Nasalance and nasality at experimental velopharyngeal openings in palatal prosthesis: a case study

Abstract

The use of prosthetic devices for correction of velopharyngeal insufficiency (VPI) is an alternative treatment for patients with conditions that preclude surgery and for those individuals with a hypofunctional velopharynx (HV) with a poor prognosis for the surgical repair of VPI. Understanding the role and measuring the outcome of prosthetic treatment of velopharyngeal dysfunction requires the use of tools that allow for documenting pre- and post-treatment outcomes. Experimental openings in speech bulbs have been used for simulating VPI in studies documenting changes in aerodynamic, acoustic and kinematics aspects of speech associated with the use of palatal prosthetic devices. The use of nasometry to document changes in speech associated with experimental openings in speech bulbs, however, has not been described in the literature.ObjectiveThis single-subject study investigated nasalance and nasality at the presence of experimental openings drilled through the speech bulb of a patient with HV. Material and MethodsNasometric recordings of the word "pato" were obtained under 4 velopharyngeal conditions: no-opening (control condition), no speech bulb, speech bulb with a 20 mm2 opening, and speech bulb with 30 mm2 opening. Five speech-language pathologists performed auditory-perceptual ratings while the subject read an oral passage under all conditions. ResultsKruskal-Wallis test showed significant difference among conditions (p=0.0002), with Scheffé post hoc test indicating difference from the no-opening condition.ConclusionThe changes in nasalance observed after drilling holes of known sizes in a speech bulb suggest that nasometry reflect changes in transfer of sound energy related to different sizes of velopharyngeal opening.

Management of Residual Clefts in Maxillofacial Prosthodontics: A Clinical Case

“…As for the impact of the bulb obturator on phonation, the study of A. Lima-Gregio and Coll. investigated nasalance and nasality at the presence of experimental openings on the speech bulb of a patient with velopharyngeal hypofunction, it concludes that different sizes of velopharyngeal influences the transfer of sound energy thus nasometry [21].…”

Rehabilitation of Surgically Resected Soft Palate with Interim Velopharyngeal Obturator

“…In this case report we were successfully able to rehabilitate the patient with a pharyngeal obturator within only a few days of treatment duration, restoring normal functions of speech and deglutition without any aggressive surgical therapy. This Pharyngeal obturator not only helped to restore normal function but also helped the patient psychosocially and as for other maxillofacial, prosthodontics appliances lead to improve the oral health related quality of life [10,11].…”

Palatal lifting prosthesis and velopharyngeal insufficiency: Preliminary report

“…The use of prosthetic devices for correction of velopharyngeal insufficiency is an alternative treatment for patients with conditions that preclude surgery, and for those with hypo functional velopharynx. Prosthetic management requires close cooperation between the prosthodontist and a phoniatrician (speech pathologist) (7,8).…”