2013 Volume 17 Issue 1 Pages 13-24
Purpose: The purpose of this study was to create adaptational criteria for palatal lift prosthesis (PLP) and to examine the effects of PLP as a device for dysphagic patients.
Methods: A group in whom PLP was attached in addition to function training (PLP group, N＝57) was compared with the group which underwent function training (non-PLP group, N＝49). Analysis of the PLP group was performed based on the initial evaluation (articulation test, examination of velopharyngeal function, maximum phonation time (MPT), food test (FT), modified water swallowing test (MWST), videofluoroscopy (VF), video-endoscopy (VE), nutrition state, and subjective health investigation) after making the PLP. Both groups were examined every 3 months (about 3, 6, 12 months and more than 12 months) after the initial evaluation.
Results: We needed to define the clinical state of subjects rather than their disease itself because almost all subjects had cerebrovascular disease. Especially, more than 80% of subjects suffered from inability to elevate their tongue and soft palate, rhinolalia aperta, articulatory disorder, dysfunction of oral stage and pharyngeal stage.
In the PLP group, the subjects who were suspected of aspiration on FT and MWST when the initial evaluation was showed decreased aspiration after using the PLP. In addition, improvement of velopharyngeal function and nasal regurgitation was observed in VF. Our finding suggested that the PLP caused a build-up of pressure in the oral cavity during swallowing, and helped to reduce residues of materials in the oral cavity and pharynx. Moreover, there was no difference in the state of mastication for rice and soft solids in VE. Therefore, this finding suggested that the PLP helped to improve the swallowing function although it had an insignificant effect on the mastication. Regarding the period of service of the PLP, it was more effective to use the PLP for more than 6 months.
Conclusion: To identify adaptation to using the PLP, it is important to perceive not only the disease of patients but also the clinical state. Our findings suggest that the PLP is effective for inability to elevate the tongue and soft palate, rhinolalia aperta, articulatory disorder, dysfunction of oral stage and pharyngeal stage. In addition, regarding the period of service of the PLP, it was more effective to use the PLP for more than 6 months.
