• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.4
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• pp.517-523
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• 2000

Nasopharyngeal closure is a sphincter mechanism between the activities of the soft palate, lateral pharyngeal wall and the posterior pharyngeal wall, which divides the oral cavity and the nasal cavity. It participates in physiological activities such as swallowing, breathing and pronunciation. In case of an error in this mechanism, it is called a nasopharyngeal incompetence. The causes of this error are defects in (1) length, function, posture of the soft palate (2) depth and width of the nasopharynx, (3) activity of the posterior and lateral pharyngeal wall. The purpose of this study is to analyze the nasopharynx of cleft palate patients using lateral cephalograms and at the same time, evaluate the degree of hypernasality of each vowels to find its relationship with nasopharyngeal incompetence. The following results were obtained: 1. The length of the soft palate was markedly short than normal. 2. The adequate ratio was smaller than the normal value. 3. As the adequate ratio decreased, when articulating vowels, anatomic mVPI increased. 4. When articulating each vowels, anatomic VPI was in proportion with the degree of hypernasality. 5. The degree of hypernasality was greater in high vowels(/i/, /u/) than low vowel(/a/). From the above results, it can be concluded that in cleft palate patients, lateral cephalograms can be used effectively in diagnosing and evaluating nasopharyngeal incompetence. The anatomic structure of the nasopharynx has close relation to the degree of hypernasality.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.94-100
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• 1997

Background and Objectives : In children with tracheal stenosis, operative management remains a challenging problem due to difficulties of operative techniques and postoperative care. The purpose of this study was to determine the effectiveness of tracheal resection with end to end anastomosis as operative management for tracheal stenosis in children. Materials and Methods : 6 children with severe tracheal stenosis underwent tracheal resection with end to end anastomosis. Causes of stenosis were trauma in 1 case and prolonged intubation or tracheotomy in 5 cases. The diagnoses were made by radiologic evaluation (plain X-ray, CT, 3-Dimensional CT) and confirmed by direct laryngoscopy and ventilating bronchoscopy under general anesthesia. Thyroplasty and unilateral arytenoidectomy were performed in 1 case. Suprahyoid release was done in 1 case with severe adhesion. Decanulation was achieved following postoperative endoscopic examination and pulmonary function test. Postoperative physical and radiologic examinations were given at regular intervals. Results : Stenosis were improved from grade III grade I in 4 cases and from grade II to grade I in 2 cases. Decanulation was achieved on average postoperative 6 months in 5 cases, and 10 years in 1 case due to exertional dyspnea. There were 1 each case of immediate postoperative subcutaneous emphysema, pneumothorax and wound infection. Postoperative granulomas at anastomosis site were treated with laser vaporization under suspension laryngoscope and bronchoscope in 3 cases. There was 1 each case of delayed postoperative vocal cord palsy, aspiration pneumonia and loss of cough reflex. Conclusion In tracheal stenosis of children, tracheal resection with end to end anastomosis has good result with preservation of normal airway. Preoperative evaluation of local factors such as swallowing, vocal cord movement and cough reflex and general condition was important for successful treatment. As the cases in adults, authors considered this operation to be a curable operative management for tracheal stenosis.

• 재활복지
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• v.20 no.3
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• pp.179-193
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• 2016

Chin Tuck Against Resistance Exercise(CTARE) and Shaker exercise is used to common for strengthening of suprahyoid muscle. No previous studies was compare of two exercises for patients with dyaphagia. This study investigated the effects of CTARE and Shaker exercise on suprahyoid, sternocleidomastoid muscle activity in stroke older patients with dysphagia. Ten stroke patients with dyaphagia voluntarily participated in this study. All subjects was performed in the order in the CTARE (isometric, isokinetic), Shaker (isometric, isokinetic), and repeated each ten trials. After CTARE was performed, subjects took a 5 min wash out period to minimize muscle fatigue. Activity of suprahyoid and sternocleidomastoid muscle during two training was analyzed using surface electromyography(sEMG). Wilcoxon signed rank test was used to assess differecences for muscles activity between the effects of the CTAR and Shaker exercise within group. CTARE and Shaker exercise showed no significant difference activity in suprahyoid muscle(p > .05). CTARE showed significantly lower muscle activity in sternocleidomastoid muscle than Shaker exercise(p < .05). CTARE in stroke older patients with dysphagia may be a effective intervention to improve swallowing function than Shaker exercise.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.50-54
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• 2019

