• Archives of Plastic Surgery
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• v.33 no.2
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• pp.144-148
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• 2006

The velopharyngeal dysfunction usually occurs in patients with previous operation of the cleft palate or with submucosal cleft palate. In case of velopharyngeal dysfunction without cleft palate, no study has been made when it comes to operative method and postoperative results. Here, we would like to present the operative methods and the postoperative results with the cases we've experienced. This study is based on seven cases of velopharyngeal dysfunction without cleft palate from 1999 to 2004. Analysis of age, sex, etiology, operative methods, satisfaction rate and speech evaluation was done. The patients were 3 males and 4 females, with an age ranged from 10 to 28 at the time of surgery. The follow-up period was more than six months. One case had bifid uvula, another had atypical anomaly in palate, and five cases had no anatomical abnormality. The palatal lengthening was done on one patient, the levator muscle repositioning on another patient and to the rest of them, the superiorly based posterior pharyngeal flap was done. It was difficult to determine the etiology of the velopharyngeal dysfunction without cleft palate. The speech improvement and the satisfaction rate of the patients and parents were diverse. Although the authors had a problem with statistical analysis between the operative age and the speech improvement, it was reasonable to perform a surgical operation because postoperative speech improvement was observed in most cases regardless of age. There is little statistical correlation, but significantly higher outcomes were observed in palatal lengthening and levator muscle repositioning than in pharyngeal flap.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.56-61
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• 2011

Cornelia de Lange syndrome(CdLS) is a well-described multiple malformation syndrome typically involving proportionate small stature, developmental delay, specific facial features, major malformations, and behavioral abnormalities. Dental issues include micrognathia, crowding of teeth, small teeth, absent teeth, poor oral hygiene, and periodontal disease. We present a case of CdLS in a 10-year-old girl. Micrognathia, crowding of teeth, and bifid uvula are the characteristic features of this case. Dental treatments for this child including preventive and restorative procedures were performed under outpatient general anesthesia.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.57-60
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• 2011

Spontaneous tonsillar bleeding is a rare condition in ENT unit. Almost reported cases have been related to infection of tonsils. Prior to introduction of antibiotics, spontaneous tonsillar bleeding was usually related to superficial capsular bleeding due to acute or chronic tonsillitis. The presented case is a 36-year old healthy man without history of acute, chronic tonsillitis, and coagulation disorder who complained of dyspnea and oropharyngeal foreign body sensation after vomitting. Examination revealed a reddish polypoid mass of the right tonsil. Furthermore, the mass pushed uvula and tongue base, caused nearly total obstruction of oropharynx. All rountine laboratory test results were within normal limits. Computed tomography (CT) showed low density mass of attached in upper pole of right tonsil without enhancement. We performed tonsillectomy including the reddish polypoid mass under general anesthesia. The pathology revealed lymphoepithelial tissue with reactive hyperplasia. This is the first reported tonsillar hematoma presenting as a large oropharyngeal mass which was caused by vomitting.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.54-56
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• 2012

Purpose: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. Methods: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. Results: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. Conclusion: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.

• Neonatal Medicine
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• v.15 no.1
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• pp.89-93
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• 2008

Duplication of chromosome 12p has been rarely reported and are thought to be associated with congenital malformations and impaired development. We report a baby boy born with multiple dysmorphic features and congenital malformations. His karyotype was 46,XY, add(12)(p13.3). He has suffered from intrauterine growth restriction at birth. He showed abnormal cranio-facial findings such as microcephaly, hypognathia, clepft palate and low set ear. He presented with absence of uvula, micropenis and rocker bottom features of both feet, congenital heart disease, poor corticomedullary differentiation of kidney, and sensorineuronal hearing loss. We have been follow up him for seizure disorder and delayed development at out patient department.

• The Journal of Internal Korean Medicine
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• v.12 no.1
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• pp.105-113
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• 1991

The results of the investigation of literature were summerized as follows ; 1. Information of voice, the pharynx, the larynx, the epiglottis, the uvula and the hyoid bone were concerned. 2. In disorders of voice and speech, Lung channel, Stomach channel, Spleen channel, Heart channel, Liver channel, Kidney channel, Im channel (任脈), and Chung channel (衝脈) were concerned. 3. The disorders of voice and speech were showed as follows ; aphonia, ashasia, seong-shi (?嘶), seom-eo(?語) kwang-eo (狂語), jeong-seong (鄭?), dok-eo (獨語) and chak-eo (錯語). 4. The cause of Aphonia and Aphasia were freauently as follows ; abnormal rising of Liver energy (肝邪暴逆), excessive heart fire (心火太過), deficiency of heart-blood (心血太虛), apoplexy of heart spleen (心脾俱中風), consumption of lung fluid caused by heat evil (肺津被灼), deficiency of lung energy (肺氣虛寒) and dificiency of kidney energy (腎虛). 5. The cause of seom-eo, kwang-eo, Jeong-seong were as follows ; the heart of stomach (胃中熱), the heat evil attach the blood chamber (血人血室) and the consumption of healthy energy (精氣奪). 6. In disorders of voice and speech, flaceid tong with aphasia (舌?) and aphasia due to throat disease (喉?) were divided.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.475-482
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• 2019

