Abstract
Palatal defects of the oral cavity can be either congenital or acquired following trauma or surgical excision of malignant disease. Palatal defects can greatly affect function and subsequent quality of life. Rehabilitation using a removable obturator can be a preferable treatment option as it allows regular review post-surgery. This case study reports on the design and construction of a removable “speech bulb” obturator. A 50-year-old female patient presented complaining of nasal regurgitation and looseness of her current palatal obturator. She had previously undergone wide surgical excision of her soft palate under general anaesthesia due to adenoid cystic carcinoma. Treatment consisted of the provision of a new removable obturator, paying careful attention to the design of the “speech bulb” itself. The design of the “speech bulb” is crucial to optimise function, and the method of prosthesis fabrication is fully described. This case highlights the impact of obturator fit on a patient’s quality of life and will be of benefit to clinicians from many disciplines including dentists, oral and maxillofacial surgeons, Ear, Nose & Throat (ENT) surgeons and speech and language therapists.
Highlights
Palatal defects can be either congenital, i.e., cleft palate, or acquired following trauma or surgical excision of malignant disease
Treatment consisted of the provision of a new removable obturator, paying careful attention to the design of the “speech bulb” itself
A pharyngeal obturator or “speech bulb” is a removable maxillary prosthesis with an extension protruding into the pharynx
Summary
Palatal defects can be either congenital, i.e., cleft palate, or acquired following trauma or surgical excision of malignant disease. Normal physiological functions are regulated by the velopharyngeal valve which helps to separate the oral and nasal cavities during swallowing and speech [3]. This valve comprises the soft palate, lateral pharyngeal wall and posterior pharyngeal wall which directs air flow and sound into the oral and nasal cavities. A dental prosthesis is designed to obturate the palatal defect but to restore function and to re-establish velopharyngeal valve closure [4]. A pharyngeal obturator or “speech bulb” is a removable maxillary prosthesis with an extension protruding into the pharynx This protrusion separates the oropharynx and the nasopharynx during speaking and swallowing, aiming to improve function, speech and quality of life for the patient [5]
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