• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.282-286
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• 2016

Objective : Obturator neuropathy is a rare condition. Many neurosurgeons are unfamiliar with the obturator nerve anatomy. The purpose of this study was to define obturator nerve landmarks around the obturator foramen. Methods : Fourteen cadavers were studied bilaterally to measure the distances from the nerve root to relevant anatomical landmarks near the obturator nerve, including the anterior superior iliac spine (ASIS), the pubic tubercle, the inguinal ligament, the femoral artery, and the adductor longus. Results : The obturator nerve exits the obturator foramen and travels infero-medially between the adductors longus and brevis. The median distances from the obturator nerve exit zone (ONEZ) to the ASIS and pubic tubercle were 114 mm and 30 mm, respectively. The median horizontal and vertical distances between the pubic tubercle and the ONEZ were 17 mm and 27 mm, respectively. The shortest median distance from the ONEZ to the inguinal ligament was 19 mm. The median inguinal ligament lengths from the ASIS and the median pubic tubercle to the shortest point were 103 mm and 24 mm, respectively. The median obturator nerve lengths between the ONEZ and the adductor longus and femoral artery were 41 mm and 28 mm, respectively. Conclusion : The obturator nerve exits the foramen 17 mm and 27 mm on the horizontal and sagittal planes, respectively, from the pubic tubercle below the pectineus muscle. The shallowest area is approximately one-fifth medially from the inguinal ligament. This study will help improve the accuracy of obturator nerve surgeries to better establish therapeutic plans and decrease complications.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.2
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• pp.140-148
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• 1999

The use of obturator is the prosthetic rehabilitation approach for restoration of the defected maxillary shape and function for the patients with palatal defect. The obturator can change the shape of vocal tract and nasality, but few reports on the effects of the change were presented. So, the authors performed the experimental study to compare the difference between the sizes of vowel triangles produced by maxillectomized patients before and after obturator-wearing and to consider how much improvement in speech intelligibility can be expected by obturator wearing. The 8 patients who were totally maxillectomized due to palatal cancer were participated as subjects. They produced 5 vowels(/a/, /i/, /u/, /e/, /o/) before and after obturator-wearing. The formants of the vowels were analyzed by the spectrogram of CSL, and their speech intelligibility were judged by normal 8 listeners. As results, the frequency of the first and the second formant showed no significant difference between the articulation before and after wearing, but the comparison of the sizes of vowel triangles, related with the speech intelligibility, showed significant difference. The vowel triangle of the articulation after wearing was larger than that of the articulation before wearing. /i/ showed the lowest speech intelligibility score among the vowel articulation before wearing. After wearing obturators, their scores increased on the whole, especially, in /a/, but the intelligibility of /u/ decreased after wearing.

• The Journal of Advanced Prosthodontics
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• v.3 no.2
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• pp.106-109
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• 2011

Oral cancer treatment involves the surgical removal of all or part of the maxilla, leaving the patient with a defect that compromises the integrity and function of the oral cavity. The postoperative restoration of esthetics, deglutition, and speech shortens recovery time in the hospital and expedites the patient's return to the community as a functioning member. The surgical obturator is the proven treatment option in such situations. This article describes a simple technique to fabricate a surgical obturator that restores patient's original dentition and facial and palatal tissue form. The obturator fabricated with this technique utilizes the vacuum formed index of patient's original tissue form and duplicated partly in heat and partly in auto polymerizing acrylic resin. Duplication of the original tissue form helps patient to minimize the immense physiological trauma immediately after the surgical resection. The obturator fabricated with this technique supports soft tissues after surgery and minimizes scar contracture and disfigurement, and thus may have a positive effect on the patients' psychology.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.6
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• pp.586-590
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• 2008

Construction of an obturator for rehabilitation of a patient who underwent a maxillectomy is vital. Routinely a constructed obturator includes denture portion. A patient who may present anatomical limitations due to surgical or radiotherapy complications often challenges the clinician. Purpose: This clinical report describes a patient with severe trismus after surgical resection and radiotherapy treatment of a tumor in the upper left maxilla. Conclusion: This report describes the concepts of using a rotational path insertion for an obturator and a separately constructed maxillary denture. The stability and retention of the obturator were obtained from anatomical features. Where as these were achieved through magnetic attachments and the remaining edentulous ridge to ensure esthetic and function of the prosthesis.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.1
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• pp.30-34
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• 2020

Maxillectomy is performed to remove the tumor in the palate, maxillary sinus, buccal mucosa or nasal cavity. The resection range depends on the size and the extent of the tumor and it affects speech production or cause nasal regurgitation during feeding. Obturator can occlude an opening such as an oro-nasal fistula and protect the defect area. Successful reconstrucion of the patient's oral cavity who have gone over the maxillectomy is a difficult task. The condition and number of teeth, the remaining support area, and the extent of the defect area have a great influence on manufacturing the obturator. If these factors are disadvantageous, the prognosis of the prosthesis is uncertain. The final obturator must have a sufficient retention in the patient's oral cavity and must not irritate the surrounding tissue and support area where the resection was performed.In this case, a 55 year old female went through the maxillectomy and the only 3 teeth remained. And the retention of the maxillary prosthesis seems to be poor. So that, we fabricated the closed hollow obturator which has reduced weight compared to the conventional obturator. Consequently the closed hollow obturator can give better sealing and the adaptation.

