• Imaging Science in Dentistry
• /
• v.53 no.4
• /
• pp.283-289
• /
• 2023

The apnea-hypopnea index is widely regarded as a measure of the severity of obstructive sleep apnea (OSA), a condition characterized by recurrent episodes of apnea or hypopnea during sleep that induce airway collapse. OSA is a catastrophic problem due to the wide range of health issues it can cause, including cardiovascular disease and memory loss. This review was conducted to clarify the roles of various imaging modalities, particularly cone-beam computed tomography (CBCT), in the diagnosis of and preoperative planning for OSA. Unfortunately, 2-dimensional imaging techniques yield insufficient data for a comprehensive diagnosis, given the complex anatomy of the airway. Three-dimensional (3D) imaging is favored as it more accurately represents the patient's airway structure. Although computed tomography and magnetic resonance imaging can depict the actual 3D airway architecture, their use is limited by factors such as high radiation dose and noise associated with the scans. This review indicates that CBCT is a low-radiation imaging technique that can be used to incidentally identify patients with OSA, thereby facilitating early referral and ultimately enhancing the accuracy of surgical outcome predictions.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.3
• /
• pp.267-275
• /
• 2005

Obstructive sleep apnea syndrome (OSAS) is characterized by sleep-induced obstruction of the upper airway that results in cessation of airflow. Obstruction can occur at a number of points in the airway, but frequently in the oropharynx. A diagnostic evaluation includes cephalometry, computed tomography, magnetic resonance imaging, acoustic reflection technique, polysomnography and fibroptic endoscopy. Cephalometric measurements of the patients with obstructive sleep apnea have revealed that posterior airway anatomy has strong relations with the symptoms of them. A lateral cephalogram is routinely obtained in the radiologic evaluation of sleep apnea patients. The purpose of this study is to provide a the lateral cephalometric korean norms for the diagnosis and treatment of the patients with obstructive sleep apnea by analyzing the abnormal occlusion of Korean adults.

• Speech Sciences
• /
• v.14 no.4
• /
• pp.261-271
• /
• 2007

The purpose of this study was to determine the effectiveness of CPAP (Continuous Positive Airway Pressure) therapy on the treatment of hypernasality in patients with cleft lips and palates. 7 preschool children with severe hypernasality participated in the study. Acoustic measurements of nasality were done by using the NasalView (version 1.31). Results showed that the nasalance values were reduced linearly in both vowels according to the treatment period. The sharp treatment effect was observed at the beginning stage. The nasality values of the vowel /i/ showed a sharp decrease at the Evaluation Phase 1 and 2 and a small increase at the Phase 4 followed by a drop in the end. Further studies would be desirable for various patients with different disorder types.

• Korean Journal of Bronchoesophagology
• /
• v.19 no.1
• /
• pp.5-10
• /
• 2013

Bilateral vocal cord palsy (BVCP) present a challenging condition which result from various etiologies including iatrogenic recurrent laryngeal nerve injury, progressive neurological disorder, intubation, trauma, tumor and idiopathic cause. Careful history taking, laryngoscopic evaluation, laryngeal EMG, and imaging studies are helpful for providing a precise diagnosis and planning appropriate treatment. BVCP causes airway restriction and not vocal dysfunction. In patients with BVFP, treatment is directed at maximizing the airway, while attempting to limit the negative effects of treatment on vocal function. A variety of surgical procedures are available for mangement of BVCP. The most conservative, limited procedure should be selected initially, and then further surgery and more extensive surgery can be tailored to the patient's airway and voice needs. This review will address the etiology, diagnosis, and managements of BVCP.

