Prosthetic Speech Aid Appliances Medical Assignment Help

Prosthetic Speech Aid Appliances

Prosthetic care for the cleft patient mav be Il\?ce~\ar~ Ior  wo reasons: first, teeth that are so frequently Illi~sing in the cleft-afflicted patient should be replaced. Second. in patients who have failed to obtain velopharyngeal competence with SUrgical corrections. a speech aid appliance can be made by the dentist to decrease hypernasal speech. A speech aid appliance is an acrylic bulb attached to a toothborne
ap liance in the maxilla (Fig. 27-19). The bulb is fitted to project onto the undersurface of the soft palate and lifts the soft palate superiorly. If this bulb does not give adequate function, another projection ‘of acrylic (i.e., bulb obturator). can be placed’ to extend to the posterior aspect of the palate. This narrows the pharyngeal isthmus, and the size can be adjusted for maximal effectiveness. The posterior pharyngeal wall then will contact this bulb in function: In many instances the size of the bulb can be reduced
as the .pharyngeal m usculature becomes more active. Thi~type of appliance is used in two instances: (1) before a pharyngeal   flap procedure to develop muscle action or (2) if the secondary surgical procedures are not successful in pro ucing velopharyngeal.competence. The speech aid appliance is also useful concomitantly to hold prosthetic dental replacements, to cover hard palate defects, and to support deficie t upper lips by a flange extending into the labial sulcus. Obviously the maintenance of the residual dentition in an optimal state is prerequisite for successful speech aid appliance therapy,

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