CPT® Code 21084

1. Indications

The speech aid prosthesis is indicated for patients who exhibit specific conditions that affect their ability to speak and swallow effectively. These indications include:

• Acquired defects of the soft palate These may result from trauma, surgery, or disease processes that compromise the integrity and function of the soft palate.
• Congenital defects of the soft palate These are present at birth and can include conditions such as cleft palate, which may lead to difficulties in speech and swallowing.
• Dysfunction of the palatopharyngeal sphincter This dysfunction can lead to inadequate closure between the oropharynx and nasopharynx, resulting in speech and swallowing difficulties.

2. Procedure

The procedure for creating a speech aid prosthesis involves several key steps that ensure a custom fit and optimal functionality for the patient. These steps include:

• Step 1: Patient Assessment The initial step involves a thorough assessment of the patient's oral and pharyngeal anatomy, as well as their specific speech and swallowing challenges. This assessment helps in determining the appropriate design and specifications for the prosthesis.
• Step 2: Impression Taking An impression of the soft palate is taken using a suitable impression material. This step is critical as it captures the unique contours and features of the patient's soft palate, ensuring that the prosthesis will fit comfortably and function effectively.
• Step 3: Mold Creation Once the impression is obtained, a mold is created from it. This mold serves as the foundation for fabricating the custom speech aid prosthesis, allowing for precise replication of the patient's anatomy.
• Step 4: Fabrication of the Prosthesis Using the mold, a custom speech aid prosthesis is fabricated. This prosthesis is designed to cover the soft palate and extend into the pharynx, facilitating improved separation of the oropharynx and nasopharynx during speech and swallowing.
• Step 5: Fitting and Adjustment After the prosthesis is fabricated, it is fitted to the patient. Adjustments may be made to ensure comfort and functionality, allowing the patient to effectively use the prosthesis for improved speech and swallowing.

3. Post-Procedure

Post-procedure care involves monitoring the patient's adaptation to the speech aid prosthesis. Patients may require follow-up visits to assess the fit and function of the prosthesis, as well as to make any necessary adjustments. It is important for patients to receive guidance on the proper care and maintenance of the prosthesis to ensure its longevity and effectiveness. Additionally, speech therapy may be recommended to help the patient maximize the benefits of the prosthesis in improving their speech and swallowing abilities.