• The Journal of Advanced Prosthodontics
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• v.7 no.1
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• pp.8-14
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• 2015

PURPOSE. To assess function by identifying changes in swallowing and masticatory performance in maxillary obturator prosthesis wearers. MATERIALS AND METHODS. Sixty subjects were recruited for the study, of which 20 were obturator wearers, 20 were completely dentulous and 20 had removable partial/complete dentures with similar Eichner's Index. Swallowing ability was evaluated with and without obturator using the "Water Drinking Test"; Masticatory performance was evaluated with the Sieve test; and maximum occlusal force was recorded with the help of a digital bite sensor. The data was analyzed using the Statistical Package for Social Science version 15.0 with a confidence level at 95%. RESULTS. Profile, behavior of drinking and time taken to drink were significantly improved (P<.001) in subjects after wearing obturator. Masticatory performance was not significantly different (P=.252) in obturator wearer when compared with dentulous or removable partial/complete denture wearer, but significantly (P<.001) high inter group difference in maximum occlusal force existed. Correlation between masticatory performance and maximum occlusal force was not significant (P=.124). CONCLUSION. Swallowing ability was significantly improved after wearing obturator but masticatory performance was not significantly different from those having similar occlusal support zone in their dentition.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.78-82
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• 2009

Obturator nerve block has been used for analgesia of hip pain, relaxation of adductor muscle spasm related to cerebral palsy or paraplegia and in urologic surgery to prevent inadvertent obturator activity during lateral wall cystoscopy. Recently, ultrasound guidance has gained popularity in the field of peripheral nerve block and have been reported in some benefits. We describe here successfully performed both obturator nerve block under ultrasound guidance.

• Proceedings of the KSLP Conference
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• 1999.11a
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• pp.183-183
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• 1999

배경 : 주로 palatal defect 환자들의 상악(maxilla)의 결손으로 인한 형태와 기능을 복구시키기 위한 보철적 재활(prosthetic rehabilitation)방법으로 쓰이는 obturator는 비음의 초래를 막고 vocal tract의 모양에 영향을 줄 수 있으나, palatal cancer 환자를 대상으로 말산출(speech production)에 관한 obturator 장착 효과에 대한보고는 거의 없다. 또한 모음은 자음에 비해 더 nasality에 영향을 주며 모음 삼각도의 면적크기가 말 명료도의 객관적인 측정치로 사용될 수 있다. 연구목적 : Palatal cancer 환자의 obturator 장착 전후 모음 산출 측정치를 통해 모음 삼각도의 크기를 비교함으로써, obturator 장착이 말 명료도 개선에 어느 정도의 효과를 주는지 보고자 하였다. (중략)

• Korean Journal of Veterinary Research
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• v.53 no.2
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• pp.73-76
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• 2013

The aim of this study was to produce a simple and inexpensive technique for estimating the obturator foramen area (OFA) from young calves based on the hypothesis that OFA can be extrapolated from simple linear measurements. Three linear measurements - dorsoventral height, craneocaudal width and total perimeter of obturator foramen - were obtained from 55 bovine hemicoxae. Different algorithms for determining OFA were then produced with a regression analysis (curve fitting) and statistical analysis software. The most simple equation was OFA ($mm^2$) = [3,150.538 + ($36.111^*CW$)] - [147,856.033/DH] (where CW = craneocaudal width and DH = dorsoventral height, both in mm), representing a good nonlinear model with a standard deviation of error for the estimate of 232.44 and a coefficient of multiple determination of 0.846. This formula may be helpful as a repeatable and easily performed estimation of the obturator foramen area in young bovines. The area of the obturator foramen magnum can thus be estimated using this regression formula.

• The Journal of Advanced Prosthodontics
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• v.4 no.4
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• pp.248-253
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• 2012

Maxillary obturator prosthesis is the most frequent treatment option for management of partial or total maxillectomy. Heavy weight of the obturators is often a dislocating factor. Hollowing the prosthesis to reduce its weight is the well established fact. The alternate technique to hollow-out the prosthesis has been described in this article which is a variation of previously described processing techniques. A pre-shaped wax-bolus was incorporated inside the flasks during packing of the heat-polymerized acrylic resin to automatically create the hollow space. The processing technique described is a single step flasking procedure to construct a closed-hollow-obturator prosthesis as a single unit. To best understand the technique, this article describes management of a patient who had undergone partial maxillectomy secondary to squamous cell carcinoma rehabilitated with a hollow-obturator prosthesis.