• Title/Summary/Keyword: Oropharynx

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Oral and Oropharyngeal Reconstruction with a Free Flap

  • Jeong, Woo Shik;Oh, Tae Suk
    • Archives of Craniofacial Surgery
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    • v.17 no.2
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    • pp.45-50
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    • 2016
  • Extensive surgical resection of the aerodigestive track can result in a large and complex defect of the oropharynx, which represents a significant reconstructive challenge for the plastic surgery. Development of microsurgical techniques has allowed for free flap reconstruction of oropharyngeal defects, with superior outcomes as well as decreases in postoperative complications. The reconstructive goals for oral and oropharyngeal defects are to restore the anatomy, to maintain continuity of the intraoral surface and oropharynx, to protect vital structures such as carotid arteries, to cover exposed portions of internal organs in preparation for adjuvant radiation, and to preserve complex functions of the oral cavity and oropharynx. Oral and oropharyngeal cancers should be treated with consideration of functional recovery. Multidisciplinary treatment strategies are necessary for maximizing disease control and preserving the natural form and function of the oropharynx.

A Case of Extranodal NK/T-cell Lymphoma, Nasal Type of the Oropharynx and Supraglottis (구인두와 성문상부에 발생한 결절 외 비성 NK/T 세포 림프종 1예)

  • Baek, Hun Hee;Lim, Sung Hwan;Lee, Mi Ji;Kim, Seung Woo
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.35-38
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    • 2017
  • The extranodal nasal NK/T-cell lymphoma was formerly known as lethal midline granuloma due to its most common clinical pattern like a destructive midline facial tumor. It often spread to other extranodal sites, such as skin, soft tissue, testis, upper respiratory tract, and gastrointestinal tract etc. For this reason, the term of extranodal NK/T-cell lymphoma, nasal type is preferred. Its disease entity may have a prominent admixture of inflammatory cells and necrotic tissues, further causing difficulty in diagnosis. A 44-year-old man was visited to our clinic with complaints of dysphagia and odynophagia during six months. He underwent three times punch biopsies and then, two times incisional biopsies. Finally, He was diagnosed as extranodal NK/T-cell lymphoma, nasal type involving oropharynx and supraglottis. We report an extremely rare case of extranodal NK/T-cell lymphoma, nasal type occurred in oropharynx and supraglottis with a brief review of literature.

The Effect of Mandibular Anterior Repositioning on the Upper Airway Volume (하악의 전방 이동이 상부기도의 용적에 미치는 영향)

  • Choi, Jae-Kap;Kee, Woo-Cheon;Kang, Duk-Sik
    • Journal of Oral Medicine and Pain
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    • v.24 no.1
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    • pp.69-80
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    • 1999
  • OBJECTIVES: This study was designed to measure the minimal cross-sectional areas and volumes of the pharynx in snoring patients and normal subjects and to see if there is an increase in the minimal cross-sectional areas and volumes of the pharynx with advancement of the mandible. METHODS: The pharyngeal computed tomography and 3-dimensional reconstruction were used to measure the cross-sectional areas and volumes of the nasopharynx, oropharynx, and hypopharynx with the jaw in normal position and in protrusive position in 7 patients with snoring and 7 control subjects while they were awake. RESULTS: The oropharynx was revealed to have the most narrow site in the pharynx and there was a tendency for the snorers to have a smaller nasopharyngeal and oropharyngeal cross-sectional area than normal subjects but not statistically significant. There were no significant differences in the volumes of the nasopharynx and oropharynx between the two groups. With advancement of the jaw the minimal cross-sectional area of oropharynx was significantly increased, and the volume was also increased but not significantly. The minimal cross-sectional areas and volumes of nasopharynx as well as hypopharynx were not significantly influenced by the advancement of the mandible. CONCLUSIONS: There was a tendency for snorers to have a smaller oropharynx than normal subjects and the oropharyngeal lumen was increased with the advancement of the mandible in both snorers and normal subjects.

