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Use of palatal lift and palatal augmentation prostheses to improve dysarthria in patients with amyotrophic lateral sclerosis: A case series

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Use of palatal lift and palatal augmentation prostheses to improve dysarthria in patients with amyotrophic lateral sclerosis: A case series

Auteurs : Salvatore J. Esposito ; Hiroshi Mitsumoto ; Megan Shanks

Source :

The Journal of Prosthetic Dentistry [ 0022-3913 ] ; 2000.

RBID : ISTEX:1CE85EF1120DE35A0097858432B7FF480D94D589

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Abstract

Abstract: Statement Of Problem. Amyotrophic Lateral Sclerosis (ALS) is a progressive, adult onset neurodegenerative disorder manifesting itself as a loss of motor capabilities and untimely death. The dysarthria seen in patients with ALS who have bulbar symptoms causes severe problems with communication. The struggle to be understood comes at a time when progressive cumulative disabilities make communication with family, friends, and healthcare workers vital. The use of palatal lift/augmentation prostheses for dysarthria in ALS is not a frequently requested procedure by neurologists. Purpose. The purpose of this retrospective outcomes study was to evaluate the effectiveness of this treatment on improving speech function and intelligibility in this group of patients. This study also reviews the history, incidence, pathogenesis, and speech characteristics of the patient with ALS. Methods. A retrospective study of 25 patients treated with a prosthesis was performed using chart reviews and phone/office interviews to evaluate the efficacy of a palatal lift and/or augmentation prosthesis to improve speech in ALS patients. Results. Twenty-one patients (84%) treated with a palatal lift demonstrated improvement in their dysarthria, specifically in reduction of hypernasality, with 19 (76%) benefiting at least moderately for 6 months. Of the 10 patients treated with a combination palatal lift and augmentation prosthesis, 6 (60%) demonstrated improvement in articulation. A majority of patients indicated it was easier to speak with less effort involved when wearing the prosthesis. Conclusion. On the basis of this preliminary retrospective study, the use of a palatal lift/augmentation prosthesis should be considered in ALS patients with dysarthria. (J Prosthet Dent 2000;83:90-8.)

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DOI: 10.1016/S0022-3913(00)70093-X

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Salvatore J. Esposito

<affiliation><mods:affiliation>Chair, Department of Dentistry</mods:affiliation>
<wicri:noCountry code="subField">Dentistry</wicri:noCountry>
</affiliation>

Hiroshi Mitsumoto

<affiliation><mods:affiliation>Section Head, Neuromuscular/EMG, Department of Neurology</mods:affiliation>
<wicri:noCountry code="subField">Neurology</wicri:noCountry>
</affiliation>

Megan Shanks

<affiliation><mods:affiliation>Neuromuscular Fellow, Department of Neurology</mods:affiliation>
<wicri:noCountry code="subField">Neurology</wicri:noCountry>
</affiliation>

