Restoration of Trumpet-Playing Ability using a Maxillofacial Prosthesis and External Pressure Support in a Patient with a Maxillary Defect: A Case Report.

PURPOSE: We present what is the first reported case of restoring playing function under high intraoral pressure using external compression applied to a maxillofacial prosthesis in a trumpet player with a maxillary defect, to our best knowledge.

MATERIALS AND METHODS: A 51-year-old man with left maxillary sinus sarcoma underwent total maxillectomy with rectus abdominis myocutaneous flap reconstruction. A definitive obturator was fabricated; obturator and palatal contours were refined at chairside under simulated blowing with a trumpet mouthpiece and nasal endoscopic visualization. After adjuvant therapy, including a 70 Gy proton beam, playing trumpet was no longer possible with the final prosthesis alone due to high intraoral pressures during trumpet performance produced air leakage along the obturator-mucosa interface. A customized extraoral headband that applied localized pressure over the leakage pathway was effective and making it possible playing trumpet.

RESULTS: Playing ability was poor without the prosthesis, improved with the obturator, and further enhanced when the obturator was combined with the headband. Trumpet embouchure requires precise anterior support and sustained intraoral pressure beyond routine speech goals. Screening under simulated playing identified a leakage path not evident in daily life. Targeted external compression mitigated leakage without compromising comfort, enabling occupation-specific function.

CONCLUSION: When an obturator alone is insufficient under high-pressure tasks, a temporary extraoral pressure support may help restore performance if pressure is carefully titrated and tissues are monitored.