Palatal perforation closure using a hawleytype appliance in a patient with sarcoidosis

INTRODUCTION: Palatal perforations are rare butchallenging complications that may result from systemicconditions such as sarcoidosis. These defects can significantlyimpair speech, swallowing, and overall quality of life. This casereport presents the prosthetic management of a patient withpalatal perforation secondary to maxillary bone loss associatedwith sarcoidosis and long-term corticosteroid therapy.Case description: A 26-year-old female presented to ourclinic with a recently noticed opening in the palate. Clinicalexamination revealed a perforation in the palatal region.The patient had a medical history of sarcoidosis and hadbeen on long-term steroid treatment. Cone-beam computedtomography (CBCT) showed severe maxillary bone resorption.She reported long-standing nasal obstruction and notedthe palatal opening a few weeks prior. Her main complaintsincluded nasal regurgitation of food and fluids during mealsand severe speech impairment. A conventional maxillaryimpression was taken, and a Hawley-type removable prosthesiswas fabricated. An acrylic extension was designed to obturatethe perforation site. At the delivery appointment, immediateimprovement in speech was observed. During follow-up, thepatient reported elimination of nasal leakage during eating,indicating functional success of the appliance.DISCUSSION: Sarcoidosis, particularly with prolongedcorticosteroid use, can lead to destructive lesions in themaxillofacial bones. In this case, prosthetic rehabilitation usinga modified Hawley appliance effectively sealed the palataldefect, significantly improving both phonation and swallowing.This non-invasive approach may serve as an efficient interim orlong-term solution for similar cases where surgical options arelimited or contraindicated. Keywords: Sarcoidosis, Palatal Perforation, Maxillary BoneLoss, Prosthodontics, Removable Appliance