavkaza, 2011; 3: 36-37.
  58. Fomenko IV, Filimonova EV, Dmitrienko, et all. Epidemiological characteristics of inherited facial cleft at Volgograd and Volgograd region. Stomatologiya detskogo vozrasta i profilaktika, 2009; 1: 20-24.
  59. Pogosyan IA, Blokhina SI, Menzorova NV, et al. Specifics of multimodality rehabilitation of children with inherited orthopedical pathology in multidisciplinary specialized medical clinic. Systemnaya integratsia v zdravookhranenii, 2011; 2: 26-31.
  60. Churkin AYu. New aspects of fabrication and application of immediate prosthesis for repair of defects after maxillary resection. Systemnyi analiz I upravleniye v biomedicinskikh sistemakh, 2010; 9: 1: 77-82.
  61. EN Zhulev, SD Arutyunov, IYu Lebedenko. Maxillo-facial orthopedical stomatology dentistry: Textbook for doctors. М.: LLC «Medicinskoe informacionnoe agentstvo», 2008; 160.
  62. Arutyunov AS, Kitsul IS, Komov EV, et all. Experimental assessment of organization for orthopedical care for patients with maxilla-facial defects in the current context. Russian stomatological journal, 2009; 2: 43-47.
  63. Vaibhao I. Shambharkar, Santosh B. Puri, Pravinkumar G. Patil. A simple technique to fabricate a surgical obturator restoring the defect in original anatomical form. J Adv Prosthodont, 2011; 3: 106-109.
  64. Maranzano M, Freschi G, Atzei A, et all. Use of vascularized iliac crest with internal oblique muscle flap for mandible reconstraction. Inc. Microsurgery, 2005; 25: 299-304.
  65. Rodman R. Tumors of the Hard Palate and Upper Alveolar Ridge. Tumors of the Hard Palate and Upper Alveolar Ridge. Texas, 2011; 1-10.
  66. Earley MJ. Primary maxillary reconstruction after cancer excision. J Plast Surg. Chepstow, 1989; 628-637.
  67. Baryshev VV, Andreev VG, Akki AD. Possibilities of orbital reconstruction in cancer patients (literature review). Siberian oncological journal, 2012; 5: 80-84.
  68. Korsak AK, Lubetskiy AV, Lapkovskiy VI. Surgical treatment in children with inherited clefts of superior lip and palate in early childhood. Sovremennaya stomatologiya, 2007; 4: 40-43.
  69. Slepchenko MA. Orthopedical methods for repair of maxillary defects after resection: Author’s abstract for Phd dissertation. L.: 1974; 19.
  70. Smirnov EV, Lesnykh NI, Donov AN, et all. Rational prosthesis of maxillary defects after resection. Sovremennaya orthopedicheskaya stomatologiya, 2011; 15: 44-49.
  71. Iordanishvili AK. Clinical orthopedical dentistry. М.: MEDpress-inform, 2007; 248.
  72. Lebedenko IYu, Kurlyandskaya SV, Belolopatkova AV, et all. Life of outstanding people: Kurlyandskiy. М.: Mol. gvardiya, 2002; 207.
  73. Devin J. Okay, Eric Genden, Daniel Buchbinder, et all. Prosthodontic guidelines for surgical reconstruction of the maxilla:A classification system of defects. The journal of prosthetic dentistry, 2001; 86: 4: 352-363.
  74. Giulio Cantu, Carlo L. Solero, Stefano Riccio. Surgery for Malignant Maxillary Tumors Involving the Middle Cranial Fossa. Skull Base, 2010; 20: 2: 55-60.
  75. Mohamed A. Aramany Basic principles of obturator design for partially edentulous patients. Part I: Classification. The journal of prosthetic dentistry, 2001; 86: 6: 559-561.
  76. Mohamed A. Aramany Basic principles of obturator design for partially edentulous patients. Part II: Classification. The journal of prosthetic dentistry, 2001; 86: 6: 562-568.
  77. Karayan AS, Nazaryan DN, Senyuk AN. Specifics of maxillary reconstruction for preparing for fixed prosthesis. Stomatologiya, 2011; 5: 27-35.
  78. Steven P. Davison, David A. Sherris, N. Bradly Meland An Algorithm for Maxillectomy Defect Reconstruction. The Laryngoscope. Philadelphia, 1998; 108: 2: 215-219.