Muscular dystrophy (MD) is a heterogeneous group of inherited neuromuscular disorders, characterized by progressive muscle weakness. Severity of the disease ranges from mild to severe, and the disease is mostly caused by mutations in a number of genes. These genetic mutations cause lack of proteins which are essential for muscle cell stability. Muscle fibers are gradually replaced by fat and fibrous tissue. The muscles of the head and neck are affected in several types of MD that manifest as altered craniofacial morphology and dental malocclusion. A 3-year-10-month old, 15.0 kg boy with MD presented to Seoul National University Dental Hospital, Seoul, South Korea because of extensive carious teeth. A number of dental caries in primary dentition were identified during clinical oral examination. Due to dental anxiety and underlying systemic disease, general anesthesia was considered. General anesthesia was induced and maintained with intravenous anesthetics, propofol and remifentanil. Caries treatments - resin restoration, pulpectomy, zirconia crown restoration, stainless steel crown restoration - were performed. Under general anesthesia, successful dental procedure was done. Total intravenous anesthesia (TIVA) was performed instead of inhalation anesthesia in order to avoid risk of complications such as malignant hyperthermia and life-threatening rhabdomyolysis. With decreasing muscle function, plaque control becomes more difficult and leads to gingivitis. Especially, the open-mouth posture worsens gingivitis and can leads to malocclusions and problems in swallowing. Regular and periodic dental care is essential for maintaining oral health for patients with MD.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.1
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• pp.82-89
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• 2023

The tongue is one of the most common sites of oral cancer. Glossectomy is known as the gold standard for tongue cancer treatment. However, surgical removal can lead to reduced mobility of the tongue and the patients may have difficulty performing normal oral functions like swallowing and pronunciation. Therefore, additional prosthetic consideration to supplement the function of the impaired tongue is needed for oral rehabilitation of such patients. Palatal augmentation prosthesis helps the tongue to reach the palate by lowering the position of the palatal polished surface. The oral functions of the patients with limited tongue mobility can be improved by the prosthesis. In this case, palatal augmented maxillary denture and conventional mandibular denture were fabricated for the completely edentulous patient with reduced tongue mobility after glossectomy due to tongue cancer. As a result, the oral functions of the patient were improved with the prosthesis.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.320-329
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• 2023

Background: Oral frailty has garnered considerable interest following its identification as a risk factor for physical frailty. The Korean oral frailty diagnosis criteria have emphasized the need for extensive research on oral frailty diagnostic items and interventions. Our study performed an in-depth analysis of the tongue-palate pressure patterns in healthy community-dwelling older adults. Methods: Of the 217 older adults aged ≥60 years who visited a senior center in Wonju, 205 participants who completed tongue pressure measurement were included in the final analysis. Pressure changes over time were recorded by instructing the participants to press their tongue against the hard palate with for 7 seconds per cycle. The participants were divided into the normal and abnormal tongue pressure (NTP and ATP, respectively) groups based on whether they achieved the target tongue pressure at least once; tongue pressure patterns were compared between the groups. Furthermore, the average time taken to achieve the standard tongue pressure value was calculated for the participants in the NTP group and used to evaluate the decrease in tongue pressure in the ATP group. Results: Among the 205 participants, 40.5% had ATP. The tongue pressure graph revealed a gentle and consistent incline that was maintained even after achieving standard tongue pressure in the NTP group. The graph was more extreme in the ATP group, and the changes in the pressure type varied across individuals; the tongue pressure was only 48.4%, 40.7%, 31.9%, and 22.6% of the NTP in the participants in their 60s, 70s, 80s, and ≥90s, respectively (p<0.05). Conclusion: Tongue pressure weakness was observed in 40.5% of the healthy community-dwelling older adults. Furthermore, ATP graphs were observed in the patients with tongue pressure weakness. Thus, activities improving the oral function in community-dwelling older adults and systematic oral rehabilitation programs should be devised to promote normal swallowing.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.383-389
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• 2005

