Speech prosthesis retention problems in dysarthria: case report.

Prosthesis retention and adaptation problems in the management of dysarthria due to paralysis of the palatopharyngeal mechanism has been frequently reported in the literature. This report describes treatment of speech prosthesis retention difficulty in a 20-year-old woman who sustained a cranial cerebral trauma in a motor vehicle accident. Residual deficits included moderate-to-severe dysarthria with a significant palatopharyngeal valving disorder, higher level cognitive impairments, and long-term memory deficits. Speech intelligibility was maximized via the fitting of an intraoral speech prosthesis. Sensory perceptual changes created by the appliance resulted in prosthesis retention problems. When traditional desensitization techniques were unsuccessful, introduction of a topical anesthetic, Zylocaine Viscous, blocked the sensory feedback loop and eliminated the retention problem.