• Title/Summary/Keyword: Nasal surgery

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Speech Outcome and Timing of Furlow Palatoplasty in Cleft Palate (Furlow 구개성형술을 시행한 구개열에서 언어발달과 적절한 수술시기)

  • Jin, Ung Sik;Kim, Suk Wha;Lee, Soung Joo
    • Archives of Plastic Surgery
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    • v.33 no.1
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    • pp.67-74
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    • 2006
  • Palatoplasty using Furlow's double-opposing Z-plasty has been performed from June, 1995 to September, 1999 at Seoul National University Children's Hospital. The goal of this study is to determine the optimal timing of repair and cleft severity affecting velopharyngeal function. This is the retrospective study of patients operated by the second author. The mean age of patients was 10.53 months. The patients could be divided into three groups-isolated cleft palate(n=70), unilateral cleft lip and palate(n=88), and bilateral cleft lip and palate(n=42). To evaluate the velopharyngeal function, we used two parameters, speech evaluation and cineofluorography using DSR(digital subtraction radiography). Also, to determine the relevance between cleft severity and speech development, we measured the distance between maxillary tuberosities and cleft margins. Among 200 patients, about 96% had no or minimal hypernasality and 87% had no or mild nasal emission. The cleft width and length of soft palate seemed not to be related with the speech development. Palatoplasty at the age under 12 months resulted in less 'nasal emission' and better 'articulation' of the parameters that were assessed at the age of 7 years. It can be concluded Furlow palatoplasty shows satisfactory results and also it seems that it is better to perform the operation before the age of 12 months.

Palatal Fistula of a Healthy Adult after an Infectious Disease: A Case Report (건강한 성인에서 감염성 질환 후 발생한 구개누공 치험례)

  • Choi, Hyun Nam;Park, Jin Hyung;Han, Yea Sik
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.80-83
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    • 2012
  • Purpose: In rare cases, infectious disease can become the cause of palatal fistula as it usually occurs in immunocompromised patients. We are reporting this case because we have successfully reconstructed palatal fistula occurring due to infectious disease in a healthy adult. Methods: A 62-year-old female patient had visited our hospital with a palatal hole that had occurred after suffering from a severe febrile disease. An oro-nasal fistula measuring $1.5{\times}1.3cm$ has been observed in the junction of the soft palate and hard palate, and is presumed to be caused by an infectious disease according to the patient's history. It was reconstructed using a hinge flap and a mucoperiosteal flap. Results: For 6 months, no recurrence or complications had been observed. The post operative patient was satisfied with the improvement in nasal speech and fluid regurgitation. Conclusion: We reported this case since we had obtained a functionally satisfactory result by reconstructing the palatal fistula due to infectious disease in a healthy adult.

Common Sites, Etiology, and Solutions of Persistent Septal Deviation in Revision Septoplasty

  • Jin, Hong Ryul;Kim, Dae Woo;Jung, Hahn Jin
    • Clinical and Experimental Otorhinolaryngology
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    • v.11 no.4
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    • pp.288-292
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    • 2018
  • Objectives. To investigate the common causes of persistent septal deviation in revision septoplasty and to report the surgical techniques and results to correct them. Methods. A total of 100 consecutive patients (86 males) who had revision septoplasty due to persistent septal deviation from 2008 and 2014 were included in the study. Their mean age was 35.6 years and the mean follow-up duration was 9.1 months. Presenting symptoms, sites of persistent septal deviation, techniques used to correct the deviation, and surgical results were reviewed. Results. The mean interval between primary and revision surgery was 6.2 years. Forty-eight patients received revision septoplasty and 52 received revision septoplasty combined with rhinoplasty. Nasal obstruction was the most presenting symptom in almost all patients. The most common site of persistent septal deviation was middle septum (58%) followed by caudal septum (31%). Correcting techniques included further chondrotomy and excision of deviated portion in 76% and caudal batten graft in 39%. Rhinoscopic and endoscopic exams showed straight septum in 97% and 92 patients had subjective symptom improvement postoperatively. Conclusion. Middle septum and caudal septum were common sites of persistent deviation. Proper chondrotomy with excision of deviated middle septum and correction of the caudal deviation with batten graft are key maneuvers to treat persistent deviation.

