Palatal Lift Prosthesis Appeal

Posted by: on July 19, 2011 in Committee Outreach 

Need for a palatal lift prosthesis.

I hope that you might be able to assist me in the management of a patient who is well known to the rehabilitation department at Zithulele Hospital.

Mr Tamsanqa Tshiti is a 48 year old man who had a severe stroke in late 2010. The effects of the stroke left him with significant impairments in the areas of mobility, self-care and participation in other activities of daily living, and communication.

Mr Tshiti lives in the area surrounding Zithulele Hospital, in an extremely rural area of the Wild Coast of the Eastern Cape Province. Access to services is both limited and difficult, the latter owing to the extremely high levels of poverty in which members of this community exist.

Through his strong commitment to his own recovery, and enthusiastic engagement with rehabilitative measures, Mr Tshiti has made significant progress in the areas of mobility, self-care, and participation in other activities of daily living. However, communication still poses a major challenge for Mr Tshiti.

Although Mr Tshiti’s language system is largely in-tact, the stroke has caused him to have a flaccid dysarthria, which has left his speech hypernasal and extremely unintelligible. On assessment, it is evident that his soft palate (velum) is immobile, possibly as the result of bilateral damage to his tenth cranial nerve.

It appears that Mr Tshiti would obtain considerable benefit from a palatal lift prosthesis, as his speech intelligibility improves considerably when he speaks with his nostrils occluded. My assessment also indicates that he would be a good candidate for such a prosthesis: the other components of his speech-language system are grossly in-tact, he has no gag reflex, and no excess spasticity, he appears to have fair movement of the lateral pharyngeal walls, as well as adequate dentition to support the prosthesis. Although Mr Tshiti might experience difficulty in inserting or removing a prosthesis independently, I feel certain that he will be able to learn this skill.

I am convinced that Mr Tshiti’s communication and therefore his overall quality of life would improve significantly with a palatal lift prosthesis. Unfortunately, such items are not readily available through the public health system, and I have not been able to discover any way for Mr Tshiti to obtain the prosthesis through the normal channels.

Would any member of the Academy be able to assist Mr Tshiti in obtaining this prosthesis? Assistance of any sort would be greatly appreciated.

Should you have any questions or concerns in this regard, please do not hesitate to contact me at stephanie.a.benn@gmail.com, or on 0798826171.

Many thanks for your time and attention,

Stephanie Benn
C/S Speech Therapist and Audiologist
Zithulele Hospital
Eastern Cape

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