DO PALATAL LIFT PROSTHESES STIMULATE VELOPHARYNGEAL NEUROMUSCULAR ACTIVITY

The purpose of this investigation was to evaluate the ability of palat al lift protheses to stimulate the neuromuscular activity of the velop harynx. Nasendoscopic evaluations were audio-videotaped preprosthetic and postprosthetic management for 25 patients who underwent placement of a palatal lift prosthesis for velopharyngeal dysfunction (VPD), The se audio-videotapes were presented in blinded fashion and random order to three speech pathologists experienced in assessment of patients wi th VPD, They rated the tapes on the following parameters: VP gap size, closure pattern, orifice estimate, direction and magnitude of change, and qualitative descriptions of the adequacy of VP closure during spe ech, VP closure for speech was unchanged in 69% of patients and the nu mber of patients rated as improved or deteriorated was nearly identica l at about 15%, Postintervention gap shape remained unchanged in 70% o f patients, The extent of VP orifice closure during speech remained un changed in 57% of patients, Articulations that could impair VP functio n improved in 30% of patients, deteriorating in only 4%, Results of th is study neither support the concept that palatal lift prostheses alte r the neuromuscular patterning of the velopharynx, nor provide objecti ve documentation of the feasibility of prosthetic reduction for weanin g.