World Journal of Dentistry

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VOLUME 10 , ISSUE 1 ( January-February, 2019 ) > List of Articles

CASE REPORT

Speech Aid Prosthesis: A Non-surgical Approach for the Management of Velopharyngeal Insufficiency

Purnendu Bhushan, Tapan K Patro, Angurbala Dhal, Lokanath Garhnayak, Debasish Mishra, Arunkharavela Mohanty

Keywords : Computer-assisted designing-computer-assisted manufacturing, Laser sintering, Speech aid prosthesis, Velopharyngeal insufficiency

Citation Information : Bhushan P, Patro TK, Dhal A, Garhnayak L, Mishra D, Mohanty A. Speech Aid Prosthesis: A Non-surgical Approach for the Management of Velopharyngeal Insufficiency. World J Dent 2019; 10 (1):67-71.

DOI: 10.5005/jp-journals-10015-1605

License: CC BY-NC 4.0

Published Online: 01-02-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Aim: Managing a case of velopharyngeal insufficiency (VPI) using speech aid prosthesis (SAP) fabricated using computer-assisted designing (CAD)-computer-assisted manufacturing (CAM) laser sintering technology. Background: Velopharyngeal insufficiency (VPI) is a failure of the body's ability to temporarily close the communication between the nasal cavity and the mouth because of an anatomic dysfunction of the soft palate or the lateral or posterior wall of the pharynx.   Velopharyngeal insufficiencies (VPIs) can be congenital or acquired which may require surgical intervention. However, when the surgical treatment is not feasible or opted (due to various reasons), by a patient, prosthetic management of velopharyngeal insufficiency can be carried out non-surgically using a speech-aid prosthesis. Case description: A single case, where a 37-year-old male patient reported with the complaint of inadequate clarity of speech due to the defect in the palate since birth. The patient exhibited symptoms of velopharyngeal insufficiency. The patient was not motivated to undergo surgery and also had associated medical contraindications due to uncontrolled diabetes. To manage this case a speech aid prosthesis (SAP) with speech bulb on a Co-Cr metal framework was fabricated with the use of CAD-CAM laser sintering. Conclusion: A logical approach to the history taking and treatment planning resulted in a successful outcome for the patient, using speech aid prosthesis. In the current case, there was an appreciable improvement in the ease of speech and its clarity for the patient. Clinical significance: The CAD-CAM laser sintering fabricated speech aid prosthesis helps in better management of velopharyngeal insufficiency with enhancing phonetics and muscle response.


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  1. Mahanna GK, Beukelman DR, Marshall JA, Gaebler CA, Sullivan M. Obturator prostheses after cancer surgery: an approach to speech outcome assessment. J Prosthet Dent. 1998 Mar 31;79(3):310-316.
  2. Turkaslan S, Baykul T, Aydin MA, Ozarslan MM. Articulation performance of patients wearing obturators with different buccal extension designs. Eur J Dent. 2009 Jul;3(3):185.
  3. Knowles JC, Chalian VA, Shanks JC. A functional speech impression used to fabricate a maxillary speech prosthesis for a partial glossectomy patient. J Prosthet Dent 1984;51: 232-237.
  4. Davis JW, Lazarus C, Logemann J, Hurst PS. Effect of a maxillary glossectomy prosthesis on articulation and swallowing. J Prosthet Dent. 1987;57(6):71
  5. Skolnick L, McCall GN, Barnes M. The sphincteric mechanism of velopharyngeal closure. Cleft Palate J. 1973;10:286-305.
  6. Shifman A, Finkelstein Y, Nachmani A, Ophir D. Speech-aid prostheses for neurogenic velopharyngeal incompetence. The Journal of prosthetic dentistry. 2000 Jan 1;83(1):99-106.
  7. Abreu A, Levy D, Rodriguez E, Rivera I. Oral rehabilitation of a patient with complete unilateral cleft lip and palate using an implant-retained speech-aid prosthesis: Clinical report. Cleft Palate Craniofac J. 2007;44:673-677.
  8. Kummer AW, Speech Evaluation for Patients with Cleft Palate. Clin Plastic Surg. 2014;41: 241-251
  9. Tobey EA, Lincks J. Acoustic analyses of speech changes after maxillectomy and prosthodontic management. J Prosthet Dent. 1989 Oct 31;62(4):449-455.
  10. Beumer J, Curtis A, Marunick MT. Maxillofacial rehabilitation. Prosthodontic and surgical considerations. St Louis: Ishiyaku Euro-America; 1996. p. 285-329.
  11. Chambers MS, Lemon JC, Martin JW. Obturation of the partial soft palate defect. J Prosthet Dent. 2004;91(1):75-79.
  12. Taylor TD, Desjardins RP. Construction of the meatus-type obturator: its advantages and disadvantages. J Prosthet Dent. 1983;49(1):80-84.
  13. Alageel O, Abdallah MN, Alsheghri A, Song J, Caron E, Tamimi F. Removable partial denture alloys processed by laser-sintering technique. J Biomed Mater Res B Appl Biomater 2017;106:1174-1185.
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