Abstract
The palatal augmentation prosthesis (PAP) is designed to facilitate improvement in both speech and swallowing function in patients with tongue resection or tongue movement disorders. A number of studies focusing on its effectiveness in patients with impaired tongue function have been reported. However, there has been no report that demonstrated the effectiveness of the PAP in patients with hard tissue defects from segmental mandibulectomy. We applied a PAP to a 56-year-old male patient with impaired tongue movement and insufficient lip closure who had undergone segmental mandibulectomy due to osteoradionecrosis. The PAP with a special form to augment the mandible defect and assist the lip closure produced positive outcomes in swallowing and speech function. The speech function was evaluated with syllable intelligibility and conversational intelligibility tests. The intelligibility of syllables and conversation increased with a PAP. The tongue-palate contact patterns were also examined using a static palatogram.By using a PAP, abnormal contact patterns decreased and approximately normal tongue-palate contact patterns were obtained. Also, tongue thrust swallow changed to the normal swallowing pattern by using a PAP. The swallowing function was evaluated with a videofluoroscopic swallow study and tongue pressure measurement. With a PAP, the incidence of aspiration was eliminated, and obvious decreases in oral residue, number of swallows, oral transit time and pharyngeal transit time were confirmed. Also, the tongue pressure was increased with a PAP. The results suggested that the PAP improved the tongue tip anchor function and lateral tongue pressure by giving a form to augment the mandible defect and assist the lip closure. The effectiveness of the PAP in improving both speech and swallowing function in patients with hard tissue defects was demonstrated.
