Maxillofacial prosthetic management of oral incompetence following commando surgery and partial maxillectomy: A clinical report

Abstract

Extensive oncologic resection in the maxillofacial region frequently results in functional deficits that compromise oral competence and patient quality of life. The present clinical report describes a patient who underwent commando surgery with partial maxillectomy and reconstruction using a pectoralis major myocutaneous flap following treatment for squamous cell carcinoma. The patient presented with an extensive facial defect, inadequate mouth closure, persistent salivary drooling, tissue exposure and discomfort during routine activities. A custom facial shield prosthesis was fabricated to provide passive external support and protect the reconstructed tissues. A lightweight clear acrylic prosthesis was designed to conform to the postoperative facial contours. Following insertion, the prosthesis provided passive coverage and support of the reconstructed tissues, with satisfactory clinical adaptation and patient-reported acceptance. Because comfort and salivary leakage were assessed only descriptively, these observations were not treated as objective functional outcomes. The primary clinically supported role of the prosthesis was protection of reconstructed tissues during postoperative healing when definitive correction was not feasible.