Use of palatal augmentation prostheses to maintain …
N2 - A palatal augmentation prosthesis (PAP) is used to facilitate improvement in the speech and swallowing functions of patients with tongue resection or tongue movement disorders. However, a PAP's effect is limited in cases where articulation disorder is severe due to wide glossectomy and/or segmental mandibulectomy. In this paper, we describe speech outcomes of a patient with an articulation disorder following glossectomy and segmental mandibulectomy. We used a palatal plate (PP) based on a PAP, along with an artificial tongue (KAT). Speech improvement was evaluated by a standardized speech intelligibility test consisting of 100 syllables. The speech intelligibility score was significantly higher when the patient wore both the PP and KAT than when he wore neither (p=0.013). The conversational intelligibility score was significantly improved with the PP and KAT than without PP and KAT (p=0.024). These results suggest that speech function can be improved in patients with hard tissue defects with segmental mandibulectomy using both a PP and a KAT. The nature of the design of the PP and that of the KAT will allow these prostheses to address a wide range of tissue defects.
Use of palatal augmentation prostheses to maintain speech ..
We report a case of a carcinoma of the oral floor with post-operative dysphagia which improved with a palatal augmentation prosthesis.
An 82-year-old man was hospitalized because of swelling and pain of the oral floor and dysarthria. He underwent an operation for removal of the tumor one month after the first visit.
Although he started water-drinking training on the seventh postoperative day, he had a swallowing disorder. He had a videofluoroscopic (VF) examination which showed that the swallowing disorder was caused by an inability to contact the palate with the tongue. Therefore we made a palatal augmentation prosthesis to improve his swallowing function. He received a videofluoroscopic (VF) examination again, which demonstrated an increase in the area and time of linguopalatal contact during swallowing. He became able to expectorate and to swallow pasty substances.
The purpose of this lecture is to discuss medical procedure of reconstraction of multiple agenesis. The solution could be rather difficult – including setting up an ideal treatment plan and coordinating the whole treatment process – since several dental disciplines take part in the process of the treatment. Therefore, orthodontic therapy often consists of only adjusting the position of pillars and gaps in the place of agenesis, then the prosthetic reconstruction takes place. The age of the patient and other factors are important when planning the final prosthetic reconstruction. The author analyze the process of treatment plan formation on several cases, then possible complications, which can occur during the treatment, together with consequential modifications. Resolving multiple agenesis is thus based on interdisciplinary co-operation of an orthodontist, prosthodontist and implantologist; in some cases an maxillofacial surgeon can be involved. The authors stress the importance of the therapy coordinator who manages individual phases of the treatment, who bears the responsibility for forming the team, as well as for the treatment results.