Delayed Surgical Obturator-Case Series

Abstract

Maxillofacial surgery involving part or whole of maxilla involves wide open surgical wounds which need to be protected to prevent disease due to oral contamination and close the communication. The surgical obturator fabricated for the purpose, prior to surgical excision, could be underextended compared to the resected site. The reason for underextension could be attributed to the unintentional extension of the lesion at the surgical table, to prevent metastasis or to avoid recurrences. In such situation, it is essential to fabricate a delayed surgical obturator within a week postsurgically. However, manipulation of surgical site during initial periods of healing would be agonizing to the patient. Management of impression, surgical undercut, support of the graft, and adjacent tissues are of high concern during the initial period of healing. This case series describes the significance of delayed surgical obturator in maxillofacial defect immediate to the postoperative phase.

Keywords: Delayed surgical obturator; Invasive mucormycosis; Maxillofacial defect.

Fig. 1

Postoperative view of the defect

Fig. 2

Impression of the defect area

Fig. 3

Hollow bulb fabrication using arbitrary method

Fig. 4

Hollow bulb attached to obturator plate

Fig. 5

Die sectioning using split cast method

Fig. 6

Plaster pillar made for hollow bulb

Fig. 7

Bite rims made of acrylic in polished surface for lip support

Fig. 8

Tissue surface of delayed surgical obturator with hollow bulb

Fig. 9

Delayed surgical obturator intraoral view