Speech outcomes in patients rehabilitated with maxillary obturator prostheses after maxillectomy: a prospective study.

PURPOSE: Speech outcome measurements are valuable in guiding treatment and determining the effectiveness of rehabilitation with a maxillary obturator prosthesis in individuals with palatal resection. Although speech outcome data exist in the literature for such patients, relatively few reports have used clinical tools designed to measure the acoustic, physiologic, and perceptual bases of speech. This investigation reports these measures for individuals rehabilitated with a maxillary obturator.

MATERIALS AND METHODS: Speech measurements were collected prospectively at three clinical visit times (preoperative, postresection without an obturator, and with a definitive obturator) for 12 patients assigned to three groups based on the extent of their resection (< half the hard palate, > or = half the hard palate, hard and soft palates). Acoustic data were obtained with the Nasometer, aeromechanical data were collected with the PERCI-SARS, and perceptual ratings of speech intelligibility were obtained through listener analysis.

RESULTS: Significant differences existed among the three treatments for all dependent variables and revealed that speech without an obturator is significantly different from the preoperative state, while speech with an obturator does not differ significantly from preoperative function. Individuals with soft palate involvement exhibited significantly poorer nasalance values than individuals with involvement of the hard palate only.

CONCLUSION: Rehabilitation with a maxillary obturator is successful in restoring preoperative speech function. Rehabilitation of individuals with involvement of the soft palate may be more challenging.