Speech-aid prostheses for neurogenic velopharyngeal incompetence
Identifieur interne : 008D89 ( Main/Exploration ); précédent : 008D88; suivant : 008D90Speech-aid prostheses for neurogenic velopharyngeal incompetence
Auteurs : Arie Shifman ; Yehuda Finkelstein ; Ariela Nachmani ; Dov OphirSource :
- The Journal of Prosthetic Dentistry [ 0022-3913 ] ; 2000.
Descripteurs français
- Wicri :
- topic : Médecine dentaire.
English descriptors
- KwdEn :
- Autopolymerizing acrylic resin, Aviv university, Cerebral palsy, Chaim sheba, Clear acrylic resin, Cleft, Cleft palate, Cleft palate craniofac, Closure, Closure pattern, Contingent noncompliance, Continuous speech, Coronal, Dent, Dental medicine, Dentistry, Dysarthric patient, Effective nasopharyngeal obturation, Effective treatment approach, Extension wires, Family members, Final prosthesis, Hypernasality, Incompetence, Incompetent patients, Insufficiency, Intelligibility, Intermediate closure, Kfar saba, Labial errors, Maxillary, Maxillary section, Maxillofacial prosthetics, Maximal closure, Medial movement, Meir hospital, Mild hypernasality, Mild velar movement coronal, Multiview videofluoroscopy, Nasal emission, Nasal resonance, Nasopharyngeal, Nasopharyngeal obturation, Nasopharyngeal section, Nasopharyngeal sections, Nasopharyngoscopic control, Neck surgery, Oral view, Palatal, Palatal dimple, Palatal elevation, Palate, Palate surgery unit, Peroral examination, Pharyngeal, Pharyngeal walls, Plast reconstr surg, Plps, Portal area, Posterior border, Posterior pharyngeal wall, Prosthesis, Prosthet, Prosthet dent, Prosthetic, Prosthetic dentistry, Prosthetic management, Prosthetic treatment, Retentive loop, Sackler school, Shifman, Shutter sign, Soft palate, Speech intelligibility, Speech production, Speech therapy, Superior view, Surg, Surgical treatment, Valving mechanism, Velocardiofacial syndrome, Velopharyngeal, Velopharyngeal closure, Velopharyngeal incompetence, Velopharyngeal insufficiency, Videonasopharyngoscopic examinations, Weak pressure consonants.
- Teeft :
- Autopolymerizing acrylic resin, Aviv university, Cerebral palsy, Chaim sheba, Clear acrylic resin, Cleft, Cleft palate, Cleft palate craniofac, Closure, Closure pattern, Contingent noncompliance, Continuous speech, Coronal, Dent, Dental medicine, Dentistry, Dysarthric patient, Effective nasopharyngeal obturation, Effective treatment approach, Extension wires, Family members, Final prosthesis, Hypernasality, Incompetence, Incompetent patients, Insufficiency, Intelligibility, Intermediate closure, Kfar saba, Labial errors, Maxillary, Maxillary section, Maxillofacial prosthetics, Maximal closure, Medial movement, Meir hospital, Mild hypernasality, Mild velar movement coronal, Multiview videofluoroscopy, Nasal emission, Nasal resonance, Nasopharyngeal, Nasopharyngeal obturation, Nasopharyngeal section, Nasopharyngeal sections, Nasopharyngoscopic control, Neck surgery, Oral view, Palatal, Palatal dimple, Palatal elevation, Palate, Palate surgery unit, Peroral examination, Pharyngeal, Pharyngeal walls, Plast reconstr surg, Plps, Portal area, Posterior border, Posterior pharyngeal wall, Prosthesis, Prosthet, Prosthet dent, Prosthetic, Prosthetic dentistry, Prosthetic management, Prosthetic treatment, Retentive loop, Sackler school, Shifman, Shutter sign, Soft palate, Speech intelligibility, Speech production, Speech therapy, Superior view, Surg, Surgical treatment, Valving mechanism, Velocardiofacial syndrome, Velopharyngeal, Velopharyngeal closure, Velopharyngeal incompetence, Velopharyngeal insufficiency, Videonasopharyngoscopic examinations, Weak pressure consonants.
