A COMPREHENSIVE PROSTHETIC MANAGEMENT OF A VELOPHARYNGEAL DEFECT: A CASE REPORT

Authors: Dr. Anulekha CK, Dr. Sreedevi Kondareddy, Dr. Sai Krishna Seelam, DR. SUPRIYA NARUMALLA, DR. SARBADA SAI KARISHMA, Dr. Manasa Murala

DOI: 10.18231/j.aprd.12087.1846673437

Keywords: Velopharyngeal insufficiency, obturator prosthesis, cleft palate, prosthodontic management, hollow bulb, speech rehabilitation, non-surgical approach

Abstract: Velopharyngeal dysfunction (VPD), resulting from soft and hard palate anomalies, can significantly compromise speech intelligibility, swallowing, and overall oronasal function. This report highlights the prosthodontic management of a patient with a congenital velopharyngeal insufficiency and a completely edentulous maxillary arch. The patient presented with nasal regurgitation and hypernasality, contraindicating surgical correction due to her medical condition and age. A pharyngeal obturator with a hollow bulb design was planned for the maxillary arch to restore velopharyngeal closure during function. For the partially dentate mandibular arch with root canal-treated abutments, fixed prosthodontic rehabilitation was executed to enhance occlusion and support. The obturator was functionally contoured using dynamic impression techniques to achieve optimal closure without impeding muscle movement. The prosthetic approach aimed to establish effective separation between the oropharynx and nasopharynx during speech and swallowing, reduce hypernasality, and prevent nasal regurgitation. This case emphasizes the importance of individualized prosthetic planning in managing VPD when surgical options are not feasible. Proper impression techniques and periodic adjustments are vital for long-term success. Prosthodontic rehabilitation, when tailored with anatomical and functional considerations, remains a reliable modality in restoring essential oral and pharyngeal functions, significantly improving the patient's quality of life.