Nasalance in patients with maxillary defects - Reconstruction versus obturation.

BACKGROUND: An important question remains on how to obtain good quality of speech for patients needing maxillectomy. Oral and nasal spaces must be separated either by surgical means or by using an obturator-prosthesis. An objective measure of oronasal closure is nasalance. Different rehabilitative strategies should be compared.

METHODS: Between 1990 and 2000, 88 patients underwent maxillectomy of which 28 (32%) were available for examination. Ten patients had obturators (group l) and in 18 patients the maxilla was biologically reconstructed with different techniques (group 2). Sound pressure of nasal and oral airways were assessed seperately using a computerized sampling system (NasalView) and standardized German texts. Nasalance was calculated and compared with an uncompromised sample of patients.

RESULTS: There were no significant differences between group 1 and group 2 concerning nasalance. Furthermore, the achieved values of nasalance were similar to healthy individuals.

CONCLUSION: Nasalance after maxillectomy can be normal after sufficient rehabilitation.