• The Korean Journal of Emergency Medical Services
• /
• v.10 no.3
• /
• pp.61-70
• /
• 2006

Purpose: The purpose of this study is to develop a realistic illustration using watercolors on a complete airway obstruction maneuver that is at an appropriate level for elementary school students from the first grade through the third. The illustration is a series of cuts divided into specific frames designed to illustrate the method to be followed in an action or a practical skill that would otherwise be too difficult to explain in written form. Methods: The fundamental theory of the Jeong In-Sung's instruction learning program based on the WEB to construct an appropriate site of instruction learning was used after modification. In this study analysis, design, and production stages were realized. Results: 1. In Stage 1, impressions of the illustration, in sketch form, were received. In Stage 2, results of impressions from a modified illustration were received. After an appropriate level of understanding and accuracy in the practical steps for emergency maneuvers were achieved the illustrations entering Stage 3 and color was added to the sketches. 2. In Stage 3, the illustration was completed by adding color to the contents for the practical steps in the complete airway obstruction maneuver. 3. For composition evaluation, a result of 100% appropriateness was obtained for both items of harmony between illustration and subject being studied and sufficiency in quantity of illustrations. Also high results for appropriateness in items such as clarity, creating interest, illustration size, and tone preference as related to content were achieved and thus completed the production stages. Conclusion: The Complete Airway Obstruction Maneuver Illustration developed specifically for the characteristics and cognitive level of elementary school students grade 1 through grade 3 was appropriate for teaching and learning. There is a need for future research on developed illustrations aimed at elementary school students grade 1 through 3 on the complete airway obstruction maneuver. There is also a need for continued effort in developing certified evaluating tools that can judge the suitability of illustrations and developing illustrations related to emergency maneuvers for various subjects and appropriate for learner level.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.37
• /
• pp.19.1-19.7
• /
• 2015

Background: The purpose of this retrospective study was to investigate the usefulness of tracheostomy scoring system in the decision of postoperative airway management in oral cancer patients. Materials and methods: A total of 104 patients were reviewed in this retrospective study, who underwent radical resection with or without neck dissection and free flap reconstruction due to oral cancer. The patients were classified into three groups according to the timing of the extubation; extubated groups (n = 51), overnight intubation group (n = 45), and tracheostomy group (n = 8). Cameron's score was used to evaluate the relation between the state of the patient's airway and the type of the operation. Results: Tracheostomy was performed in eight patients (8/104, 7.7 %). A total of 22 patients (21.2 %) had more than 5 points of which 17 patients (77.3 %) did not have a tracheostomy and any postoperative emergency airway problems. The tracheostomy scores were significantly different among the three groups. Hospital stay showed a significant correlation with the tracheostomy score. Conclusions: The scoring system did not quite agree with the airway management of the authors' clinic; however, it can be one of the clinical factors predicting the degree of the postoperative airway obstruction and surgical aggressiveness for recovery. The further studies are needed for clinically more reliable scoring systems.

• The korean journal of orthodontics
• /
• v.53 no.6
• /
• pp.358-364
• /
• 2023

Objective: This study aimed to three-dimensionally evaluate the pharyngeal airway space (PAS) of patients with anterior open bite (AOB) by using cone-beam computed tomography (CBCT) and compare the findings with those obtained in individuals with normal occlusion. Methods: The open bite group (OBG, n = 25) consisted of patients with an anterior overbite of -3 mm or less, while the control group (n = 25) consisted of age- and sex-matched individuals with an anterior overbite of 1-3 mm, Angle Class I malocclusion (1° ≤ point A-nasion-point B angle ≤ 4°), and a normodivergent profile (22° ≤ Frankfort mandibular plane angle ≤ 28°). After the CBCT data were reconstructed into a three-dimensional image, the PAS was segmented into four parts, and the volume of each part was measured. Pharyngeal airway length (PAL) and the area and transverse width of the part showing minimal constriction were also measured. Pearson's correlation analysis was used to evaluate the correlation between changes in the PAS and the amount of anterior overbite. Results: The OBG showed a significantly narrower airway space in the nasopharyngeal, hypopharyngeal, and total airway volumes. The OBG also showed a significantly smaller area and transverse width of the part with minimal constriction. The OBG showed a significantly longer PAL, but there was no correlation between the amount of anterior overbite and the changes in PAS. Conclusions: The PAS was associated with AOB. Patients with AOB had a narrower PAS and a smaller part showing minimal constriction.

