Effect of a maxillary glossectomy prosthesis on articulation and swallowing.

Swallowing was found to be substantially improved with the prosthesis. Less aspiration, less time necessary to complete the swallow, and greater variation in food consistency tolerated were all positive results of the prosthesis. In addition, videofluoroscopic studies of tongue movements during speech revealed that tip-alveolar /t-d/ and back-velar /k-g/ productions were more normal with the prosthesis. With the prosthesis, the understandibility of /t/ and /d/ was improved 20% and that of /k/ and /g/, 33%. It is clear that compromises must be effected in prosthesis design to facilitate improvement in both speech and swallowing. A large prosthetic mass in the oral cavity can also negatively change speech resonance. These issues are being investigated, as are acoustic and perceptual studies of speech articulation. Future research should address whether a combination of maxillary and mandibular prostheses would result in better speech and swallowing function. A mandibular prosthesis could replace missing teeth and alveolar contour that might influence speech and swallowing. A mandibular prosthesis might also allow construction of a smaller maxillary glossectomy prosthesis to interact with the mandibular prosthesis.