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Quantitative Analysis of Esophageal Transit of Radionuclide in Patients with Dermatomyositis-Polymyositis (피부근염-다발성근염 환자에서 방사성 동위원소를 이용한 식도 스캔의 정량적 분석)

  • Lee, Myung-Hae;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.2
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    • pp.183-188
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    • 1989
  • Esophageal transit of radionuclide was quantitatively analyzed in 29 patients with dermatomyositis-polymyositis. Fourteen patients (48.3%) showed retention of tracer in oropharynx. The mean value of percent retention of oropharynx was $15.5{\pm}16.6%$. Esophageal dysfunction was found in 19 patients (65.5%). Among them 4 showed mild, 12 showed moderate and 3 showed severe esophageal dysfunction. Dysphagia was found in 11 patients (37.9%), which was closely related to percent retention of oropharynx.Quantitative analysis of esophageal transit of radionuclide seemed to be a useful technique for evaluation of dysphagia in patients with dermatomyositis-polymyositis.

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THE SIZE OF UPPER AIRWAY OF THE SNORER IN UPRIGHT AND SUPINE POSITION (Snorer의 앙와위와 직립위에서의 상기도 크기)

  • Kim, Jong-Chul;Cho, Hong-Kyu;Lee, Gye-Hyeong
    • The korean journal of orthodontics
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    • v.26 no.1 s.54
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    • pp.43-52
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    • 1996
  • The purpose of this study was to compare and evaluate the upper airway structure between the snorers and asymptomatic control subjects depending on the positional change. Lateral cephalograms in the upright and supine position were taken in 25 female snorers and 20 female asymptomatic control subjects. The length and the area of the soft palate, tongue and airway were measured and evaluated statistically. The results obtained were as follows : 1. The snorers showed longer and higher tongue, narrower and longer airway, inferiorly positioned hyoid bone, longer and broader soft palate and narrower hypopharynx than the control subjects both in the upright and supine position. In addition, the snorers showed broader tongue area and narrower oropharynx area than the control subjects in supine position. 2. Depending on the positional change from upright to supine position, the controls and the snorers showed decreased airway length and superior positioned the hyoid bone. In addition, the snorers showed decreased tongue length and height, airway length and thickness and oropharynx area, but increased tongue area and soft palate area.

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CEPHALOMETRIC STUDY OF OBSTRUCTIVE SLEEP APNEA PATIENTS IN THE UPRIGHT AND SUPINE POSITIONS

  • Kim, Jong-Chul;Lowe, Alan A
    • The korean journal of orthodontics
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    • v.25 no.6 s.53
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    • pp.655-664
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    • 1995
  • Sixty male patients with polysomnographically documented OSA were included in this study. A pair of cephalograms were obtained in the upright and supine positions. In the supine position, the ANB angle, lower facial height and the cross-sectional area of soft palate increased and there was a decrease in the vertical airway length and oropharynx cross-sectional area. Positional changes did not affect the cross-sectional area of tongue, but the cross-sectional area of the oropharynx decreased in the supine position. The obese group had higher AI and RDI. Maxillary unit length, C3-H, the cross-sectional areas of tongue, soft palate and oropharynx were significantly greater in the group Obese than in non-obese group. No correlation was noted between the mandibular unit length and OSA severity, The group of small mandibular unit length showed shorter lower facial height and maxillary unit length, and smaller cross-sectional area of tongue than the long mandibular unit length group. Hyold bone positioned more inferiorly and cross-sectional area of nasopharynx decreased as the OSA severity increased.

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A Case of the Soft Palate Reconstruction Using the Bilateral Palatal Mucomuscular Flap and Pharyngeal Flap after Wide Resection (연구개 및 구개수 암종의 광범위 절제 및 국소 점막근 피판 재건술 1예)

  • Gu, Ga Young;Lee, Hye Ran;Jang, Jeon Yeob
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.31-35
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    • 2022
  • The soft palate of carcinoma limited to the uvular region is infrequent among oropharyngeal cancers. The oropharynx regulates swallowing and speech through dynamic motions. Failure to reconstruct after surgical resection of the oropharynx structure can lead to permanent velopharyngeal insufficiency. Therefore, suitable reconstruction is important in establishing proper functional outcomes while maintaining oncological safety. We present a case of a 66-year-old male who was diagnosed with oropharynx cancer limited in the uvula accompanied by lymph node metastasis. After surgical resection, reconstruction was performed with the united arrangement of bilateral palatal mucomuscular flap and superiorly based posterior pharyngeal flap. There was no aspiration or reflux after feeding and epithelialization completely occurred after 1 month postoperatively. We report a successful case that the reconstruction with the local flap described above could preserve proper oropharyngeal function after primary surgery in small-sized oropharyngeal cancer.

