Patients who have undergone glossectomies with or without microvascular free-flap (radial forearm) reconstruction can improve consonant speech phonemes [k,g] and swallowing ability with the aid of a palatal augmentation (tongue) removable prosthesis (Figure 20-11). This can be considered when the remnant dorsum of the tongue (or reconstructed tongue with a flap) cannot make contact with the junction of the hard and soft palate. For optimal results, the patients will benefit with additional speech and swallowing therapy from a speech pathologist after being fitted with the palatal augmentation prosthesis.31 The success of a palatal augmentation prosthesis usually depends on the location and function of the residual tongue, degree of other resected adjacent entities (eg, mandible, floor of mouth, soft palate and especially base of tongue), along with the degree of the patient's motivation and family support.32
Figure 20-10. A, Soft-palate defect with microvascular radial free-flap reconstruction of the lateral pharyngeal wall. B, Speech bulb extension on denture base extended into the nasopharynx. C, Speech bulb prosthesis in place.
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