• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제37권
• /
• pp.38.1-38.6
• /
• 2015

Background: The posterior movement of mandible was known as the main cause of the changes in the pharyngeal airway space (PAS) and the postoperative obstructive sleep apnea (OSA). The purpose of this study was to know the changes of PAS and position of hyoid bone. Methods: Lateral cephalographies of 13 patients who had undergone sagittal split ramus osteotomy (SSRO) setback surgery were taken preoperatively (T1), postoperatively within 2 months (T2), and follow-up after 6 months or more (T3). On the basis of F-H plane, diameters of nasopharynx, oropharynx, and hypopharynx were measured. The movements of the soft palate, tongue, and hyoid bone were also measured. Results: The amount of mandible setback was $7.5{\pm}3.8mm$. In the measurements of PAS, there was a statistically significant decrease of $2.8{\pm}2.5mm$ in nasopharynx (P < 0.01), and $1.7{\pm}2.4mm$ in oropharynx (P < 0.01) were observed after surgery. The hypopharynx decreased $1.0{\pm}2.1mm$ after surgery and continuously decreased $1.0{\pm}2.8mm$ at follow-up. The changes in hyoid bone position showed the posterior movement only after surgery and posteroinferior movement at follow-up. Conclusions: The PAS such as nasopharynx, oropharynx, and hypopharynx showed relatively high correlation with the amount of mandibular setback. The change of resistance in upper airway may be important for the prevention of OSA after mandibular setback surgery.

• The korean journal of orthodontics
• /
• 제50권4호
• /
• pp.238-248
• /
• 2020

Objective: To investigate the effects of the long-term use of a maxillary protraction facemask with miniplate (FM-MP) on pharyngeal airway dimensions in growing patients with cleft lip and palate (CLP). Methods: The study included 24 boys with CLP (mean age, 12.2 years; mean duration of FM-MP therapy, 4.9 years), divided into two groups according to the amount of A point advancement to the vertical reference plane (VRP): Group 1, > 4 mm; Group 2, < 2 mm; n = 12/group. After evaluating the skeletodental and airway variables using lateral cephalograms acquired before and after FM-MP therapy, statistical analyses were performed. Results: Group 1 showed greater forward and downward displacements of the posterior maxilla (posterior nasal spine [PNS]-horizontal reference plane [HRP]; PNS-VRP), greater increase in ANB, more forward tongue position (tongue tip-Pt vertical line to Frankfort horizontal plane), and greater increase in the oropharynx (superior posterior airway space [SPAS]; middle airway space [MAS]) and upper nasopharynx (PNS-adenoid2) than did Group 2. While maxillary advancement (A-VRP and PNS-VRP) correlated with increases in SPAS, MAS, and PNS-adenoid2, downward displacement of the PNS (PNS-HRP) correlated with increases in SPAS, MAS, PNS-adenoid1, and PNS-adenoid2, and with a decrease in vertical airway length (VAL). Mandibular forward displacement and decrease in mandibular plane correlated with increases in MAS. Conclusions: FM-MP therapy had positive effects on the oropharyngeal and nasopharyngeal airway spaces without increases in VAL in Group 1 rather than in Group 2. However, further validation using an untreated control group is necessary.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• 제19권1호
• /
• pp.21-27
• /
• 2008

Total laryngectomy is the most useful procedure tor advanced laryngopharyngeal cancer, but it remains the major problem such as loss of voice. Voice restoration is essential for every patients who undergo a total laryngectomy. Ideal voice rehabilitation methods can resolve three factors. First, every laryngectomee can produce voice sufficient for communication, second every patient should be allowed to use both hands freely during phonation, and last, the voice restoration methods should be easy and safe without complication during and after treatment. Among various voice rehabilitation procedures during or after total laryngectomy, it can be divided electronic and pneumatic methods. In pneumatic methods, there are also divided both pulmonary air and non-pulmonary air methods. The non-pulmonary air methods include esophageal speech, buccal speech, and pharyngeal speech. Pulmonary air methods are divided into surgical and non-surgical such as pneumatic speech aid. In the surgical methods, there are neoglottic operation, tracheopharyngeal shunt, and tracheopharyngeal shunt operations. Recently, tracheoesophageal shunt with or without prosthesis are being recognized the most effective method. Blom-Singer low pressure prosthesis, Panje button, and Provox are well known types of prosthesis in the tracheoesophageal shunt operation. Amatsu method is a kind of famous tracheoesophageal shunt method without using prosthesis. Authors tried to review the published articles for evaluation of effectiveness and problems of tracheoesophageal shunt operation with or without prosthesis. In conclusion, indwelling type of prosthesis and pharyngeal myotomy and plexus neurectomy are recommended for higher success rate during tracheoesophageal puncture procedure. More over, Amatsu method is also one of the recommended voice rehabilitation procedure during total laryngectomy. In this situation, pharyngeal myotomy and plexus neurectomy may be helpful for better fluent communication.