Abstract
Abstract: Statement Of Problem. When surgical treatment is not considered an option, prosthetic management of velopharyngeal insufficiency is carried out by means of a speech-aid prosthesis, whereas velopharyngeal incompetence is traditionally managed by a palatal lift prosthesis. Varying degrees of treatment success have been attributed to palatal lift prostheses. Purpose. This study introduces the use of nasopharyngeal obturation instead of palatal elevation for the management of velopharyngeal incompetence. Methods. Seven patients afflicted by neurogenic velopharyngeal incompetence were treated with wire-extension speech-aid prostheses constructed to circumvent the dysfunctional soft palate. The shape of the nasopharyngeal section was functionally molded in speech and swallowing and controlled by video-nasopharyngoscopic examinations. Results. Effective nasopharyngeal obturation with notable improved speech was achieved in all patients. Even though all patients ultimately tolerated the prostheses well, 2 patients denied any improvement in speech with the finalized prostheses. Conclusion. Wire-extension speech-aid prostheses used by the patients were an effective treatment approach for velopharyngeal incompetence. Nasopharyngoscopic control is mandatory for maximizing the effect of velopharyngeal closure around the nasopharyngeal section of the prosthesis in function, yet it allows free nasal breathing. Velopharyngeally incompetent patients should be carefully tailored for prosthetic treatment because of contingent noncompliance. (J Prosthet Dent 2000;83:99-106.)
Url:
DOI: 10.1016/S0022-3913(00)70094-1
Affiliations:
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<term>Cerebral palsy</term>
<term>Chaim sheba</term>
<term>Clear acrylic resin</term>
<term>Cleft</term>
<term>Cleft palate</term>
<term>Cleft palate craniofac</term>
<term>Closure</term>
<term>Closure pattern</term>
<term>Contingent noncompliance</term>
<term>Continuous speech</term>
<term>Coronal</term>
<term>Dent</term>
<term>Dental medicine</term>
<term>Dentistry</term>
<term>Dysarthric patient</term>
<term>Effective nasopharyngeal obturation</term>
<term>Effective treatment approach</term>
<term>Extension wires</term>
<term>Family members</term>
<term>Final prosthesis</term>
<term>Hypernasality</term>
<term>Incompetence</term>
<term>Incompetent patients</term>
<term>Insufficiency</term>
<term>Intelligibility</term>
<term>Intermediate closure</term>
<term>Kfar saba</term>
<term>Labial errors</term>
<term>Maxillary</term>
<term>Maxillary section</term>
<term>Maxillofacial prosthetics</term>
<term>Maximal closure</term>
<term>Medial movement</term>
<term>Meir hospital</term>
<term>Mild hypernasality</term>
<term>Mild velar movement coronal</term>
<term>Multiview videofluoroscopy</term>
<term>Nasal emission</term>
<term>Nasal resonance</term>
<term>Nasopharyngeal</term>
<term>Nasopharyngeal obturation</term>
<term>Nasopharyngeal section</term>
<term>Nasopharyngeal sections</term>
<term>Nasopharyngoscopic control</term>
<term>Neck surgery</term>
<term>Oral view</term>
<term>Palatal</term>
<term>Palatal dimple</term>
<term>Palatal elevation</term>
<term>Palate</term>
<term>Palate surgery unit</term>
<term>Peroral examination</term>
<term>Pharyngeal</term>
<term>Pharyngeal walls</term>
<term>Plast reconstr surg</term>
<term>Plps</term>
<term>Portal area</term>
<term>Posterior border</term>
<term>Posterior pharyngeal wall</term>
<term>Prosthesis</term>
<term>Prosthet</term>
<term>Prosthet dent</term>
<term>Prosthetic</term>
<term>Prosthetic dentistry</term>
<term>Prosthetic management</term>
<term>Prosthetic treatment</term>
<term>Retentive loop</term>
<term>Sackler school</term>
<term>Shifman</term>
<term>Shutter sign</term>
<term>Soft palate</term>
<term>Speech intelligibility</term>
<term>Speech production</term>
<term>Speech therapy</term>
<term>Superior view</term>
<term>Surg</term>
<term>Surgical treatment</term>
<term>Valving mechanism</term>
<term>Velocardiofacial syndrome</term>
<term>Velopharyngeal</term>
<term>Velopharyngeal closure</term>
<term>Velopharyngeal incompetence</term>
<term>Velopharyngeal insufficiency</term>
<term>Videonasopharyngoscopic examinations</term>
<term>Weak pressure consonants</term>
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<keywords scheme="Teeft" xml:lang="en"><term>Autopolymerizing acrylic resin</term>
<term>Aviv university</term>
<term>Cerebral palsy</term>
<term>Chaim sheba</term>
<term>Clear acrylic resin</term>
<term>Cleft</term>
<term>Cleft palate</term>
