J Adv Prosthodont.  2012 Nov;4(4):243-247. 10.4047/jap.2012.4.4.243.

Interim palatal lift prosthesis as a constituent of multidisciplinary approach in the treatment of velopharyngeal incompetence

• Raj N
• Raj V
• Aeran H

• KMID: 2176425
• DOI: http://doi.org/10.4047/jap.2012.4.4.243

Abstract

The velopharynx is a tridimensional muscular valve located between the oral and nasal cavities, consisting of the lateral and posterior pharyngeal walls and the soft palate, and controls the passage of air. Velopharyngeal insufficiency may take place when the velopharyngeal valve is unable to perform its own closing, due to a lack of tissue or lack of proper movement. Treatment options include surgical correction, prosthetic rehabilitation, and speech therapy; though optimal results often require a multidisciplinary approach for the restoration of both anatomical and physiological defect. We report a case of 56 year old male patient presenting with hypernasal speech pattern and velopharyngeal insufficiency secondary to cleft palate which had been surgically corrected 18 years ago. The patient was treated with a combination of speech therapy and palatal lift prosthesis employing interim prostheses in various phases before the insertion of definitive appliance. This phase-wise treatment plan helped to improve patient's compliance and final outcome.

Keyword

Velopharyngeal incompetence; Velopharyngeal insufficiency; Palatal lift prosthesis; Speech therapy

MeSH Terms

Cleft Palate
Compliance
Humans
Hypogonadism
Male
Mitochondrial Diseases
Nasal Cavity
Ophthalmoplegia
Palate, Soft
Prostheses and Implants
Speech Therapy
Velopharyngeal Insufficiency
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia

Figure

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  Fig. 1 Pretreatment intraoral view showing low draped soft palate balanced occlusal scheme was given to the patient for anothwith bifid uvula.

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  Fig. 2 A: Intra oral view of acrylic edentulous interim palatal lift appliance, B: Dentulous interim palatal lift appliance, C: Intra oral view of dentulous interim palatal lift appliance.

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  Fig. 3 A: Trial metal framework showing the palatal extension with occlusal rests on canines, premolar, and molars and direct retainers on maxillary right second molar, canine and maxillary left second premolar, B: Intraoral view of definitive palatal lift prosthesis showing considerable elevation of soft palate that will help in velopharyngeal closure.

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