An inability to adequately close the palatopharyngeal port during speech results in hypernasalance that, depending upon its severity, can render speakers difficult to understand or unintelligible.
[1] The potential for compromised intelligibility secondary to hypernasalance is underscored when consideration is given to the fact that only three English language phonemes – /m/, /n/, and /ng/ – are pronounced with an open palatopharyngeal port.
Thus, the orthodontic wire clasps used to retain interim palatal lift prostheses are sometimes extended in a mesial direction up to two mesiodistal tooth diameters.
Clasps designed in this fashion can be flexed laterally by patients or their caregivers to facilitate the insertion and removal of the interim palatal lift prosthesis.
The clasps arise as extensions of a cast metallic alloy prosthetic component termed a major connector that engages the hard palatal mucosa and the lingual surfaces of some or all of the maxillary teeth.
Cast definitive palatal lift prosthesis clasps engage dental abutment surfaces harboring what typically represent 0.01 or 0.02 inch undercuts responsible for prosthetic retention.
Alternatively, custom bent wrought wire clasps can be soldered to the cast metallic alloy component of the definitive palatal lift prosthesis from which they extend to engage the undercuts responsible for prosthetic retention.
Dentoalveolar growth and development, pediatric dental exfoliation, and exodontia secondary to periodontitis, carious lesions, other pathoses, or trauma can necessitate the fabrication of successive palatal lift prostheses that may be deemed too costly and/or time-consuming.
Such patients can develop residual palatopharyngeal incompetence that could necessitate the fabrication of palatal lift prostheses that occlude the offending nasopharyngeal ports.
During a pharyngoplasty, incisions are made into the lateral and posterior pharyngeal walls in an effort to elevate strips of native tissue away from its normal position.
The flaps are strategically sutured into recipient sites where they provide postoperative tissue volume in areas of the lateral oropharynx and nasopharynx believed not to preoperatively adduct enough to realize palatopharyngeal closure.
Vascular anatomy must be preoperatively assessed and the provision of lateral pharyngeal wall bulkiness carries the risk of inducing obstructive sleep apnea.