<term>Cleft palate craniofac</term>
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<term>Closure pattern</term>
<term>Contingent noncompliance</term>
<term>Continuous speech</term>
<term>Coronal</term>
<term>Dent</term>
<term>Dental medicine</term>
<term>Dentistry</term>
<term>Dysarthric patient</term>
<term>Effective nasopharyngeal obturation</term>
<term>Effective treatment approach</term>
<term>Extension wires</term>
<term>Family members</term>
<term>Final prosthesis</term>
<term>Hypernasality</term>
<term>Incompetence</term>
<term>Incompetent patients</term>
<term>Insufficiency</term>
<term>Intelligibility</term>
<term>Intermediate closure</term>
<term>Kfar saba</term>
<term>Labial errors</term>
<term>Maxillary</term>
<term>Maxillary section</term>
<term>Maxillofacial prosthetics</term>
<term>Maximal closure</term>
<term>Medial movement</term>
<term>Meir hospital</term>
<term>Mild hypernasality</term>
<term>Mild velar movement coronal</term>
<term>Multiview videofluoroscopy</term>
<term>Nasal emission</term>
<term>Nasal resonance</term>
<term>Nasopharyngeal</term>
<term>Nasopharyngeal obturation</term>
<term>Nasopharyngeal section</term>
<term>Nasopharyngeal sections</term>
<term>Nasopharyngoscopic control</term>
<term>Neck surgery</term>
<term>Oral view</term>
<term>Palatal</term>
<term>Palatal dimple</term>
<term>Palatal elevation</term>
<term>Palate</term>
<term>Palate surgery unit</term>
<term>Peroral examination</term>
<term>Pharyngeal</term>
<term>Pharyngeal walls</term>
<term>Plast reconstr surg</term>
<term>Plps</term>
<term>Portal area</term>
<term>Posterior border</term>
<term>Posterior pharyngeal wall</term>
<term>Prosthesis</term>
<term>Prosthet</term>
<term>Prosthet dent</term>
<term>Prosthetic</term>
<term>Prosthetic dentistry</term>
<term>Prosthetic management</term>
<term>Prosthetic treatment</term>
<term>Retentive loop</term>
<term>Sackler school</term>
<term>Shifman</term>
<term>Shutter sign</term>
<term>Soft palate</term>
<term>Speech intelligibility</term>
<term>Speech production</term>
<term>Speech therapy</term>
<term>Superior view</term>
<term>Surg</term>
<term>Surgical treatment</term>
<term>Valving mechanism</term>
<term>Velocardiofacial syndrome</term>
<term>Velopharyngeal</term>
<term>Velopharyngeal closure</term>
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<term>Videonasopharyngoscopic examinations</term>
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<front><div type="abstract" xml:lang="en">Abstract: Statement Of Problem. When surgical treatment is not considered an option, prosthetic management of velopharyngeal insufficiency is carried out by means of a speech-aid prosthesis, whereas velopharyngeal incompetence is traditionally managed by a palatal lift prosthesis. Varying degrees of treatment success have been attributed to palatal lift prostheses. Purpose. This study introduces the use of nasopharyngeal obturation instead of palatal elevation for the management of velopharyngeal incompetence. Methods. Seven patients afflicted by neurogenic velopharyngeal incompetence were treated with wire-extension speech-aid prostheses constructed to circumvent the dysfunctional soft palate. The shape of the nasopharyngeal section was functionally molded in speech and swallowing and controlled by video-nasopharyngoscopic examinations. Results. Effective nasopharyngeal obturation with notable improved speech was achieved in all patients. Even though all patients ultimately tolerated the prostheses well, 2 patients denied any improvement in speech with the finalized prostheses. Conclusion. Wire-extension speech-aid prostheses used by the patients were an effective treatment approach for velopharyngeal incompetence. Nasopharyngoscopic control is mandatory for maximizing the effect of velopharyngeal closure around the nasopharyngeal section of the prosthesis in function, yet it allows free nasal breathing. Velopharyngeally incompetent patients should be carefully tailored for prosthetic treatment because of contingent noncompliance. (J Prosthet Dent 2000;83:99-106.)</div>
</front>
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<name sortKey="Nachmani, Ariela" sort="Nachmani, Ariela" uniqKey="Nachmani A" first="Ariela" last="Nachmani">Ariela Nachmani</name>
<name sortKey="Ophir, Dov" sort="Ophir, Dov" uniqKey="Ophir D" first="Dov" last="Ophir">Dov Ophir</name>
<name sortKey="Shifman, Arie" sort="Shifman, Arie" uniqKey="Shifman A" first="Arie" last="Shifman">Arie Shifman</name>
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