Esthetic and Functional Rehabilitation of Maxilla with Multiple Palatal Defects using Speech Aid Prosthesis

Abstract

Introduction: The soft palate acts as a dynamic separator between the oral and nasal cavity. The soft palate, lateral and posterior pharyngeal walls form the velopharyngeal closure so that all of them create a three-dimensional muscular valve, which is known as velopharyngeal sphincter. When some or all of the anatomic structure of the soft palate is congenitally missing or developmentally defective, it is called as palatopharyngeal insufficiency. The palatopharyngeal obturator obturates the defect of the soft palate and maintains the contact of the prosthesis with the posterior and lateral walls of the pharynx. This in turn restores the function of the palatopharyngeal obturation. Aim: The aim of this article is to describe a simple and convenient method to rehabilitate a patient with multiple palatal openings and defects using speech aid prosthesis. Case report: A 45-year-old male patient reported to the Department of Prosthodontics, Sri Hasanamba Dental College & Hospital Hassan, Karnataka, India with complaint of difficulty in swallowing and speech. On intraoral examination, a large soft palate defect was evident extending up to hard palate and maxillary anterior vestibular defect and a fissure connecting them. Maxillary arch was completely edentulous except two teeth in the posterior region. A hollow bulb speech aid prosthesis was fabricated to rehabilitate the defect. Conclusion: This palatopharyngeal obturator improved the speech intelligence and corrected nasal regurgitation. It also improved the masticatory efficacy and appearance of the patient. This in turn resulted in psychological improvement of the patient. Clinical significance: A hollow bulb speech aid prosthesis is a good option for patients who are not willing to undergo surgery. It rehabilitates nasal regurgitation and speech intelligency.