Midface reconstruction: surgical reconstruction versus prosthesis.
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Carcinoma, Squamous Cell↗
Biomedical subjects
M T Marunick
Publications and source records attributed to M T Marunick.
Maxillary dental arch form related to voice classification: a pilot study.
This pilot study evaluated maxillary dental arch form dimensions and volume to determine if these parameters could be predictors for or related to voice classification. Nine white female professional singers ranging in age from 26 years to 53 years were studied. A maxillary dental impression and stone dental casts were made using standard dental procedures. Measurements were made from 10 points on each cast to determine the depth of the palate measured from first molar (depth A) and from first bicuspid (depth B), the width measured from cuspid-to-cuspid (width A) and from second molar to second molar (width B), and the length of the palate. An impression of the palatal arch of each cast was made to determine the volume of the palate using fluid displacement methods. Audio recordings were made for each subject, and based on speaking fundamental frequency, spectral analysis, voice profile, and tessitura confirmation, the actual voice classification of each subject in soprano, mezzo, and alto was achieved. Correlation and discriminant analysis tests were performed on the data. The discriminant analysis revealed that no single measurement is a predictor for voice classification. However, the discriminant analysis applied to the predictors depth A, depth B, and volume gives optimal results, ie, each subject was classified in her true group.
Adult↗
Osteoradionecrosis of the maxillary-orbital complex after neutron beam radiotherapy.
OBJECTIVE: Neutron beam radiotherapy (NRT) has been advocated for treatment of malignant salivary gland tumors and adenoid cystic carcinoma of the paranasal sinuses. The purpose of this study is to determine whether primary or adjuvant NRT results in a significantly increased rate of osteora-dionecrosis (ORN) of the maxillary-orbital complex (MOC). STUDY DESIGN AND SETTING: All patients who received primary or adjuvant NRT involving the MOC and/or maxillofacial prosthetic rehabilitation at Wayne State University from 1992 to 1997 were evaluated (n = 9). RESULTS: ORN did not develop in any of the 5 patients who received primary NRT. All 4 patients who received adjuvant NRT after surgical resection had ORN involving the MOC within the irradiated fields. CONCLUSION: The reported trend of ORN after definitive surgery and NRT shows a markedly increased complication rate. SIGNIFICANCE: The use of adjuvant NRT after definitive surgical resection involving the MOC should be considered with great caution.
Adult↗
Functional criteria for mandibular implant placement post resection and reconstruction for cancer.
STATEMENT OF PROBLEM: Osseointegrated implants used in the mandible post resection and reconstruction for cancer represents a treatment option with the potential for functional improvement and enhanced quality of life. Unfortunately, protocols for their use in this patient population have been empirical and technique-driven with the assumption that they will overcome most, if not all, functional deficits encountered. PURPOSE: The article reviews the salient oral physiologic factors for this group of patients and presents a rational approach and functional criteria for patient selection and implant placement. Other considerations discussed include: timing of implant placement, irradiated and compromised tissues, patient motivation, and tumor prognosis. CONCLUSION: These principles, if followed, may enhance realistic functional outcomes for this patient population.
Dental Implantation, Endosseous↗
Total maxillary osteoradionecrosis after adjuvant neutron radiotherapy: a clinical report.
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Adenocarcinoma↗
Timing of edentulation and extraction in the management of oral cavity and oropharyngeal malignancies.
BACKGROUND: Pretreatment dental evaluation is an essential element in the management of the head and neck cancer patient. Frequently, the dental condition requires edentulation or multiple extractions prior to radiotherapy. These extractions may be carried out at the time of oncologic resection. Such practice is routine for some surgeons but resisted by others who fear increased postoperative wound complications. To date, no study evaluating the safety and efficacy of extractions at the time of surgical resection has been reported. This paper retrospectively examines the postoperative course of head and neck cancer patients with varying strategies of dental management. METHODS: Retrospective analysis of patients with surgically treated oral cavity or oropharyngeal malignancies and dental extractions or edentulation at a tertiary oncology center from 1985 to 1994 was made. Postoperative wound infection, fistula, and length of stay data were compared for patients undergoing concurrent extraction and those having dental extractions in the postoperative period. RESULTS: Thirty-two patients underwent ablative resection with concurrent extraction, whereas 23 had postsurgical extractions. The infection and fistula rates were 16% and 9% in the concurrent group and 35% and 26% for patients having postsurgical extractions. Mean postoperative stays were significantly shorter for patients undergoing concurrent extraction (15 +/- 8 days) compared with those of the postsurgical group (27 +/- 14 days). CONCLUSIONS: Patients whose extractions were performed concurrent with the oncologic resection experienced fewer postoperative wound complications and had significantly shorter postoperative hospitalizations than did the postsurgical group.
Female↗
The effect of surgical intervention for head and neck cancer on whole salivary flow: a pilot study.
For many patients, rehabilitation and quality of life after treatment of head and neck cancer are issues that confront both them and their physicians. Various levels of xerostomia are often reported as one of the side effects of treatment. This study evaluated the effects of surgical intervention (alone) that involve major salivary glands on whole salivary flow. Five subjects with head and neck cancer who lost a submandibular gland at surgery were evaluated before and after treatment to determine resting and stimulated whole salivary flow rates. Three subjects demonstrated a decrease in resting and three a decrease in stimulated flow rates compared with pretreatment levels. Two subjects rebounded to near or above presurgery flow rates. Although a trend was identified for a decrease in resting and stimulated flow rates, the sample size was too small to statistically validate this trend. The decreases in flow rates recorded at the last test were of insufficient magnitude to elicit a complaint of xerostomia.
