Rehabilitasi Pasien Karsinoma Sel Skuamosa Pasca Bedah Menggunakan Obturator dengan Magnet

Abstract

Latar Belakang. Tindakan pembedahan pada pasien dengan kanker rongga mulut dapat mengakibatkan terjadinya defek di area intra oral dan maksillofasial. Defek tersebut dapat mengakibatkan terganggunya fungsi normal rongga mulut, yaitu mengunyah, bicara dan estetis, serta mengurangi rasa percaya diri. Untuk megatasinya diperlukan rehabilitasi fungsi rongga mulut berupa pembuatan obturator. Tujuan. Rehabilitasi defek pasca bedah pada pasien karsinoma sel skuamosa yang melibatkan palatum keras, sebagian palatum lunak, rongga hidung dan sinus maksilaris. Laporan Kasus dan Penatalaksanaan. Seorang pasien laki-laki, usia 74 tahun, datang ke klinik prostodonsia RSGM UGM, atas rujukan dari RSUP Dr Sardjito Yogyakarta, untuk dibuatkan hidung dan penutup untuk langit-langit mulutnya yang terbuka. Pasien merasa malu karena kondisi hidungnya yang hilang dan terbuka, serta susah untuk menelan makanan dan jika berbicara kurang jelas karena langit-langit mulutnya juga hilang/terbuka. Pasien telah menjalani operasi pembedahan hidung dan palatum, karena terdiagnosa karsinoma sel skuamosa. Pemeriksaan obyektif menunjukkan terdapat defek yang cukuo besar pada rongga hidung dan palatum durum dan sebagian palatum molle. Gigi yang tersisa pada rahang atas hanya gigi 23. Perawatan yang dilakukan adalah dengan pembuatan protesa hidung dan obturator. Obturator dibuat dari bahan resin akrilik dengan klamer C pada gigi 23. Untk menambah kekuatan retensi maka ditambahkan magnet di fitting surface obturator yang dilekatkan dengan protesa hidung. Kontrol dilakukan 1 bulan kemudian. Pasien merasa nyaman menggunakan obturator dengan penguat magnet pada protesa hidung. Pasien bisa menelan makanan dan bicaranyapun sudah lebih jelas. Pasien juga merasa obturatornya tidak mudah lepas, ketika menelan makanan maupun saat berbicara. Kesimpulan. Penggunaan obturator dengan magnet dapat mengembalikan fungsi normal rongga mulut akibat defek pasca bedah, serta mengembalikan rasa percaya diri pasien.

Background. Surgery in patients with cancer of the oral cavity can result in defects in the area of intra-oral and maxillofacial. Defects can lead to discruption of the normal functions of the oral cavity, ie chewing, talking and aesthetic, as well as reducing confidence. In order to fix the function, the patient needed rehabilitation of oral function such as the manufacture of the obturator. Objective. Postoperative rehabilitation defects in patients with squamous cell carcinoma involving the hard palate, part soft palate, nasal cavity and the maxillary sinus. Case Report and Management. A male patient, aged 74, came to the clinic of prosthodontics Gadjah Mada University Dental Hospital, upon referral from the Dr. Sardjito Hospital Yogyakarta. He wanted to make the nose and the cover for his open mouth roof. He feels embarrassed because of the condition of his nose was missing and open, as well as difficult to swallow food and if he talk was less obvious because of the condition of his nose was missing and open, as well as difficult to swallow food and if he talk was less obvious because the roof of his mouth is also missing/open. He had undergone nose and palate surgery, as diagnosed squamous cell carcinoma. The objective examination shows that there substantial defects in the nasal cavity and hard palate and part of the soft palate. The remaining teeth in the upper jaw only element 23. The treatment that performed in this patient was making the nose and obturator prosthesis. Obturator is made of acrylic resin with C clamer on teeth 23. In order to add strength retention, there was addition of magnet on the obturator fitting surface that attached to the nose prosthesis. The control performed one month later. Patient feels comfortable using the obturator prosthesis with magnetic on nose prosthesis. He can already swallow food again and the talk has been clearer. He also feels comfort since the obturator was not easily escape, while swallowing food or speaking. Conclusion. The use of the obturator with magnets can restore the normal function of the oral cavity caused by post-surgical defect and restore the confidence of the patient.