Evaluation and rehabilitation of glossectomy speech behavior.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Ten patients were presented to illustrate multiple-abutment fixed partial dentures used in combination with auxiliary prosthetic attachments of a fixed or removable design to solve diverse problems encountered in the rehabilitation of congenital and acquired orofacial defects. While such fixed prostheses have high initial costs, their effectiveness and long-term cost-benefits suggest that, where appropriate, they represent optimum therapy that will prove most economical over the long term.
Prior to the development of these two rehabilitation programs, there was no informational material available for patients having undergone debilitative maxillary or mandibular surgery. Realizing that what little information the patients and their families did receive during the rehabilitative process was often fragmented, misunderstood, or simply forgotten, two audiovisual programs were designed to fulfill a long-neglected need. Experience with this project indicates that if patient rehabilitation programs are to be effective, it is essential that the patients contribute to the program's development. Only in this way can members of the health-care team be assured that the transmission of pertinent information through variatious educational materials is totally effective.
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A knowledge of normal articulation is needed before the prosthodontist can assess the compensatory articulation used by glossectomy patients. The amount and portion of tongue resected is directly correlated with speech intelligibility. The loss of the tip of the tongue is more critical to intelligibility than a hemiglossectomy. Partial glossectomy speakers can often use the residual tongue stump to perform adaptive movements that approximate normal movements and should be treated as an articulation problem. The compensatory articulation used by the total glossectomy patient was reviewed. The prosthodontic management of patients with partial tongue resection often includes lowering the palatal vault, while the management of the total glossectomy patient usually requires a mandibular tongue prosthesis. These prostheses can be refined with the use of multiview videofluoroscopy, videotaping, and spectrographic analysis.
Although edentulous patients with a midline segmental resection of the mandible can rarely be treated prosthodontically, this patient's dental condition was managed with some success. This success may be related to preservation of the floor of the mouth with graft. By maximum extension of the denture borders and an interlocking occlusion, a mutual stabilization of the residual segments and the denture was achieved in the static condition, which improved swallowing, control of drooling, and self-esteem. Because of the independent muscle function of each side of the mandible, mastication could not be restored adequately.
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