Wegener 肉芽腫症による軟口蓋全欠損に対しスピーチエイドを装着した1例 A case of total soft palate defect caused by Wegener's granulomatosis and treated by application of a speech aid

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著者

    • 勝見 祐二 KATSUMI Yuji
    • 新潟大学大学院医歯学総合研究科顎顔面口腔外科学分野 Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences
    • 飯田 明彦 IIDA Akihiko
    • 新潟大学大学院医歯学総合研究科顎顔面口腔外科学分野 Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences
    • 福田 純一 [他] FUKUDA Jun-ichi
    • 新潟大学大学院医歯学総合研究科顎顔面口腔外科学分野 Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences
    • 寺尾 恵美子 TERAO Emiko
    • 新潟大学医歯学総合病院歯科診療部門言語治療室 Speech Clinic of Niigata University Medical and Dental Hospital
    • 長谷川 剛 HASEGAWA Go
    • 新潟大学大学院医歯学総合研究科分子細胞病理学分野 Division of Cellular and Molecular Pathology, Niigata University Graduate School of Medical and Dental Sciences
    • 高木 律男 TAKAGI Ritsuo
    • 新潟大学大学院医歯学総合研究科顎顔面口腔外科学分野 Division of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences

抄録

We report a case of a total soft palate defect caused by Wegener's granulomatosis, treated by application of a speech aid.<br>The patient was a 25-year-old man with a tumor accompanied by an ulcer and tenderness of the soft palate. The ulceration was extensive, and the soft palate was perforated. Finally, the soft palate became totally involved and showed an extensive defect. We obtained a biopsy specimen from the granulomatous reddish gingiva, so called "strawberry gums." Clinical appearance, a positive finding for PR3-ANCA, and histopathological findings led to a diagnosis of the upper respiratory tract-limited form of Wegener's granulomatosis. Although the symptoms such as ulceration and tenderness were improved by administration of steroids and immunosuppressants, nasal leakage of food and hypernasality were severe. We decided to apply a speech aid. The obturator was adjusted by functional impression of the pharyngeal area, so that the space between the obturator and pharyngeal posterior wall would be narrowed. It took only 2 weeks to complete the speech aid fabrication. Remarkable improvement of velopharyngeal function and speech intelligibility was confirmed on logopedic and phoniatric evaluation.<br>We considered application of a speech aid to be effective for a patient with a total soft palate defect caused by Wegener's granulomatosis who had vascular abnormalities and required long-term administration of steroids and immunosuppressants, because it could be fabricated and applied within a short time, without an invasive procedure.

We report a case of a total soft palate defect caused by Wegener's granulomatosis, treated by application of a speech aid.<br>The patient was a 25-year-old man with a tumor accompanied by an ulcer and tenderness of the soft palate. The ulceration was extensive, and the soft palate was perforated. Finally, the soft palate became totally involved and showed an extensive defect. We obtained a biopsy specimen from the granulomatous reddish gingiva, so called "strawberry gums." Clinical appearance, a positive finding for PR3-ANCA, and histopathological findings led to a diagnosis of the upper respiratory tract-limited form of Wegener's granulomatosis. Although the symptoms such as ulceration and tenderness were improved by administration of steroids and immunosuppressants, nasal leakage of food and hypernasality were severe. We decided to apply a speech aid. The obturator was adjusted by functional impression of the pharyngeal area, so that the space between the obturator and pharyngeal posterior wall would be narrowed. It took only 2 weeks to complete the speech aid fabrication. Remarkable improvement of velopharyngeal function and speech intelligibility was confirmed on logopedic and phoniatric evaluation.<br>We considered application of a speech aid to be effective for a patient with a total soft palate defect caused by Wegener's granulomatosis who had vascular abnormalities and required long-term administration of steroids and immunosuppressants, because it could be fabricated and applied within a short time, without an invasive procedure.

収録刊行物

  • 日本口腔外科学会雑誌

    日本口腔外科学会雑誌 57(8), 471-475, 2011-08-20

    社団法人 日本口腔外科学会

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各種コード

  • NII論文ID(NAID)
    10030272707
  • NII書誌ID(NCID)
    AN00189163
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    00215163
  • NDL 記事登録ID
    11215979
  • NDL 雑誌分類
    ZS44(科学技術--医学--歯科学・口腔外科学)
  • NDL 請求記号
    Z19-145
  • データ提供元
    CJP書誌  NDL  J-STAGE 
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