Article Figures & Data
Figures
- Fig 1.
A and B, A 32-year-old woman status post partial palatectomy for mucoepidermoid Ca and placement of a Trusoft obturator at the palatal defect (black arrow). The obturator bulb (white arrow) is seen extending to the level of the left choana. The bulb is the part of the obturator that inserts into the palatal defect. The postcontrast CT image shows the rounded hyperattenuated appearance of this obturator bulb, which was mistaken for enhancing tumor recurrence.
- Fig 2.
The interim obturator is constructed primarily of Trusoft and is formulated to remain soft for 6–10 weeks. The elasticity of Trusoft ensures against pressure pain. It is adjusted and contoured approximately every 2 weeks as the surgical site heals.
- Fig 3.
An 83-year-old woman with sinonasal lymphoma status post chemoradiation therapy, who developed osteoradionecrosis and underwent partial palatectomy and Trusoft obturator placement. A postcontrast CT image shows that the obturator projects into the right nasal cavity (arrow). Foci of air may get trapped in the Trusoft obturator, creating a confusing imaging appearance, which can be mistaken for infection.
- Fig 4.
Axial postcontrast CT images demonstrate 2 other examples of patients status post maxillectomy for tumor resection, with Trusoft obturators (arrows) containing trapped internal foci of air.
- Fig 5.
An example of a definitive obturator made of acrylic resin, with a closed hollow obturator bulb (arrow) molded to fill the palatal defect.
- Fig 6.
A 21-year-old woman with maxillary hemangioendothelioma status post left subtotal maxillectomy (left image) and subsequent acrylic obturator placement (right image with arrow), as shown on axial postcontrast CT images.
- Fig 7.
A 69-year-old patient with SCC of the right maxilla status post subtotal maxillectomy. An axial postcontrast CT image shows a hollow obturator (arrow) in place.
Tables
CT imaging appearance of obturator prostheses
Patient No. Age (yr) Sex Tumor Type Surgery Type Obturator Imaging Appearance HU 1 71 M Recurrent columella cancer Limited maxillectomy and palatectomy Acrylic Hyperdense 105 2 53 M Palate SCC Subtotal maxillectomy Trusoft Hyperdense 116 3 69 M Malignant spindle cell sarcomtaoid cancer of maxillary sinus Subtotal maxillectomy Acrylic Hyperdense 116 4 68 M Adenoid cystic carcinoma of palate Subtotal maxillectomy Trusoft Hyperdense 136 5 74 M SCC of maxilla Subtotal maxillectomy Acrylic Hyperdense 134 6 21 F Maxillary epitheloid hemangioendothelioma Subtotal maxillectomy Acrylic Hyperdense 124 7 83 F SCC of maxilla Complete maxillectomy Acrylic Hyperdense 155 8 32 F Mucoepidermoid carcinoma of the palate Partial palatectomy Acrylic Hyperdense 123 9 82 M Melanoma of sinonasal cavity Subtotal maxillectomy Trusoft Heterogeneous 72 10 83 F Lymphoma of the sinonasal cavity with palatal fistula Partial palatectomy Trusoft Heterogeneous 44 11 56 M Mucoepidermoid Ca of palate Subtotal maxillectomy Trusoft Heterogeneous 64 12 62 M SCC of maxilla Total maxillectomy Hollow Air −960 13 43 M Radiation-induced sarcoma of maxilla Subtotal maxillectomy Hollow Air −989 14 79 F Maxillary alveolar ridge carcinoma Subtotal maxillectomy Hollow Air −971 15 69 F Maxillary carcinoma Subtotal maxillectomy Hollow Air −935
