[Evaluation of maxillary prosthesis for better QOL].

Conventional maxillary prostheses were fabricated for more than 200 cases of postoperative maxillary defect. The maxillary prosthetics could be combined at any time in the course of primary tumor treatment by taking care to start early, fabricating quickly and lightening the prosthesis weight. Of these 200 cases, 104 who had visited during the one year period of 1992, were sent questionnaires for the evaluation of maxillary prosthesis. The questionnaires were composed of subjective and objective evaluations of speech, swallowing, eating and the feeling and duration of usage. Of 98 answers obtained, 94 valid answers were converted into points and analyzed in combination with the classifications of maxillary defect, stroke of mouth opening and the number of residual teeth. As the sizes of maxillary and soft palate defects increased, each point on the evaluations of speech, swallowing, eating, and feeling decreased, except the duration of usage in one day. The stroke of the mouth opening and the number of residual teeth were related to the abilities to swallow and eat. The analysis in this study revealed that early prosthesis fabrication served to enhance the quality of life. The patients, however, took a long time to become skilled in using the prosthesis. To obtain better prosthesis function, it is important (1) to avoid soft palate defects, (2) to minimize gingival and hard palate defects, (3) to make the mouth opening more than 20mm, and (4) to preserve the teeth material as much as possible. On the basis of these results, the author concludes that maxillary prosthetics designed according to our concept greatly enhance the quality of life of patients with postoperative maxillary defects.