Palatal lifting prosthesis and velopharyngeal insufficiency: preliminary report

Area of Science:

• Speech-Language Pathology
• Craniofacial Anomalies
• Prosthodontics

Background:

• Velopharyngeal insufficiency (VPI) is a common complication following surgical repair of cleft palate.
• VPI can lead to significant speech disorders, including hypernasality and impaired articulation.
• Palatal lift prostheses offer a non-surgical approach to manage VPI in specific patient populations.

Purpose of the Study:

• To evaluate the effectiveness of palatal lift prosthesis (PLP) in improving speech in pediatric patients with a history of operated cleft palate and VPI.
• To assess the impact of PLP on hypernasality, articulation, and overall speech intelligibility.

Main Methods:

• A cohort of 10 patients (aged 8-10 years) with surgically repaired cleft palate and VPI were managed with palatal lift prostheses.
• Auditory perceptual speech evaluations were conducted pre- and post-prosthesis application.
• Key speech parameters assessed included hypernasality, compensatory articulation, nasal emission, facial grimace, and speech intelligibility.

Main Results:

• Significant improvements were observed in speech intelligibility (90%) and hypernasality (10% reduction).
• Positive changes were noted in glottal articulation (85.7%) and reduction in facial grimace (85.7%).
• The application of palatal lift prosthesis demonstrated statistically significant positive outcomes (p<0.05 for key measures).

Conclusions:

• Palatal lift prostheses are an effective treatment modality for improving speech in young patients with repaired cleft palates experiencing velopharyngeal insufficiency.
• This prosthetic intervention can lead to enhanced speech intelligibility and reduced hypernasality, positively impacting communication function.