• International Journal of Oral Biology
• /
• 제45권1호
• /
• pp.8-14
• /
• 2020

Bilobalide isolated from the leaves of Ginkgo biloba has several pharmacological activities such as neuroprotective, anti-inflammatory, and anticonvulsant. However, the effect of bilobalide on cancer has not been clearly established. The main purpose of this study was to investigate the effect of bilobalide on cell growth and apoptosis induction in FaDu human pharyngeal squamous cell carcinoma. This was examined by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay, nuclear 4′,6-diamidino-2-phenylindole dihydrochloride staining, DNA fragmentation analysis, and immunoblotting. Bilobalide inhibited the growth of FaDu cells in dose- and time-dependent manners. Treatment with bilobalide resulted in nuclear condensation and DNA fragmentation in FaDu cells. Furthermore, it promoted the proteolytic cleavage of procaspase-3/-7/-8/-9 with increase in the amount of cleaved caspase-3/-7/-8/-9. Bilobalide-induced apoptosis in FaDu cells was mediated by the expression of Fas and the activation of caspase-8, caspase-3, and poly (ADP-ribose) polymerase. Immunoblotting revealed that the antiapoptotic mitochondrial protein Bcl-2 was downregulated, but the proapoptotic protein Bax was upregulated by bilobalide in FaDu cells. Bilobalide significantly increased Bax/Bcl-2 ratio. These results suggest that bilobalide inhibits cell proliferation and induces apoptosis in FaDu human pharyngeal squamous cell carcinoma via both the death receptor-mediated extrinsic apoptotic pathway and the mitochondrial-mediated intrinsic apoptotic pathway.

• Tuberculosis and Respiratory Diseases
• /
• 제63권2호
• /
• pp.173-177
• /
• 2007

Tuberculosis remains as a major public health problem worldwide. In addition to classic pulmonary tuberculosis, tuberculosis may sometimes present atypically. In the case of atypical tuberculosis, the unusual sites and properties that mimic other diseases can lead to a misdiagnosis and therapeutic delay. Abdominal and pharyngeal tuberculosis are uncommon extrapulmonary manifestations of tuberculosis. To the best of our knowledge, a combination of abdominal and pharyngeal tuberculosis with endobronchial tuberculosis has not been reported. We report a case of concurrent abdominal and pharyngeal tuberculosis in a patient with chronic endobronchial tuberculosis mimicking a metastatic malignancy on computed tomography and FDG-PET.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제13권3호
• /
• pp.338-345
• /
• 1991

Velopharyngeal incompetence (VPI) is a condition of inadequate functional valving between the oral and nasal cavities that results in hypernasal speech and nasal air escape. VPI is caused by the following factors ; cleft palate, soft palate defect, pharyngomegaly, velopharyngeal sphincter muscle anomaly and maxillary advancement surgery, etc. Velopharyngeal function is assessed by a variety of measures that include speech evaluation, cephalogram, airflow study, videofluoroscopy and nasoendoscopy. The management of VPI is classified into four main groups ; prosthesis, insertion of implant, palatoplasty and pharyngoplasty. Pharyngeal flap is the most common surgical procedure for correcting VPI since Schoenborn's report in 1875. We report seven cases of VPI which were treated by modified modified superiorly based pharyngeal flap with good results.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제39권
• /
• pp.22.1-22.9
• /
• 2017

