A supportive-type prosthetic speech aid

Abstract

The design and evaluation of a special speech aid is described as constructed for a patient who had bulbospinal poliomyelitis resulting in almost complete pharyngeal and palatal paralysis. The appliance elevates the palate to a position approximating that of normal retraction, thereby narrowing the lumen of the palatopharyngeal valve. The degree of elevation and retraction of the palate accomplished by the supporting prosthesis represents an adjustment to several requirements: (1) a reduction in palatopharyngeal lumen needed to decrease hypernasality and increase oral pressure for consonant articulation, (2) the preservation of an airway to provide for comfortable nasal breathing, (3) the avoidance of undue stress upon the supporting teeth as the appliance resists the natural elasticity and weight of the palate in elevation, and (4) the absence of injury to the soft palate as a result of pressure from the supporting portion of the palatal section. The patient has worn a speech aid of the type described over a period of more than two years, indicating that the requirements of construction and wearability have been met. The improvement in the patient's speech is demonstrated by portrayal through “visible speech” patterns in which the speech of the patient is shown to approximate that of a normal speaker when the appliance is in situ.