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Speech-aid prostheses for neurogenic velopharyngeal incompetence
A Shifman1, Y Finkelstein, A Nachmani
1Maurice and Gabriela Goldschleger School of Dental Medicine, and Chaim Sheba Medical Center, Tel-Hashomer, Israel.
The Journal of Prosthetic Dentistry
|January 13, 2000
Summary
This study shows wire-extension speech-aid prostheses effectively manage velopharyngeal incompetence by using nasopharyngeal obturation. This method improved speech in most patients, offering an alternative to traditional palatal lift prostheses.
Area of Science:
- Dentistry
- Prosthodontics
- Speech Pathology
Background:
- Traditional management of velopharyngeal incompetence includes palatal lift prostheses, with variable success.
- Surgical options are not always feasible for velopharyngeal insufficiency.
Purpose of the Study:
- To evaluate nasopharyngeal obturation as an alternative to palatal elevation for velopharyngeal incompetence.
- To introduce wire-extension speech-aid prostheses for managing neurogenic velopharyngeal incompetence.
Main Methods:
- Seven patients with neurogenic velopharyngeal incompetence received wire-extension speech-aid prostheses.
- Prostheses were designed to bypass the dysfunctional soft palate.
- Video-nasopharyngoscopy guided functional molding for speech and swallowing.
Main Results:
- All patients achieved effective nasopharyngeal obturation and improved speech.
- Two patients reported no speech improvement despite overall tolerance.
- Prostheses allowed for free nasal breathing while enhancing velopharyngeal closure.
Conclusions:
- Wire-extension speech-aid prostheses are an effective treatment for velopharyngeal incompetence.
- Nasopharyngoscopic control is crucial for optimizing prosthesis function.
- Careful patient selection is necessary due to potential noncompliance.
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