Le document en format XML

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<term>Augmentation</term>
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<term>Dynamic structures</term>
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<term>Editorial council</term>
<term>Esposito</term>
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<term>Family interviews</term>
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<term>Healthcare workers</term>
<term>Hypernasality</term>
<term>Initial placement</term>
<term>Interview process</term>
<term>Less effort</term>
<term>Levator palati</term>
<term>Lingual</term>
<term>Lingual alveolar</term>
<term>Lingual palatal</term>
<term>Lower medulla</term>
<term>Lower motor neuron dysfunction</term>
<term>Maxillofacial prosthetics</term>
<term>Memorial cancer center</term>
<term>Mitsumoto</term>
<term>Nasal cavities</term>
<term>Nasal emission</term>
<term>Neuromuscular disease</term>
<term>Neuron</term>
<term>Normal speech</term>
<term>Optimal results</term>
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<term>Palatal augmentation</term>
<term>Palatal augmentation prostheses</term>
<term>Palatal augmentation prosthesis</term>
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<term>Preliminary retrospective study</term>
<term>Product information</term>
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<term>Retrospective outcomes study</term>
<term>Retrospective study</term>
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<term>Shank</term>
<term>Soft palate</term>
<term>Speech characteristics</term>
<term>Speech function</term>
<term>Speech improvement</term>
<term>Speech pathologist</term>
<term>Speech pathologists</term>
<term>Spinal cord</term>
<term>Successful patients</term>
<term>True pathogenesis</term>
<term>Velar consonants</term>
<term>Velopharyngeal incompetence</term>
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<term>Alveolar ridge</term>
<term>Ambiguous nucleus</term>
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<term>Esposito</term>
<term>Familial amyotrophic</term>
<term>Family interviews</term>
<term>Glutamate</term>
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<term>Hard palate</term>
<term>Healthcare workers</term>
<term>Hypernasality</term>
<term>Initial placement</term>
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<term>Lingual</term>
<term>Lingual alveolar</term>
<term>Lingual palatal</term>
<term>Lower medulla</term>
<term>Lower motor neuron dysfunction</term>
<term>Maxillofacial prosthetics</term>
<term>Memorial cancer center</term>
<term>Mitsumoto</term>
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<term>Nasal emission</term>
<term>Neuromuscular disease</term>
<term>Neuron</term>
<term>Normal speech</term>
<term>Optimal results</term>
<term>Palatal</term>
<term>Palatal augmentation</term>
<term>Palatal augmentation prostheses</term>
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<term>Palatopharyngeal</term>
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<term>Preliminary retrospective study</term>
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<term>Retrospective outcomes study</term>
<term>Retrospective study</term>
<term>Sclerosis</term>
<term>Severe tongue</term>
<term>Shank</term>
<term>Soft palate</term>
<term>Speech characteristics</term>
<term>Speech function</term>
<term>Speech improvement</term>
<term>Speech pathologist</term>
<term>Speech pathologists</term>
<term>Spinal cord</term>
<term>Successful patients</term>
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<front><div type="abstract" xml:lang="en">Abstract: Statement Of Problem. Amyotrophic Lateral Sclerosis (ALS) is a progressive, adult onset neurodegenerative disorder manifesting itself as a loss of motor capabilities and untimely death. The dysarthria seen in patients with ALS who have bulbar symptoms causes severe problems with communication. The struggle to be understood comes at a time when progressive cumulative disabilities make communication with family, friends, and healthcare workers vital. The use of palatal lift/augmentation prostheses for dysarthria in ALS is not a frequently requested procedure by neurologists. Purpose. The purpose of this retrospective outcomes study was to evaluate the effectiveness of this treatment on improving speech function and intelligibility in this group of patients. This study also reviews the history, incidence, pathogenesis, and speech characteristics of the patient with ALS. Methods. A retrospective study of 25 patients treated with a prosthesis was performed using chart reviews and phone/office interviews to evaluate the efficacy of a palatal lift and/or augmentation prosthesis to improve speech in ALS patients. Results. Twenty-one patients (84%) treated with a palatal lift demonstrated improvement in their dysarthria, specifically in reduction of hypernasality, with 19 (76%) benefiting at least moderately for 6 months. Of the 10 patients treated with a combination palatal lift and augmentation prosthesis, 6 (60%) demonstrated improvement in articulation. A majority of patients indicated it was easier to speak with less effort involved when wearing the prosthesis. Conclusion. On the basis of this preliminary retrospective study, the use of a palatal lift/augmentation prosthesis should be considered in ALS patients with dysarthria. (J Prosthet Dent 2000;83:90-8.)</div>
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Use of palatal lift and palatal augmentation prostheses to improve dysarthria in patients with amyotrophic lateral sclerosis: A case series

Use of palatal lift and palatal augmentation prostheses to improve dysarthria in patients with amyotrophic lateral sclerosis: A case series

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Abstract

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