• Archives of Plastic Surgery
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• v.33 no.2
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• pp.161-167
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• 2006

After total glossectomy, recovery of swallowing and speech function can greatly improve quality of life. The reconstructed tongue must be thick enough to contact with the hard palate for articulation. If the free flap is denervation, it may procede to have atrophy postoperatively. Therefor it is difficult to maintain the tongue volume for a long period of time. To resolve this problem, we have used a innervated rectus abdominis musculocutaneous flap and maintaining the volume through a neurorrhaphy. 7 patients underwent immediate reconstruction using a reinnervated rectus abdominis musculocutaneous free flap in which included intercostal nerve was anastomosed to the remaining hypoglossal nerve. The reinnervated rectus abdominis musculocutaneous free flap has provided good tongue contour with sufficient bulk and shown no obvious atrophy in all patients even though postoperative 9 months later. Considering swallowing and articulation, we concluded that reinnervated rectus abdominis musculocutaneous flap is a viable method after total glossectomy

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.3
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• pp.123-129
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• 2022

Pediatric laryngotracheal stenosis occurs by either congenital or acquired causes and usually indicates subglottic stenosis. The main goals of treatment are decannulation, preserving phonation, and normal swallowing function. Various types and degrees of stenosis and combined anomalies would be the main barriers to reaching successful treatment results unless comprehensive understanding of stenosis. Multidisciplinary team approaches encompassing initial assessment, treatment, and postoperative care, are also necessary to achieve the best treatment outcome. Therapeutic approaches are divided into conservative, endoscopic, and open surgical approaches at length, which are not exclusive to each other. Here, an adequate selection of each therapeutic option and postoperative management will be introduced to achieve decannulation without leaving phonatory or swallowing complications.

• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.191-197
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• 1999

Background and Objective : Soft palate plays a great role in function of speech and swallowing. Ablation of tonsil cancer results in multi-demensional defect including soft palate in most cases and restoration of the postoperative oral cavity function is a continuing surgical challenge. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for these defect, which offers a thin, pliable, and relatively hairless skin, and a long vascular pedicle. The aim of the present study is to report the speech and swallowing function test results of our 5 consecutive radial forearm free flaps used for tonsil cancers. Materials and Methods : We reviewed the medical records of 5 patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for tonsil cancers, from Dec. 1997 to Oct. 1998, and analyzed the surgical methods, complications, and speech and swallowing function test results. We have examined with modified barium swallow to evaluate postoperative wallowing function and articulation and resonance test for speech. Results : The tumor sizes by TNM stage(AJCC, 1997) were T1(1), T2(2), and T4(3). The paddles of flaps were tailored in multilobed designs from oval shape to pentalobed design and in variable size from 24$cm^2$ to 108$cm^2$(average size = 78.4$cm^2$), according to the defect after ablation. This procedures resulted in satisfactory flap success and functional results all but 1 case of flap contracture in 2 postoperative week, achieved early oral diet until 16-57 postoperative day(average, 28 days) and social speech. The oropharyngeal defect including soft palate reconstruction with radial forearm free flap might be an excellent method for the maximal functional results, after ablative surgery of tonsil cancer that results in multidimensional defect.

• The korean journal of orthodontics
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• v.24 no.2
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• pp.233-246
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• 1994

The purpose of the present study was to investigate the difference of muscular activities of the tongue and lip muscles between anterior open-bite and normal occlusion during various function. Thirty eight subjects of 12.1-39.6 years were employed in this study : Eighteen subjects were anterior open-bites and tweenty subjects were normal occlusions. During rest position, maximum effort of lip sealing, command swallow of saliva and sucking & swallowing of juice, the electromyographic datas of the genioglossus, superior longitudinal muscle of tongue, upper and lower orbicularis oris were recorded and integrated with Medelec MS 25 electromyographic machine. Lateral cephalometric radiographs were taken on all subjects for the analysis of tongue posture and size. All data were recored and statistically processed. The findings of this study can be summerized as follows : 1. During the rest position, muscular activity of tongue was higher than that of lip muscle in open-bite, but no difference in normal occlusion group. 2. During the swallowing of juice, the activity of orbicularis oris was higher than that of genioglossus in open-bite. But the normal occusion was showed higher activity of tongue during the swallowing of juice. 3. The open-bite, compared to the normal occlusion, had higher value of tongue muscle activity during the rest position. 4. Compared to normal occlusion group, the open-bite had higher value of lip muscle activity during the sucking and swallowing of juice. 5. During the command swallow of saliva, the normal occlusion was showed harmonious swallowing pattern, but the open-bite showed much variation and disharmony in muscular contraction sequence, tended to absent of lip muscle activity. 6. At the lateral cephalometric radiographs, compared to the normal occlusion, the open-bite was showed lower tongue posture. But no difference was found in intermaxillary space. It is suggested that the open-bite, compared to the normal occlusion, had higher muscular activity of tongue during the rest position and various functions, showed lower tongue posture on the lateral cephalogram. In the development of anterior open-bite malocclusion, these factors may be an etiologic factor.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.330-335
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• 2007