Xerostomia is defined as a subjective complaint of dry mouth that may be perceived when there is insufficient mucosal wetting. However, the diagnosis and treatment of xerostomia is not that simple because of the fact that the subjective awareness of dry mouth is not always correlated with a diminution in the flow of saliva and there is always a difference between individuals in salivary flow rates needed for normal oral function. In the present study, the aim was to develop a questionnaire to evaluate the dry mouth symptoms and to analyze its reliability and usability as a diagnostic and analytic tool for xerostomia. The questionnaire which consists of 6 Visual Analogue Scale(VAS) type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to avoid oral dryness was developed and administered twice with 1 week's interval to the healthy 88 young adults without dry mouth symptoms(44 males and 44 females; mean age was $25.6{\pm}3.1$ years in male and $24.3{\pm}2.1$ years in female). The results were as follows. 1 The intraclass correlation coefficients of 6 questions to evaluate the subjective oral dryness were as significantly high as 0.767 for the degree of oral dryness at other times of the day, 0.850 for the amount of saliva in the mouth, and 0.791 for the degree of effect on daily life due to oral dryness and as high as 0.563 for the degree of oral dryness at night or on awakening, 0.674 for the degree of oral dryness during eating, and 0.641 for the degree of difficulty in swallowing foods. 2. Cronbach's alpha value of 6 questions was 0.982. It can be concluded that the series of questions to evaluate the subjective oral dryness has high internal consistency. 3. Cohen's kappa values of 4 questions to evaluate behavior to relieve oral dryness were as significantly high as 0.850 for the frequency of keeping a glass of water at the bedside and as high as 0.506 the frequency of awakening during sleeping due to oral dryness, 0.419 for the frequency of sipping liquids to aid in eating dry foods, and 0.407 for the frequency of using a candy or chewing gum due to oral dryness. From the results, it can be concluded that the questionnaire consisting of 6 VAS type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to relieve oral dryness has reliability of good to excellent level, and that the series of 6 VAS type questions has significantly high internal consistency to evaluate the subjective oral dryness.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.721-728
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• 2004

Velopharyngeal closure is a sphincter mechanism between the activities of the soft palate, lateral pharyngeal wall and the posterior pharyngeal wall, which divides the oral and nasal cavity. It participates in physiological activities such as swallowing, breathing and speech. It is called a velopharyngeal dysfunction when this mechanism malfunctions. The causes of this dysfunction are defects in (1) length, function, posture of the soft palate, (2) depth and width of the nasopharynx and (3) activity of the posterior and lateral pharyngeal wall. The purposes of this study are to analyze the nasopharynx of cleft palate patients using cephalometry and to evaluate the degree of hypernasality using nasometry to find its relationship with velopharyngeal dysfunction. The following results were obtained : 1. In cephalometry, there were significant differences in soft palate length, soft palate thickness, nasopharyngeal depth, nasopharyngeal area, and adequate ratio between two groups. 2. In nasometry, there were significant differences between two groups in vowel /o/ and sentences including oral consonants. 3. In cleft palate patients, though no general correlation was found between Anatomic VPI and nasalance scores, vowel /i/ and sentences including oral consonants were slightly correlated. In conclusion, cephalometry and nasometer results were significantly different between the two groups. Though in the cleft palate group, Anatomic VPI and nasalance scores, which are indices for velopharyngeal closure, excluding the vowel /i/ and sentences including oral consonants show generally no significance.

• Korean Journal of Community Nutrition
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• v.26 no.5
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• pp.327-336
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• 2021

Objectives: This study was conducted to create a 3D printable snack dish model for the elderly with low food or fluid intake along with barriers towards eating. Methods: The decision was made by the hybrid-brainstorming method for creating the 3D model. Experts were assigned based on their professional areas such as clinical nutrition, food hygiene and chemical safety for the creation process. After serial feedback processes, the grape shape was suggested as the final model. After various concept sketching and making clay models, 3D-printing technology was applied to produce a prototype. Results: 3D design modeling process was conducted by SolidWorks program. After considering Dietary reference intakes for Koreans (KDRIs) and other survey data, appropriate supplementary water serving volume was decided as 285 mL which meets 30% of Adequate intake. To consider printing output conditions, this model has six grapes in one bunch with a safety lid. The FDM printer and PLA filaments were used for food hygiene and safety. To stimulate cognitive functions and interests of eating, numbers one to six was engraved on the lid of the final 3D model. Conclusions: The newly-developed 3D model was designed to increase intakes of nutrients and water in the elderly with dementia during snack time. Since dementia patients often forget to eat, engraving numbers on the grapes was conducted to stimulate cognitive function related to the swallowing and chewing process. We suggest that investigations on the types of foods or fluids are needed in the developed 3D model snack dish for future studies.