• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.22.1-22.4
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• 2015

Velopharyngeal dysfunction in cleft palate patients following the primary palate repair may result in nasal air emission, hypernasality, articulation disorder and poor intelligibility of speech. Among conservative treatment methods, speech aid prosthesis combined with speech therapy is widely used method. However because of its long time of treatment more than a year and low predictability, some clinicians prefer a surgical intervention. Thus, the purpose of this report was to increase an attention on the effectiveness of speech aid prosthesis by introducing a case that was successfully treated. In this clinical report, speech bulb reduction program with intensive speech therapy was applied for a patient with velopharyngeal dysfunction and it was rapidly treated by 5months which was unusually short period for speech aid therapy. Furthermore, advantages of pre-operative speech aid therapy were discussed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.5
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• pp.483-488
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• 2006

Velopharyngeal function refers to the combined activity of the soft palate and pharynx in closing and opening the velopharyngeal port to the required degree. In normal speech, various muscles of palate & pharynx function as sphincter and occlude the oropharynx from the nasopharynx during the production of oral consonant sounds. Inadequate velopharyngeal function caused by neurologic disorder - cerebral apoplexy, regressive diseases - disseminated sclerosis, Parkinson's disease, congenital deformity - cleft palate, cerebral palsy and etc. may result in abnormal speech characterized by hypernasality, nasal emission and decreased intelligibility of speech due to weak consonant production. In our study, we constructed speech aids prosthesis - Speech bulb in the incomplete cleft palate VPI patient with hypernasality and assessed velopharyngeal function with nasometer which can evaluate the speech characteristics objectively.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.1
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• pp.41-47
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• 2010

Purpose: The purpose of this study was to compare the functional abilities of the low bulb obturators with those of high bulb obturators in terms of patients' evaluation. Material and methods: This study included 11 maxillectomy patients who underwent postoperative prosthodontic rehabilitations. Two obturators of the same design except for different bulb heights, were fabricated for each of the maxillectomy patient. After two months of alternate use, the functions of the obturators were measured by investigating the patients' subjective evaluations in terms of convenience, speech, nasality, leakage, and mastication and identifying their preferred prostheses. Wilcoxon signed rank test was used as a statistical method (P < .05). Results: There were no significant differences in patient evaluations of low and high bulb obturators (P >.05). And patients' preferences varied. Conclusion: In extreme situation such as in mouth opening limitation, the use of low bulb obturators can be recommended and result in comparable speech function to that of obturators with high lateral walls.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.1
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• pp.35-40
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• 2016

The maxillary defects lead to anatomical and functional deformity of the maxillofacial region. As far as functions are concerned, such defects can produce difficulty in speech, mastication, and deglutition. Obturator prostheses play a very important role in functional recovery for post-maxillectomy patients. To achieve rigidity of the obturator, appropriate retention should be given, and the weight of the prosthesis be reduced. There are two types of hollow bulb obturator: open and closed. A closed type has many advantages. Nevertheless, some problems, including complexity of fabrication and water leakage into the bulb, have the closed hollow obturator not be widely used. The one-step polymerization technique described in this case overcomes the shortcomings by easily constructing a small hollow bulb with two thermoplastic resin sheets.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.356-363
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• 2019

A patient who went through maxillectomy can have soft palate defects including oronasal fistulas and suffer from dysphagia and dysarthria due to velopharyngeal insufficiency. This defect causes the food to enter nasal cavity and creates hypernasal sound which debilitates a quality of life. An obturator can rehabilitate the substantial oral tissue defects. The maxillary obturator separates the nasopharynx from the oropharynx during speech and deglutition by closing of the defect. For edentulous obturator patient, it is difficult to obtain proper retention due to reduced peripheral sealing. Therefore, the contours of the defects must be used to maximize the retention, stability, and support. Hollow type obturator can improve physiologic function by reducing weight than the traditional obturator. This case report describes a patient with hemi-maxillectomy who recovers mastication, speech, deglutition, and appearance with a maxillary obturator using physiological border molding of the velopharyngeal area and double-processing method.