Purpose: The purpose of this study is to evaluate the functional outcome and donor site morbidity of anterolateral thigh free flap(ALT) compared to Radial forearm free flap(RFFF) for the reconstruction of partial glossectomy defect. Methods: 5 ALT free flap (group I) were attempted for partial glossectomy patients. We compared patients undergone ALT flap with those(n=11) of similar size defect reconstructed with RFFF (Group II). Rating scales for articulation and swallowing function were applied and donor site morbidity have been evaluated. Results: The scales for speech function showed no difference between the two groups (average score; group I - 6.4, group II - 6.45). Swallowing function also showed no difference between the two groups(average score; Group I - 6.6, Group II - 6.27). ALT group had one patient with donor site morbidity(numbness). All of the RFFF patients(11/11) complained and suffered from hypertrophic scar, retraction, numbness or hyperpigmentation on forearm donor site. Based on our study, ALT free flap is comparable to that of RFFF in terms of functional assessment in tongue reconstruction. Conclusion: Considering the donor site morbidity, ALT flap is to be valuable to reconstruct partial glossectomy defect.

• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.798-803
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• 2018

Objective To investigate the relationship between peak cough flow (PCF), pulmonary function tests (PFT), and severity of dysphagia in patients with ischemic stroke. Methods This study included patients diagnosed with ischemic stroke, who underwent videofluoroscopic swallowing study (VFSS), PCF and PFT from March 2016 to February 2017. The dysphagia severity was assessed using the videofluoroscopic dysphagia scale (VDS). Correlation analysis of VDS, PFT and PCF was performed. Patients were divided into three groups based on VDS score. One-way ANOVA of VDS was performed to analyze PCF, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and age among the different groups. Results The correlation coefficients of VDS and PCF, VDS and FVC, and VDS and FEV1 were -0.836, -0.508, and -0.430, respectively, all of which were statistically significant at the level of p<0.001. The one-way ANOVA indicated statistically significant differences in PCF, FVC, FEV1, and age among the VDS groups. Statistically significant differences in VDS and age were observed between aspiration pneumoia and non-aspiration pneumonia groups. Conclusion Coughing is a useful factor in evaluating the risk of aspiration in dysphagia patients. Evaluation of respiratory and coughing function should be conducted during the swallowing assessment of patients with ischemic stroke.

• The Journal of the Korea institute of electronic communication sciences
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• v.11 no.10
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• pp.995-1002
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• 2016

The aim of this study was investigated the effect of orofacial exercise program using smart phone on swallowing function and tongue strength in acute stroke patients with dysphagia. This study participated in sixteen acute stroke patients with dysphagia. All subjects allocated that randomized each eight patients in experimental and control groups. Subjects of both group received to conventional dysphagia therapy during 30 min/day, 5 times per week, for 4 weeks. Experimental group performed additionally that orofacial exercise program using smart phone, supervised under caregivers, during 30 min/day. The outcome measures were the IOPI(: Iowa Oral Performance Instrument), VR(: Vellecula Residue), PSR(: Pyriform Sinuses Residue), MIP(: Maximum Isometric Pressures). In results of study. Both group showed significant improvements after intervention in all assessments(p<.05). In comparison of change score between two groups, experimental group showed significant improvements than control group in PSR and MIP(p<.05). Orofacial exercise program using smart phone suggested that expected to positive effects the reduction of residue in pharynx and improvements of tongue strength in acute stroke patients with dysphagia.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.4
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• pp.353-360
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• 2013

Cleft lip and palate is congenital deformity in oral and maxillofacial area. Normal soft palate has velopharyngeal closure action by connecting oral cavity and nasal cavity at rest and moving upward at swallowing and specific pronunciation. Cleft palate patients with velopharyngeal insufficiency have difficulty in mastication, swallowing and pronunciation because velopharyngeal closure is incomplete. At this time, a prosthetic device used to cover palate defects is called a palatal obturator. A palatal obturator separates oral cavity and nasal cavity and recovers pronunciation, mastication, swallowing and esthetic function. The purpose of this case study is to report the results because it reaches a satisfactory result in functional and esthetic aspects through functional impression procedures using modeling compound and tissue conditioner for restoration of a cleft palate patient with velopharyngeal insufficiency.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.3
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• pp.239-245
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• 2018

If complication arises after glossectomy which leads to trouble in forming food bolus or transfer of the food, it is possible that either food bolus may block the airway or dysphagia may occur as the food bolus goes down into the airway. To solve the issue, palatal augmentation prosthesis could be used. In this case, the patient with an oral cancer is having difficulties swallowing food after glossectomy. Through taking impressions of polishing surface of his denture referring his tongue movement, the complete denture for the upper jaw was created using the concept of palatal augmentation prosthesis. This new upper denture increases the palatal-tongue contact pressure, allowing the patient to perform better swallowing and better pronunciation.

• Food Science and Industry
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• v.48 no.3
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• pp.20-27
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• 2015