Speech-aid prostheses for neurogenic velopharyngeal incompetence☆,☆☆
Section snippets
MATERIAL AND METHODS
Patients were recruited from consecutive patients attending the Palate Surgery Unit of the Department of Otolaryngology-Head and Neck Surgery, Meir Hospital, Sapir Medical Center, Kfar Saba, or at the private practice of the second author during the years 1994-1997. These patients underwent a complete ear-nose-throat examination, including assessment of speech, video-nasopharyngoscopy and multiview videofluoroscopy. Their medical background was gleaned from hospital records. Patients in whom
RESULTS
Seven patients between the ages of 11 to 64 years were assigned for this study (Table I). The time elapsed from presentation of the patients’ symptoms and their first examination was 3 months to 1 year (mean 9 months). The patients greatly differed in cause and clinical expression (Table I). They were all affected by intelligibly impaired hypernasal speech (Table II) as a consequence of various neurologic deficiencies and therefore made more effort in speech production, causing muscle fatigue.
DISCUSSION
PLP is a device reserved for patients with adequate palatal tissue but with poor control of coordination and timing of VP movements. Thus, PLP is currently considered as the only effective type of prosthesis for the management of VP incompetence.10 Gibbons and Bloomer20 were the first to use a PLP with the objectives of (1) a reduction of VP lumen to decrease hypernasality and oral pressure for consonants; (2) preservation of an airway for comfortable nasal breathing; (3) avoidance of undue
CONCLUSIONS
The wire-extension speech-aid prostheses seem to be an effective treatment approach for patients suffering with velopharyngeal incompetence who cannot be surgically treated. Molding of the nasopharyngeal section under nasopharyngoscopic control is mandatory for maximizing the effect of velopharyngeal closure around the nasopharyngeal section in function, yet allowing free nasal breathing and minimized patient’s discomfort. Patients with velopharyngeal incompetence should be carefully tailored
References (40)
- et al.
Occult and overt submucous cleft palate: from peroral examination to nasendoscopy and back again
Int J Pediatr Otorhinolaryngol
(1992) - et al.
Nasal videoendoscopy in prosthetic management of palatopharyngeal dysfunction
J Prosthet Dent
(1987) Prosthodontic management of the cleft-palate patient: a speech pathologist’s view
J Prosthet Dent
(1977)- et al.
Prosthetic management of velopharyngeal insufficiency induced by uvulopalatopharyngoplasty
Otolaryngol Head Neck Surg
(1995) - et al.
A supportive-type prosthetic speech aid
J Prosthet Dent
(1958) Modification of the palatal lift speech aid
J Prosthet Dent
(1967)- et al.
The palatal elevator button
J Prosthet Dent
(1968) - et al.
Prosthetic management and speech improvement in individuals with dysarthria of the palate
J Am Dent Assoc
(1970) - et al.
Effects of a palatal lift prosthesis upon the speech intelligibility of a dysarthric patient
J Prosthet Dent
(1971) - et al.
Treating velopharyngeal inadequacies with a palatal lift prosthesis
J Prosthet Dent
(1972)
Prosthodontic aspects of palatal elevation and palatopharyngeal stimulation
J Prosthet Dent
Palatal lift prostheses for the treatment of palatopharyngeal incompetence
J Prosthet Dent
Palatal lift prostheses for edentulous patients
J Prosthet Dent
Fluoroscopy and nasoendoscopy in designing palatal lift prostheses
J Prosthet Dent
An appliance based approach to the management of palatopharyngeal incompetency: a clinical pilot project
J Prosthet Dent
Physiologic recording of the soft palate for fabrication of obturator speech prostheses
J Prosthet Dent
Maxillofacial rehabilitation. Prosthodontic and surgical considerations
Cleft palate speech management
Coming to terms with VPI: a response to Loney and Bloem
Cleft Palate J
Glossary of prosthodontic terms
Cited by (40)
Craniofacial abnormalities in association with 22q11.2 deletion syndrome
2022, The Chromosome 22q11.2 Deletion Syndrome: A Multidisciplinary Approach to Diagnosis and TreatmentVelopharyngeal Dysfunction
2021, Cummings Pediatric OtolaryngologyPreliminary study of acoustic analysis for evaluating speech-aid oral prostheses: Characteristic dips in octave spectrum for comparison of nasality
2015, Journal of the Formosan Medical AssociationCitation Excerpt :In circumstances when surgical resection leaves a defect in the oral cavity, especially in the palate region, the velopharyngeal (VP) valving mechanism is disrupted. Several types of prosthetic management for VP insufficiency (VPI) are described for maxillofacial prosthodontics.1–9 Whereas VP incompetence is traditionally managed by palatal lift prosthesis, maxillofacial prosthodontics use speech-aid prosthesis.
Evaluation of a modular palatal lift prosthesis with a silicone velar lamina for hypernasal patients
2014, Journal of Prosthetic DentistrySurgical management of velopharyngeal insufficiency
2014, Clinics in Plastic SurgeryCitation Excerpt :These devices are anchored to the dentition and allow closure of the velopharyngeal port, either by altering the position of the velum (palatal lift prosthesis) or by occupying the pharyngeal gap (pharyngeal bulb). A comprehensive discussion of prosthetic management of VPI is beyond the scope of this article, but readers are directed to several comprehensive reports.43–47,66,77–79,81 Advantages of this technique include avoidance of surgery for patients who are poor surgical candidates or who refuse surgery, and reduced costs.
Velopharyngeal Dysfunction
2014, Cummings Pediatric Otolaryngology
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0022-3913/2000/$12.00 + 0. 10/1/102829