Nasopharyngoscopy in palatopharyngeal prosthetic rehabilitation: A preliminary report.
OBJECTIVE
Prosthetic rehabilitation of speech disorders related to palatopharyngeal dysfunction is accomplished through separation of the oral and nasal cavities. The ability to achieve this separation is challenged when the disorder or defect involves the soft palate. Prosthetic rehabilitation of soft palate disorders and defects has traditionally relied on functional contouring of a prosthesis using functionally adapted impression materials. However, there are limitations to this process, particularly in its inability to visualize function as it relates to the prosthesis in a 3-dimensional space. The aim of this study was to address this limitation by describing outcomes related to the use of nasopharyngoscopy (NPS) for visualization of the velopharyngeal port during assessment and treatment of palatopharyngeal dysfunction.


METHODS
A retrospective analysis of speech data was conducted for 5 patients who were assessed before treatment, after prosthetic intervention using conventional functional impression techniques, and after prosthetic intervention using NPS. Nasalance and velopharyngeal orifice area outcome measurements were collected for each patient at clinically predetermined intervals. Perceptual assessment of speech samples was performed as well.


RESULTS
Improvements in speech function were observed for all patients after treatment with a prosthesis designed via a conventional functional impression technique; however, no patient showed normal values for nasalance or velopharyngeal orifice area. With the use of NPS to adjust the wax impression-derived prosthesis, both nasalance and velopharyngeal orifice area measurements for all patients were within normal limits. Similarly, perceptual judgment of speech found that normal resonance balance was obtained after use of NPS.


CONCLUSIONS
The addition of NPS into prosthetic treatment for palatopharyngeal disorders shows promise for improved speech results.
Rieger
Jana M
JM
Craniofacial Osseointegration and Maxillofacial Prosthetic Rehabilitation Unit, Misericordia Community Hospital, Edmonton, Alberta, Canada. jana.rieger@ualberta.ca
Zalmanowitz
Jana G
JG
Wolfaardt
John F
JF
D000293:Adolescent; D000328:Adult; D002648:Child; D003679:Deglutition / Q000502:physiology; D003761:Dental Impression Technique; D017267:Dental Prosthesis Design; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000473:pathology / Q000503:physiopathology*; D010158:Palatal Obturators; D010160:Palate, Soft / Q000473:pathology / Q000503:physiopathology; D010614:Pharynx / Q000473:pathology / Q000503:physiopathology; D012119:Respiration; D012189:Retrospective Studies; D013064:Speech Disorders / Q000534:rehabilitation; D013067:Speech Perception / Q000502:physiology; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000534:rehabilitation*; D014833:Voice Quality / Q000502:physiology