A Palatal Speech Bulb—A Case Study

Abstract

Palatal defects of the oral cavity can be either congenital or acquired following trauma or surgical excision of malignant disease. Palatal defects can greatly affect function and subsequent quality of life. Rehabilitation using a removable obturator can be a preferable treatment option as it allows regular review post-surgery. This case study reports on the design and construction of a removable “speech bulb” obturator. A 50-year-old female patient presented complaining of nasal regurgitation and looseness of her current palatal obturator. She had previously undergone wide surgical excision of her soft palate under general anaesthesia due to adenoid cystic carcinoma. Treatment consisted of the provision of a new removable obturator, paying careful attention to the design of the “speech bulb” itself. The design of the “speech bulb” is crucial to optimise function, and the method of prosthesis fabrication is fully described. This case highlights the impact of obturator fit on a patient’s quality of life and will be of benefit to clinicians from many disciplines including dentists, oral and maxillofacial surgeons, Ear, Nose & Throat (ENT) surgeons and speech and language therapists.

Prosthetic Rehabilitation of an Unusually Self-Obturated Cleft Palate Defect in an Adult Edentulous Patient Living in a Remote Rural Area. A Clinical Report

“…That is tremendously important, since adult patients that require prosthetic rehabilitation for their unrepaired cleft palate present a unique challenge for the maxillofacial prosthodontist who treats the patient. Furthermore, VPI treatment with or without speech therapy is more effective and has more predictable outcomes in younger patients, since older patients usually demonstrate a combination of well established habitual speech and sound errors, in order to compensate for their structural deficits, abnormal neuromuscular function, incomplete closure of the velopharyngeal valve, nasal air emission, irregular jaw relationships, atypical dentition, defective intraoral tongue pressure, weak lip support, and their conductive hearing loss [6][7][8].…”