Impact of palatal prosthodontic intervention on communication performance of patients' maxillectomy defects: a multilevel outcome study.

Abstract

Obturators have been developed for surgical defects caused by cancer of the maxillary sinus and alveolar ridge. Outcome research is necessary to develop evidence-based practice guidelines. Thirty-two consecutively treated maxillectomy patients seen in the Facial Prosthetics Clinic at UNMC from 1994 through 1996 had their defects obturated for 1 month when speech intelligibility, speaking rate, nasality, and communication effectiveness were measured. With the obturator removed, mean speech intelligibility was 61%, speaking rate was 138 words per minute, and nasality was rated as 5.8 on a 0-7 point scale. With the obturator inserted, mean speech intelligibility was 94%, speaking rate was 164 words per minute, and nasality was rated as 1.6. The mean self-perception of communication effectiveness was 75% of what it was before the diagnosis of cancer. Obturation is an effective intervention for defects of the maxillary sinus and alveolar ridge on speech performance. Variations in effectiveness were noted based on site of defect and patient satisfaction with the intervention.