This report is a case of 76-year old male patient who had difficulty in swallowing, pronunciation and suffered regurgitation of food. The patient lacks uvula and both tonsils, had short palatoglossal arch and soft palate, as well as defective left palatopharyngeal arch. The height and width of the soft palate defect were measured by reconstructing the Computed Tomography (CT) image in three dimensions. Phonation and soft palate obstructing ability were examined by nasometry and nasal endoscopy. Evaluations on phonetics and swallowing were done and improvements were shown. The patient was satisfied with the results of treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.6
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• pp.427-435
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• 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.

• Imaging Science in Dentistry
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• v.54 no.2
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• pp.181-190
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• 2024

Purpose: This study compared sequential changes in skeletal stability and the pharyngeal airway following mandibular setback surgery involving fixation with either a titanium or a bioabsorbable plate and screws. Materials and Methods: Twenty-eight patients with mandibular prognathism undergoing bilateral sagittal split osteotomy by titanium or bioabsorbable fixation were randomly selected in this study. Lateral cephalometric analysis was conducted preoperatively and at 1 week, 3-6 months, and 1 year postoperatively. Mandibular stability was assessed by examining horizontal (BX), vertical (BY), and angular measurements including the sella-nasion to point B angle and the mandibular plane angle (MPA). Pharyngeal airway changes were evaluated by analyzing the nasopharynx, uvula-pharynx, tongue-pharynx, and epiglottis-pharynx (EOP) distances. Mandibular and pharyngeal airway changes were examined sequentially. To evaluate postoperative changes within groups, the Wilcoxon signed-rank test was employed, while the Mann-Whitney U test was used for between-group comparisons. Immediate postoperative changes in the airway were correlated to surgical movements using the Spearman rank test. Results: Significant changes in the MPA were observed in both the titanium and bioabsorbable groups at 3-6 months post-surgery, with significance persisting in the bioabsorbable group at 1 year postoperatively (2.29°±2.28°; P<0.05). The bioabsorbable group also exhibited significant EOP changes (-1.21±1.54 mm; P<0.05) at 3-6 months, which gradually returned to non-significant levels by 1 year postoperatively. Conclusion: Osteofixation using bioabsorbable plates and screws is comparable to that achieved with titanium in long-term skeletal stability and maintaining pharyngeal airway dimensions. However, a tendency for relapse exists, especially regarding the MPA.

• Sleep Medicine and Psychophysiology
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• v.7 no.1
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• pp.18-26
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• 2000

Objectives: To investigate the airway narrowing patterns by multi-level airway pressure(MAP) monitoring during sleep and to evaluate the value of CT scan taken during waking and sleep apneic periods to identify the level of airway narrowing(LAN) in patients with obstructive sleep apnea syndrome(OSAS). Methods: Eleven patients with OSAS underwent a night polysomnography with continuous MAP monitoring by 4-sensor(placed at nasopharynx, caudal-uvula, hypopharynx, esophagus) or 2-sensor(placed at caudal-uvula and esophagus) catheter. All patients had cine CT at five levels of high retro and alatal, low retropalatal, retroglossal, epiglottis and hypopharynx during awake and sleep periods. In each patient, LAN determined by CT scan($LAN_{CT}$) during sleep apnea was compared with LAN by MAP monitoring($LAN_{MAP}$). Results: MAP monitoring showed that four patients(36%) had a single pattern of LAN while the other seven patients(64%) showed two or more different LANs in different apneic episodes. Velopharynx was the most common level of frequently observed airway narrowing during sleep apnea(63.6%). However, a single pattern of airway narrowing was more frequent(72.7%) in airway CT during sleep apnea. Velopharynx was the most common narrowest level also in apneic CT(66%). In comparing $LAN_{CT}$ with $LAN_{MAP}$, the $LAN_{CT}$ of five patients(45.5%) were high-concordant, those of another five(45.5%) low-concordant, and that of one(9%) discordant with $LAN_{MAP}$. Conclusions: Cine CT scan during the awake state or sleep apnea may not reflect the LAN correctly in OSAS because most patients showed two or more different airway narrowing patterns during different episodes of sleep apnea in each patient.