  79. Brown JS, Shaw RJ. Reconstruction of the maxilla and midface: introducing a new classification. Lancet Oncol. Liverpool, 2010; 11: 10: 1001-1008.
  80. James S. Brown Maxillary reconstruction. Indian J Plast Surg. Liverpool, 2007; 40: 35-43.
  81. Oncology: textbook. edited by SB Peterson. М.: GEOTAR Media, 2012; 256.
  82. David J. Adelstein, John A. Ridge, David M. Brizel, et all. Transoral resection of pharyngeal cancer: Summary of a National Cancer Institute Head and Neck Cancer Steering Committee Clinical Trials Planning Meeting, November 6-7, 2011, Arlington, Virginia. Head & Neck, 2012; 34: 12: 1681-1703.
  83. Stefan Danilla. Selected Topics in Plastic Reconstructive Surgery. 2012; 242.
  84. Ross GL, Ang S W EE, Lannon D, et all. A ten-year experience of multiple flaps in head and neck surgery: how successful are they. J Reconstr Microsurg, 2008; 3: 24: 183-187.
  85. Karle WE, Anand SM, Clain JB, et all. Total soft palate reconstruction using the palatal island and lateral pharyngeal wall flaps. The Laryngoscope, 2013; 123: 929-933.
  86. Ross GL, Ang ES, Lannon D, et all. Ten-year experience of free flaps in head and neck surgery. How necessary is a second venous anastomosis . Head Neck, 2008; 8: 30: 1086-1089.
  87. Imke C Wehage, Hisham Fansa. Complex reconstructions in head and neck cancer surgery: decision making. Head & Neck Oncology, 2011; 14: 3: 1-12.
  88. Guideline for orthopedical dentistry, prosthesis for totally edentulous patients. edited by IYu Lebedenko, AS Kalivradgiyan, TI Ibragimov et al. М.: Med inf agentstvo, 2011; 448.
  89. Anuj Chhabra, G N Anandakrishna, Girish Rao, et all. Rehabilitation of Partial Maxillectomy Defect with Implant Retained Hollow Bulb Obturator Prosthesis: A Case Report. J Indian Prosthodont Soc, 2012; 2: 12: 101-107.
  90. Sanjay Karunagaran, Sony C Markose, Gregory J Paprocki. Management of the Maxillary Cancer Patien – What the General Dentist Should Know. Journal of the Tennessee Dental Association, 2013; 1: 93: 40-46.
  91. Patil PG, Patil SP. Fabrication of a hollow obturator as a single unit for management of bilateral subtotal maxillectomy. J Prosthodont, 2012; 21: 3: 194-199.
  92. Elangovan S, Loibi E. Two-piece hollow bulb obturator. Indian J Dent Res, 2011; 22: 486-488.
  93. Pravinkumar Gajanan, Smita Pravinkumar. A hollow definitive obturator fabrication technique for management of partial maxillectomy. J Adv Prosthodont, 2012; 4: 248-253.
  94. Zhulev EN, Arutyunov SD, Lebedenko IYu. Maxillo-facial orthopedical dentistry: Textbook for doctors. М.: LLC «Medicinskoe informacionnoe agentstvo». 2008; 160.
  95. Saurav Banerjee, Surender Kumar, Amit Bera, et all. Magnet retained intraoral-extra oral combination prosthesis: a case report. J Adv Prosthodont, 2012; 4: 235-238.
  96. Brusov AB, Orlovskiy IP. Ectoprsthesis for defects and deformations of midfacial region using silicone elastomers. Stomatologiya. 2010; 3: 52-56.
  97. Davydov MI, Gantsev ShKh. Oncology: textbook. М.: GEOTAR Media, 2010; 920.
  98. Petenko NN. (Translation from English). Minimal clinical recommendations of European Society of Medical Oncology (ESMO). edited by SA Tyulyandin, DA Nosov, NI Perevodchikova, М.: Izdatelskaya grouppa RONC im. N.N. Blokhina RAMN, 2010; 436.
  99. Grachev IF, Grachev DI, Arutyunov DS, et all. Social aspects for management of orthopedical stomatological care for patients with maxilla-facial defects in current settings. Siberian medical journal. 2008; 1: 68-70.
  100. Matías Cuesta-Gil, Santiago Ochandiano Caicoya, Francisco Riba-García. Oral Rehabilitation With Osseointegrated Implants in Oncologic Patients. J Oral Maxillofac Surg, 2009; 11: 67: 2485-2496.

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