• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.1
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• pp.59-62
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• 2002

We present a case of nasopharyngeal stenosis which developed after adenotonsillectomy. A 11-year-old boy underwent adenotonsillectomy because of snoring at a local clinic using a $CO_2$ LASER. After the operation, he cannot breathe via nose due to severe cicatrical nasopharyngeal stenosis. Nasopharyngeal stenosis and oropharyngeal stenosis are rare and challenging problems in the pediatric population. The most common etiology is currently the surgical trauma associated with adenotonsillectomy. Stenosis can vary from a thin band to a complete obstructing cicatrix. Presenting symptoms range from mild hyponasal speech to severe airway obstruction. We treated the patient with velopharyngoplasty using two separate rotational mucosal flaps.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.149-165
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• 1999

The pathomechanism of obstructive sleep apnea(OSA) is not clearly elucidated. The possible mechanisms are pathologic reduction of pharyngeal muscular tonus during sleep, abnormal anatomical stenosis of nasopharyx or a combination of the above two mechanisms. It is very important to find the cause(anatomical location or pathologic dynamic change) of OSA in order to treat it. Cephalometric analysis in patients with obstructive sleep apnea is a good method for evaluating anatomical morphologic change but it cannot give any information about the dynamic changes occurring during sleep. On the contrary, nasopharyngeal endoscopy offer 3 dimensional image and information about the dynamic changes. Accordingly, these two diagnostic tools can be utilize in the diagnosis and treatment planning of OSA Cephalometric analysis of craniofacial skeletal and soft tissue morphology in 53 patients with OSA and 43 controls was performed and cephalometric analysis and nasopharygeal endoscopy were performed in 9 patients with OSA in order to come up with individualized therapy plans. Following results were obtained ; Patients with OSA showed 1. body weight gain 2. clockwise mandibular rotation 3. increased anterior lower facial height 4. inferiorly positioned hyoid bone 5. increased length of soft palate 6. decreased sagittal dimension of nasopharyx 7. increased vertical length of inferior collapsable nasopharyx 8. increased length of tongue Through cephalometric analysis and nasopharygeal endoscopy(mutually cooperative in diagnosis), 9. one can find the possible origin of OSA and make a adequate individualized therapy plan and predict accurate prognosis. Cephalometric analysis and nasopharygeal endoscopy are highly recommended as a diagnostic aid in OSA patients