Utility of FDG PET-CT Scans on Nodal Staging of Squamous Cell Carcinoma in the Oral Cavity and Oropharynx (구강 및 구인두 편평상피암종의 림프절 전이에 대한 PET-CT 영상의 유용성)

  • Joo, Young-Hoon;Sun, Dong-Il;Park, Jun-Ook;Yoo, Ie-Ryung;Kim, Min-Sik
    • Korean Journal of Head & Neck Oncology
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    • v.26 no.1
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    • pp.14-18
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    • 2010
  • Objectives : We evaluated the use of FDG PET/CT for the identification of cervical nodal metastases of SCC of the oral cavity and oropharynx with histological correlation. Material and Methods : We reviewed 46 medical records, from January 2004 to July 2007, of patients who underwent FDG PET/CT and CT/MRI for SCC of the oral cavity and oropharynx before surgery. We recorded the lymph node metastases according to the neck level affected and the system used for the imaging-based nodal classification. Results : The FDG PET/CT had a sensitivity of 75.6% and a specificity of 96.7% ; it had a higher sensitivity than the CT/MRI for identification of cervical metastases on the side of the neck(26/28 vs. 20/28, p=0.031) and at each of the cervical levels(34/45 vs. 26/45, p=0.008). There was a significant difference in the $SUV_{max}$ between the benign and malignant cervical lymph nodes($3.31{\pm}3.23$ vs. $4.22{\pm}2.57$, p=0.028). The receiver-operating-characteristic (ROC) curve analysis for differentiating the benign from the malignant cervical lymph nodes, showed that the area under the curve(AUC) of the FDG PET/CT was 0.775. The cut-off value for the $SUV_{max}$ was 2.23 based on the ROC curve. There was a significant correlation between the $SUV_{max}$ and the size of the cervical lymph nodes(Spearman r=0.353, p=0.048). Conclusion : FDG PET/CT images were more accurate than the CT/MRI images. In addition, the $SUV_{max}$ cut-off values were important for evaluating cervical the cervical nodes in the patients with SCC of the oral cavity and oropharynx.

Retrospective study on change in pharyngeal airway space and hyoid bone position after mandibular setback surgery

  • On, Sung Woon;Han, Min Woo;Hwang, Doo Yeon;Song, Seung Il
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.5
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    • pp.224-231
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    • 2015
  • Objectives: The purpose of this study was to evaluate changes in the pharyngeal airway space and hyoid bone position after mandibular setback surgery with bilateral sagittal split ramus osteotomy (BSSRO) and to analyze the correlation between the amount of mandibular setback and the amount of change in pharyngeal airway space or hyoid bone position. Materials and Methods: From January 2010 to February 2013, a total of 30 patients who were diagnosed with skeletal class III malocclusion and underwent the same surgery (BSSRO) and fixation method in the Division of Oral and Maxillofacial Surgery, Department of Dentistry at the Ajou University School of Medicine (Suwon, Korea) were included in this study. Lateral cephalograms of the 30 patients were assessed preoperatively (T1), immediately postoperatively (T2), and 6 months postoperatively (T3) to investigate the significance of changes by time and the correlation between the amount of mandibular setback and the amount of change in the airway space and hyoid bone position. Results: Three regions of the nasopharynx, oropharynx, and hypopharynx were measured and only the oropharynx showed a statistically significant decrease (P<0.01). A significant posterior and inferior displacement of the hyoid bone was found 6 months after surgery (P<0.01). Analysis of the correlation between the amount of mandibular setback and the amount of final change in the airway space and hyoid bone position with Pearson's correlation showed no significant correlation. Conclusion: In this study, the oropharynx significantly decreased after mandibular setback surgery, and changes in the surrounding structures were identified through posteroinferior movement of the hyoid bone during long-term follow-up. Therefore, postoperative obstructive sleep apnea should be considered in patients who plan to undergo mandibular setback surgery, and necessary modifications to the treatment plan should also be considered.