• Phonetics and Speech Sciences
• /
• v.4 no.3
• /
• pp.171-177
• /
• 2012

The purpose of this study was to investigate whether CPAP therapy was effective for reducing the degree of hypernasality in individuals with repaired cleft palate and whether the efficacy of CPAP therapy was maintained. Five individuals with cleft palate participated in an 8-week home-based CPAP program. Results from perceptual evaluation of hypernasality and nasalance scores before and after CPAP therapy and at the follow-up speech evaluation were compared. The results of the study showed that the responses of the CPAP therapy were various among individuals. Three individuals exhibited reductions in the degree of perceived hypernasality, while nasalance scores in all individuals decreased after the therapy. The results showed that the effect of CPAP therapy was generally maintained until approximately three months after the completion of CPAP therapy.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.35 no.4
• /
• pp.211-220
• /
• 2013

Purpose: The purpose of this study was to compare the changes in the pharyngeal airway space, tongue and hyoid bone positions according to the orthognathic surgical methods of mandibular prognathism. Methods: The subjects included 30 patients (16 males, 14 females) with the skeletal class III malocclusion. Group 1 (10 patients) underwent bilateral sagittal split ramus osteotomy (BSSRO) only; group 2 (10 patients) underwent BSSRO with genioplasty; and group 3 (10 patients) underwent BSSRO, Le Fort I osteotomy. We measured the lines between the selected upper air way, hyoid bone and tongue landmarks on the lateral cephalometric x-ray films of skeletal class III. The measurements were made preoperation, within 1 week after the operation, 3~6 months after the operation and 1 year after the operation. We compared and analyzed the measurements with matched paired t-test and independent samples t-test. Results: There were no postoperative changes in the nasopharyngeal airway space in group 3. The measurements of group 3 also increased during the follow-up period as compared to the preoperative measurements. In group 1, 2 and 3, the immediate postoperative oropharyngeal and hypopharyngeal airway spaces were decreased. In the following period, the hypopharyngeal airway space returned to the preoperative positions, but the oropharyngeal airway space was not significantly changed. The upper and lower tongue was posteriorly repositioned immediately after the surgery. During the follow-up period, the lower tongue position returned to the preoperative position, and the upper tongue position was not significantly changed. Immediately after the surgery, the B point was moved to the posterior position, and a slight anterior advancement was found in the follow-up period. Conclusion: Patients who received the mandibular setback surgery showed a decrease in the posterior airway space, and those who underwent maxillary advancement showed a significant increase of the nasopharyngeal airway space, which remained stable during the evaluation period. The change of the airway space, position of the hyoid bone and tongue did not differ according to the presence or absence of genioplasty.

• The korean journal of orthodontics
• /
• v.26 no.3
• /
• pp.247-254
• /
• 1996

This study was performed to evaluate the hyoid bone position and airway in skeletal class III malocclusion and to prove the correlation between airway, hyoid bone position and mandibular position. The sample, considered of 47 class III malocclusion patients for experimmtal group and 52 class I malocclusion students for control group. Twenty three linear and angular measurements about hyoid bone position, airway size, mandibular position were taken from the lateral cephalograms. The differences between skeletal class III malocclusion group and normal occlusion group were compared and the correlation were evaluated statistically. The results obtained were as follows, 1. There were significant difference in S-APH, A-APH, N-APH, LAH-PBR, AA-PNS, PNS-ad between class I and class III malocclusion groups. 2. The hyoid bone was more anteriorly positioned in class III malocclusion group than class I malocclusion group and skeletal airway size in class III malocclusion group was smaller than class I malocclusion group. 3. There were significant difference in several measurements especially vertical and angular measurements of hyoid bone position and airway size between male and female. Usually the measurements in male were larger than female. 4. There were no significant correlation between hyoid bone position and airway size also airway size, and didn't showe significant correlation with mandibular position, 5. S-APH showed negative correlation with Wits appraisal and A-APH, N-APH showed positive correlation with Wits appraisal. On the contrary vertical measurements of hyoid bone position showed positive correlation with lower facial height.