A Case of False Negativity With COVID-19 Diagnostic Test in Total Laryngectomee (코로나바이러스 감염증-19 진단검사에 위음성을 보인 후두전절제 환자 1예)

  • Beag, Moon Seung;Kwon, Hyeok Ro;Kim, Seung Woo
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.1
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    • pp.54-57
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    • 2022
  • The coronavirus disease (COVID-19) by severe acute syndrome coronavirus-2 (SARS-CoV-2) occurs the unprecedented pandemic during recent two years and the WHO declared a global pandemic of COVID-19 in March 2020. The most common sampling sites in COVID-19 test are the oropharynx and nasopharynx. We recently encountered a total laryngectomee who had a positivity COVID-19 diagnostic test from the tracheostoma, on the other hand, false negativity from the nasal cavity. The meaning of this case is that accurate screening test could be achieved by performing a test through the tracheostoma as well as nasal cavity or oropharynx. We also would like to discuss the accurate testing methods of patients whose airflow has distorted due to surgery, the management method of these patients, and the need of further research in the COVID-19 pandemic period with relevant literature reviews.

Open rhinoplasty in secondary cleft nose deformity with suture techniques

  • Lee, Chong Kun;Min, Byung Duk
    • Archives of Craniofacial Surgery
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    • v.23 no.5
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    • pp.211-219
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    • 2022
  • Background: Correction of secondary cleft nose deformity is one of the most important portions in the management of cleft lip patients. Various techniques have been introduced to achieve adequate shape, balance, and symmetry of anatomical landmarks. None of these methods can claim to universally solve all aspects of the problems encountered in secondary cleft deformity surgery. Some authors overlook the aspect of functional rehabilitation with regard to nasal respiratory pathway problems, which is present in over 90% of the patients. This study aimed to evaluate the aesthetic and functional improvements of the authors' non-destructive technique. Methods: With over 15 years of experience, open rhinoplasty was performed, which included total remodeling of the deformed lower lateral cartilage using several suture fixation techniques without any graft or implantation with septo-turbinoplasty. A total of 150 questionnaires were sent by e-mail, but 55 completed questionnaires were returned. Surgical outcomes were evaluated using questionnaire responses, and outcomes were divided into five categories each for esthetic and functional analyses. Results: The satisfaction rate ranged from 75 % to 98%, which means "more or less," "very much," and "absolutely yes" in the esthetic and functional viewpoints. Conclusion: The results of this study strongly recommend performing the suture fixation technique and functional rehabilitation simultaneously for cleft lip/nose correction.

Retiform hemangioendothelioma in the infratemporal fossa and buccal area: a case report and literature review

  • Kim, Il-Kyu;Cho, Hyun-Young;Jung, Bum-Sang;Pae, Sang-Pill;Cho, Hyun-Woo;Seo, Ji-Hoon;Park, Seung-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.5
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    • pp.307-314
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    • 2016
  • We report a case of retiform hemangioendothelioma (RH) located in the infratemporal fossa and buccal area in a 13-year-old Korean boy. The tumor originated from the sphenoid bone of the infratemporal fossa area and spread into the cavernous sinus, orbital apex, and retro-nasal area with bone destruction of the pterygoid process. Tumor resection was conducted via Le Fort I osteotomy and partial maxillectomy to approach the infratemporal fossa and retro-nasal area. The diagnosis of RH was confirmed after surgery. In the presented patient, surgical excision was incomplete, and close follow-up was performed. There was no evidence of expansion or metastasis of the residual tumor in the 8 years after surgery. In cases of residual RH with low likelihood of expansion and metastasis, even though RH is an intermediate malignancy, close follow-up can be the appropriate treatment choice over additional aggressive therapy. To date, 29 papers and 48 RH cases have been reported, including this case. This case is the second reported RH case presenting as primary bone tumor and the first case originating in the oromaxillofacial area.

