Fluoroscopy and nasoendoscopy in designing palatal lift prostheses

Turner, Glenn E.; Williams, William N.

doi:10.1016/0022-3913(91)90355-z

Cited by 25 publications

(10 citation statements)

References 2 publications

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“…The need for independent, trained, and naive observers using an array of equipment and tests has been documented throughout the literature to draw clinical and statistical conclusions that are significant 22, 23. The use of cinefluorography, nasoendoscopy, cephalometric radiographs, and PERCI measurements of air flow and nasal area in combination with one another have been reported to contribute in optimal results 21, 24–29. It has been reported that the subjective evaluations of resonance by a speech pathologist are associated with nasal cross‐sectional area, palatopharyngeal area, and percent intelligibility.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of speech aid prostheses for acquired defects of the soft palate and velopharyngeal inadequacyâclinical assessments and cephalometric analysis: A Memorial Sloan-Kettering Study

et al. 2005

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Speech aid and obturator prostheses contribute to a higher percentage of intelligible speech. A difference in intelligibility exists in relationship to the position of the prosthesis and the anterior tubercle of the atlas vertebrae (C1), both statistically and clinically. The position for optimal speech could not be specifically located mathematically (ie, 3 mm or 3 degrees inferior to the anterior tubercle of the atlas vertebrae) from the analysis. Subjective ratings of the efficacy of the obturator-speech bulbs by the clinicians did not correspond to the percent intelligibility. A strong statistical and clinical correlation exists supporting the efficacy of speech bulb-obturator intervention after velopharyngeal insufficiency for improved intelligibility of both words and sentences.

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Section: Discussionmentioning

confidence: 99%

Efficacy of speech aid prostheses for acquired defects of the soft palate and velopharyngeal inadequacyâclinical assessments and cephalometric analysis: A Memorial Sloan-Kettering Study

et al. 2005

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“…This was partly due to the development of techniques that permitted direct visualization of the velopharyngeal mechanism. As a result, diagnosis and patient selection, accurate fitting and evaluation became a more sophisticated process (Karnell et al 1987, Turner andWilliams 1991). Although Karnell and Turner and Williams described the process, no outcome data were provided.…”

Section: Introductionmentioning

confidence: 99%

Process and outcome study of multidisciplinary prosthetic treatment for velopharyngeal dysfunction

Sell

Mars

Worrell

2006

Int J Lang Commun Disord

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In our centre surgery is the first choice of treatment for VPD, but prosthetic management can be a useful alternative when this is contraindicated, can be a useful temporary solution and can be used to evaluate the potential benefits of surgical intervention in some cases. This treatment requires the combined expertise of an interdisciplinary team involving the speech-and-language therapist, orthodontist/prosthodontist, maxillofacial technician and endoscopist.

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“…This reduces the number and length of sessions required to complete the prosthesis [4][5][6]. Though this procedure requires the additional supervision of an ENT specialist, it has the advantages of being easily tolerated by the patient, not requiring radiation as in fluoroscopic techniques and does not cause an interference with speech as in oral endoscopy [3,[7][8][9]. In this case, the use of nasendoscopy was justified to ensure proper soft tissue -obturator contact.…”

Section: Discussionmentioning

confidence: 99%

The Role of Nasendoscopy in the Fabrication of a Palatopharyngeal Obturator – A Case Report

Aras

Chitre

et al. 2014

JCDR

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A 43-year-old patient reported to the Department of Goa Dental College and Hospital with a chief complaint of difficulty in swallowing and speaking due to a defect in the roof of her mouth. Her speech was hypernasal, accompanied by facial grimacing and she complained of discharge through the nose while coughing. The patient mentioned having undergone a surgical procedure in childhood for repair of the defect; the details of which were unknown. She was also given obturator prosthesis 20y back. Due to extraction of carious teeth over the preceding 10 months of reporting to the department, the prosthesis lost retention and could not be worn.Intraoral examination revealed a Veau class II cleft palate, with the presence of maxillary right second and third molars and a partially edentulous mandibular arch [Table/ Fig-1]. The patient was given the choice of an implant supported prosthesis which she refused due to economic reasons. It was hence decided to fabricate a palatopharyngeal obturator supported by a cast framework and an acrylic removable partial denture for the mandibular arch.The conventional procedures of obturator fabrication were followed which involved making primary alginate impression, border moulding and secondary impression. With the impression in place, the patient was asked to swallow water to ensure that a seal was obtained and nasal regurgitation did not occur. The patient was also asked to say the word 'beat' with nares open and closed since it is a sound produced using the oral cavity as a primary resonating chamber. No change in the sound indicated that there was no air escape through the nose [1]. A metal framework was constructed with direct retainers on the maxillary second and third molars, meshwork dentistry section on the ridge area, complete metal coverage on the palatal aspect and struts extending posteriorly to retain the acrylic bulb. After trial of the framework, a heat cured acrylic resin record base was fabricated over it. The bulb was hollowed out using the lost salt technique [2], thereby lightening the prosthesis and increasing its retention. The record base was tried intraorally and adjustments were done using pressure indicating paste. Jaw relations and try in were carried out in a conventional manner. The obturator prosthesis and mandibular partial denture were then acrylised and delivered to the patient. The ability to swallow without regurgitation, unimpeded breathing, comfort and improvement in speech was assessed. Speech improvement was not discernable. Further, the patient experienced mild discomfort in breathing and a gagging sensation probably due to increased posterior extent of the obturator in comparison to her previous obturator prosthesis. Due to the inability to determine pharyngeal wall movement by direct oral observation, it was decided to use a three dimensional visualization method that could help in obturator revision.Nasal endoscopic evaluation was chosen as a visual aid to verify proper soft tissue-obturator contact during speech and swallowing and revise ...

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Fluoroscopy and nasoendoscopy in designing palatal lift prostheses

Cited by 25 publications

References 2 publications

Efficacy of speech aid prostheses for acquired defects of the soft palate and velopharyngeal inadequacyâclinical assessments and cephalometric analysis: A Memorial Sloan-Kettering Study

Efficacy of speech aid prostheses for acquired defects of the soft palate and velopharyngeal inadequacyâclinical assessments and cephalometric analysis: A Memorial Sloan-Kettering Study

Process and outcome study of multidisciplinary prosthetic treatment for velopharyngeal dysfunction

The Role of Nasendoscopy in the Fabrication of a Palatopharyngeal Obturator – A Case Report

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Fluoroscopy and nasoendoscopy in designing palatal lift prostheses

Cited by 25 publications

References 2 publications

Efficacy of speech aid prostheses for acquired defects of the soft palate and velopharyngeal inadequacyâclinical assessments and cephalometric analysis: A Memorial Sloan-Kettering Study

Efficacy of speech aid prostheses for acquired defects of the soft palate and velopharyngeal inadequacyâclinical assessments and cephalometric analysis: A Memorial Sloan-Kettering Study

Process and outcome study of multidisciplinary prosthetic treatment for velopharyngeal dysfunction

The Role of Nasendoscopy in the Fabrication of a Palatopharyngeal Obturator – A Case Report

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Product

Resources

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Efficacy of speech aid prostheses for acquired defects of the soft palate and velopharyngeal inadequacyâclinical assessments and cephalometric analysis: A Memorial Sloan-Kettering Study

Efficacy of speech aid prostheses for acquired defects of the soft palate and velopharyngeal inadequacyâclinical assessments and cephalometric analysis: A Memorial Sloan-Kettering Study