Background: Two-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. Bimaxillary surgery can reposition the maxillofacial bone together with soft tissue, such as the soft palate and the tongue base. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery. Methods: A prospective clinical study was designed including a survey on snoring and three-dimensional (3D) computed tomography (CT) in class III malocclusion subjects before and after bimaxillary surgery. We conducted an analysis on changes of the posterior pharyngeal space find out clinical correlations with the prevalence of snoring. Results: Among 67 subjects, 12 subjects complained about snoring 5 weeks after the surgical correction, and examining the 12 subjects after 6 months, 6 patients complained about the snoring. The current findings demonstrated the attenuation of the largest transverse width (LTW), anteroposterior length (APL), and cross-sectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, particularly at the retropalatal level. The average distance of maxillary posterior movements were measured to be relatively higher (horizontal distance 3.9 mm, vertical distance 2.6 mm) in case of new snorers. Conclusions: This study found that bimaxillary surgery could lead to the narrowing of upper airway at the retropalatal or retroglossal level as well as triggering snoring in subjects with class III malocclusion. Based on the current clinical findings, we also found that upper airway narrowing at retropalatal level may contribute to increasing the probability of snoring and that polysonography may need to be performed before orthognathic surgery in subjects with class III malocclusion.

• Journal of Dental Rehabilitation and Applied Science
• /
• 제32권4호
• /
• pp.351-357
• /
• 2016

Rehabilitation of maxillectomy patients is challenging. The maxillary defects need to functional restoration because of mastication, speech, swallowing problems. The goal of making obturator is to restore maxillary defects and give patients comfortable, esthetic prosthesis. This case report presents acquired masticatory and esthetic results and improved retention resulting from the pharyngeal obturator prosthesis using implant.

• Journal of Biomedical Engineering Research
• /
• 제19권5호
• /
• pp.495-502
• /
• 1998

A mathematical model of viscoelasticity on the material property of human pharyngeal tissue utilizing Y.C. Fung's Quasi-linear viscoelastic theory is proposed based on cyclic load, stress relaxation, incremental load, and uniaxial tensile load tests. The material properties are characterized and compared with other biological materials' results. The mathematical model is proposed by combining two characteristic functions determined from the stress relaxation and uniaxial tensile load tests. The reduced stress relaxation function G(t) and elastic response function S(t) are obtained from stress relaxation test and uniaxial tensile load test results respectively. Then the model describing stress-time history of the tissue is implemented utilizing two functions. The proposed model is evaluated and validated by comparing the model's cyclic behaviour with experimental results. The model data could be utilized as an important information for constructing 3-dimensional biomechanical model of human pharynx using FEM(Finite Element Method).

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제22권6호
• /
• pp.427-435
• /
• 2022

Background: This study aimed to investigate the relationship between pharyngeal morphology and the success or failure of blind nasotracheal intubation using standard lateral cephalometric radiography and to analyze the measurement items affecting the difficulty of blind nasotracheal intubation. Methods: Assuming a line perpendicular to the Frankfort horizontal (FH) plane, the reference point (O) was selected 1 cm above the posterior-most end of the hard palate. A line passing through the reference point and parallel to the FH plane is defined as the X-axis, and a line passing through the reference point and perpendicular to the X-axis is defined as the Y-axis. The shortest length between the tip of the uvula and posterior pharyngeal wall (AW), shortest length between the base of the tongue and posterior pharyngeal wall (BW), and width of the glottis (CW) were measured. The midpoints of the lines representing each width are defined as points A, B, and C, and the X and Y coordinates of each point are obtained (AX, BX, CX, AY, BY, and CY). For each measurement, a t-test was performed to compare the tracheal intubation success and failure groups. A binomial logistic regression analysis was performed using clinically relevant items. Results: The items significantly affecting the success rate of blind nasotracheal intubation included the difference in X coordinates at points A and C (Odds ratio, 0.714; P-value, 0.024) and the ∠ABC (Odds ratio, 1.178; P-value, 0.016). Conclusion: Using binomial logistic regression analysis, we observed statistically significant differences in AX-CX and ∠ABC between the success group and the failure group.