Treatment Option for Velopharyngeal Insufficiency: A Speech Aid

IntroductIonInflammation of the sphincter that separates the oral and nasal cavities can cause velopharyngeal (VP) dysfunction.VP defects are often divided into developmental defects, congenital defects, and transmitted defects according to their causes.Veau divided VP defects into four groups. 1 Grade I involves the palate and sometimes the submucosal region.Classes II, III, and IV include unilateral and bilateral bone structures.There are two main reasons for this poor performance-(1) due to tissue deficiency, called VP insufficiency;(2) due to weakness, called VP incompetence.Palatal defects include static defects of the hard palate and dynamic defects of the soft palate.While obturator prostheses are designed to cover defects in the hard palate, speech-assisted prostheses repair defects in the palate to improve masticatory function and speech by separating the oropharynx from the nasopharynx. 2If the ratio of the palate length to the nasopharynx depth is very high or the palate is insufficient, speech-supporting prostheses are the first choice. 3ibbons and Bloomer described a palatal lift prosthesis that was particularly useful in patients with VP insufficiency.The function of this device is to provide a closed position by adjusting the palate to the normal jaw level.If the length of the wall after the maximum is not sufficient for closure, it is necessary to add an obturator ring behind the changing palate. 4alatal lift appliances improve the function of the soft palate when placed upward and backward.During normal VP closure, superior constrictor walls move medially against the lateral portion of the superiorly and posteriorly elevated soft palate. case descrIptIonA 17-year-old male patient reported to our Department of Prosthodontics and Crown & Bridge, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India.He presented with a chief complaint of a large defect in the soft palate, difficulty in speech, and swallowing with a nasal twang.On examination (Fig. 1), a congenital malformation involving the soft palate and hypernasal