Aged↗
Masticatory function in hemimandibulectomy patients.
Surgical resection of a segment or loss of continuity of the mandible can adversely affect most of the structures essential for mastication. Five subjects who had hemimandibular resections for cure of squamous cell carcinoma were studied. Masticatory function tests were conducted pre- and post-surgery and post-prosthetic rehabilitation. A 0.5-g Frito corn chip served as the test food, and a sieve analysis was used to evaluate swallowing threshold and masticatory performance. Ten controls were studied in order to determine corresponding normative scores. Post-surgery results indicate that the extent of mandibular resection and loss of continuity tend to decrease masticatory function. The time required to perform the mastication test, and the number of strokes required to achieve swallowing threshold were increased. Prosthetic rehabilitation did improve masticatory function in some patients. Loss of mandibular continuity may not be an absolute predictor of decreased masticatory function.
Adult↗
The effect of head and neck cancer treatment on whole salivary flow.
The effects of multimodality therapy for head and neck cancer on whole salivary flow were evaluated. Eighteen subjects with head and neck cancer were studied. Resting and stimulated whole salivary flow rates were recorded, pretreatment, after individual modality therapy, and posttreatment. Twenty-four subjects with no history of head and neck cancer matched for age, and sex distribution, served as controls. Primary site, stage, major salivary glands resected, radiation fields, and dose to major salivary glands are reported. The average salivary flow rates for 18 subjects following treatment was reduced 83% for resting and 86% for stimulated saliva from pretreatment levels. The null hypothesis that the overall resting and stimulated whole salivary flow rates are unaffected by treatment (surgery and radiation) of the head and neck cancer was rejected (P values at 0.05 level of significance). Stage and location of primary, total dose delivered to and volume of gland exposure are important factors when predicting xerostomia following multimodality therapy.
Adult↗
Tracheostoma obturator fabrication.
Patients with tracheostoma defects who require obturator fabrication present unique functional and anatomic considerations. A new technique for making impressions and rehabilitating patients with these defects is described.
Acrylic Resins↗
Mastication in patients treated for head and neck cancer: a pilot study.
Patients with head and neck cancer will experience alteration of oral anatomy and physiology caused by the disease and the treatment required. Despite the implied effects on the dynamics of mastication, objective studies have not been conducted to evaluate masticatory function of these patients. Masticatory performance and swallowing threshold performance were evaluated with Frito corn chips as the test substance. Edentulous patients treated for cancer demonstrated deficiencies in both tests. Masticatory performance and swallowing threshold performance improved with prosthodontic rehabilitation but this improvement was less than with comparable controls. Techniques to evaluate masticatory factors such as dentition, dentures, biting force, temporomandibular joint status, range of motion, and saliva are suggested.
Aged↗
Osteoradionecrosis related to mastication and parafunction.
This article discusses mastication and parafunctional habits as possible etiologic factors in the development of osteoradionecrosis. From the three case reports presented it was noted that bone necrosis can occur after extended periods after radiation therapy, is seen most frequently in the mandible, and occurs most often at dosage levels exceeding 6500 rad. Recommendations after treatment to patients receiving 6500 rad or more should include caution regarding consistency of diet, use of existing prostheses, and the potential harmful effects of parafunctional habits.
Carcinoma, Squamous Cell↗
Surgical considerations in maxillofacial prosthetic rehabilitation of the maxillectomy patient.
The radical maxillectomy performed for cancer of the paranasal sinuses has as its sequella some of the potentially most devastating functional losses in the field of head and neck oncology. The patient is left after surgical management with a defect that often prevents effective speech, deglutition, and mastication. This paper addresses the surgical considerations involved in the performance of a radical maxillectomy that can result in a favorable defect allowing subsequent optimal prosthetic rehabilitation of the patient.
Dentition↗
Prosthodontic rehabilitation of midfacial defects.
A definition and classification of midfacial defects has been presented with a systematic approach to the prosthetic restoration of these defects. Patient factors, prognostic and diagnostic considerations, clinical procedures, fabrication, materials, and retention have been discussed. Patients with complex orofacial defects can be provided with prosthodontic treatment that results in an acceptable appearance and function consistent with the deficits encountered (Figs. 14 and 15).
Denture Design↗
Articulator modification for maxillofacial prosthetics.
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Dental Articulators↗
Denture aesthetics: an evaluation of laymen's preferences.
The purpose of this study was to evaluate whether the lay public perceives anterior teeth selected by William's typal matching method as aesthetically pleasing. The theory was tested by laymen responding to questions about photographs of three edentulous male and three edentulous female patients. These patients were selected as representatives of square, tapering, and ovoid facial forms. The photographs were portrait views of the patients wearing different dentures displaying square, tapering, and ovoid teeth. Substantiation for typal match was found in the square female, square male, and the ovoid female patients. Responses to the photographs demonstrated a preference for square tooth forms over ovoid, and then tapering. Overall, ovoid teeth were preferred for females and square teeth were preferred for males.
Attitude↗