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


OBJECTIVE
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.


CONCLUSIONS
On the basis of this preliminary retrospective study, the use of a palatal lift/augmentation prosthesis should be considered in ALS patients with dysarthria.
Esposito
S J
SJ
Department of Dentistry, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. esposis@ccf.org
Mitsumoto
H
H
Shanks
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D004401:Dysarthria / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008447:Maxillofacial Prosthesis; D008875:Middle Aged; D010158:Palatal Obturators; D010159:Palate; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D012189:Retrospective Studies; D013065:Speech Intelligibility; D016896:Treatment Outcome