Nonsurgical Management of a Palatal Fistula

Abstract

A multidisciplinary craniofacial care approach is needed in the management and treatment of cleft lip and palate. Careful planning, constant communication and consultation with the different specialties on board create a better treatment plan. The dental specialists involved in the team can be very much beneficial to develop practical treatment options in the formulation of treatment objectives of the cleft patient. One of the common postsurgical outcomes encountered in the treatment of cleft palate is a palatal fistula. The choice for a cleft prosthesis to benefit both pediatric and adult patients are presented alongside the rationale of the given cleft device. The different types of cleft appliances used by the patient from feeding plates to obturators with speech devices greatly enhance the well-being, nourishment, and psychosocial behavior of the patient. Another adverse sequela of a postsurgical cleft palate closure is velopharyngeal insufficiency. It is a condition where the failure of the soft palate to come in contact with the posterior pharyngeal walls to create a velopharyngeal closure lead to defective speech. The palatopharyngeal bulb or a speech aid will mechanically compensate to create a velopharyngeal seal thus producing a coherent voice. The fabrication and construction of cleft devices are also presented in this chapter.The options provided in this chapter are all nonsurgical management of a palatal fistula from a dental perspective.KeywordsCleft palateFeeding plateObturatorPalatal fistulaSpeech bulbRapid palatal expandersVelopharyngeal insufficiency