Speech Outcome after Closure of Oronasal Fistula Following Cleft Palate Repair: A report of a case (구개봉합술 후 발생한 구비강누공의 폐쇄 후 말소리 결과 : 증례보고)

  • Seo, Min-Gyo;Kim, Da-Wa;Kim, Eun-Ju;Yoon, Bo-Keun;Kim, Seong-Il;Leem, Dae-Ho;Ko, Seung-O;Moon, Seung-Young;Kim, Hyun-Ki;Shin, Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.1
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    • pp.1-6
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    • 2009
  • Oronasal fistula are a well-known complication of surgical treatment of cleft palate, occurring most frequently in the alveolus and hard palate. Previous reports have demonstrated that oronasal fistulas, particularly if greater than l cm in diameter, had an adverse effect on speech. The aim of this study was to demonstrate the relationship between the size of the fistula and the influence on velopharyngeal function. The site and size of the fistula were indicated on graph paper with calipers and measured in $mm^2$. Speech assessment was carried out using a Nasometer, VPI articulation differential test, spectrography. Patient whose fistulas affected their speech had significantly larger fistulas than those whose fistulas did not. The study shows that the larger the fistula, the greater the risk of hypernasality and nasal emission, but even small fistulas can cause speech problems. If obstruction of the nasal passage is eliminated in a patient with a previously asymptomatic fistula, it may result in a fistula becoming symptomatic, resulting in hypernasality and nasal emission. In conclusion, even small fistulas can influence speech production and should be considered before any treatment is planned. The study lends support to early closure of oronasal fistulas, particularly before pharyngeal flap surgery is contemplated.

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A LATERAL CEPHALOMETRIC ANALYSIS OF THE KOREAN ADULT NOSE IN ANGLE'S CLASS I OCCLUSION (Angle's class I 교합의 한국인 성인 코에 두부방사선 계측학적 연구)

  • Chin, Byung-Rho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.4
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    • pp.333-342
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    • 1997
  • The purpose of this study was to establish a set of standard values for the form of the nose and its relationship to other craniofacial structures in young korean adults in angle's class I occlusion. The subjects were 40 (20 male, 20 female) Korean dental students in angle's class I occlusion. Lateral cephalometric radiographs were used to determine the form of the nose and its positon relative to other craniofacial structures. The results were obtained as followed. 1. There was a significance between the registered male and female measurements in nasal height(P<0.05). (Male: 58.23mm Female : 54.62mm) 2. There was a significance between the registered male and female measurements in nasal length(P<0.05). (Male : 54.18mm Female : 49.38mm) 3. The vertical distances from the tip of the nose in Korean adults were significantly greater in the male(P<0.05) and were smaller in both sex in comparison with caucasian.

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Spectral Characteristics and Nasalance Scores of Hypernasality in Patient with Cleft Palate

  • Soh, Byung-Soo;Shin, Hyo-Keun;Kim, Hyun-Gi
    • Speech Sciences
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    • v.12 no.1
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    • pp.27-35
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    • 2005
  • Differential instrumentation for the diagnoses of individuals with Cleft palate has been used to objectively measure speech problems. The Cepstrum Method was used to study the vocal tract transfer function. The vocal tract transfer function and the source spectrum should be considered in the evaluation of nasal resonance. The aim of this study was to collect quantitative data on the acoustic Instrumentation used for evaluating hypernasality. Normal subjects (9 male, 21 female; 37 male children, 20 female children) and individuals with VPI (13 male, 8 female; 16 male children, 9 female) participated in this study. The vowel /i/ was selected to gauge the severances of hypernasality Spectral and Cepstral studies using CSL was used to identify the acoustic characteristics. Cepstrum analysis shows significant differences in quefrency and amplitude. The quefrency of normal groups was shorter than that of the VPI groups, while the amplitude of normal groups was lower than that of the VPI groups. This may have significance in the evaluation 'of nasal resonance.

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A Case of Epithelioid Hemangioendothelioma on the Choana (후비공에 발생한 상피모양 혈관내피종 1예)

  • Sohn, Jung Heob;Cho, Kyoung Rai
    • Journal of Rhinology
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    • v.25 no.2
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    • pp.118-122
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    • 2018
  • Epithelioid hemangioendothelioma is a rare vascular tumor with intermediate malignity and metastasis risk. It presents epithelioid cells with intracytoplasmic vacuoles and low mitotic activity. Its vascular nature can be confirmed by immunohistochemical studies (vimentin, CD31, CD34, and factor VIII). It is extremely rare in the nasal cavity, with only one case reported on the middle turbinate in Korea. The authors present a case of epithelioid hemangioendothelioma on the choana with a size of 2mm, which easily coult have been misdiagnosed as a blood clot.