<p>A 44-year-old female nasopharyngeal cancer survivor developed speech and swallowing difficulties several years after radiation therapy. Symptoms included nasal regurgitation, reduced swallowing efficiency, and unclear speech, significantly affecting her quality of life. Clinical examination revealed impaired oral and pharyngeal functions due to chronic radiation side effects, with imaging confirming velopharyngeal incompetence and reduced hyolaryngeal excursion. Swallowing maneuvers and dietary modifications provided some improvement but did not address the primary issue of nasal leakage. A conventional intraoral prosthesis was initially used to improve velopharyngeal closure but was unsuccessful due to severe tension in the soft palate, which caused displacement of the prosthesis during swallowing. A modified intraoral prosthesis was then designed, featuring a slight posterior incline created with soft plate wax to guide the bolus downward. Additional wax was applied to increase thickness at the posterior and lateral borders, enhancing tongue-palate contact during swallowing and speech, based on the principles of palatal augmentation. The wax was later converted to acrylic resin. The modified prosthesis successfully prevented nasal regurgitation and improved pronunciation, especially the /g/ sound. Videofluoroscopic swallowing studies (VFSS) confirmed enhanced bolus transport with the prosthesis in place. Quantitative analysis using ImageJ software revealed an 87.7% reduction in pharyngeal residue, from 553 to 68 pixels. This case highlights the importance of customized, interdisciplinary approaches in managing complex sequelae of cancer treatment.</p>