• Title/Summary/Keyword: swallowing disorder

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DENTAL TREATMENT IN A PATIENT WITH ANGELMAN SYNDROME DUE TO UNIPARENTAL DISOMY (편친 이염색체성 엔젤만 증후군(Angelman syndrome) 환자의 치과치료)

  • Park, Sung-Hee;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Jang, Ki-Taeg
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.11-15
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    • 2016
  • Angelman syndrome is characterized by a partial deficit of paired autosomal chromosome 15, which contains a subunit of the GABA (Gamma-Amino Butyric Acid) receptor. The main clinical characteristics of this syndrome are delayed neuropsychological development, intellectual disability, and speech impairment. The syndrome has oral manifestations such as diastemas, tongue thrusting, sucking swallowing disorder, and excessive chewing behavior. A 3-year-6-month old girl with Angelman syndrome was scheduled for dental treatment. She had multiple caries, but she was poorly cooperative for treatment due to developmental delay and movement disorder, so general anesthesia was considered. The patient with Angelman syndrome was successfully treated under general anesthesia. There were no postoperative complications related to anesthesia and dental treatment. When treating children with this syndrome, the dentist needs to manage their uncooperative behavior and medical problem.

Case Report : Botulinum Toxin Treatment in Oromandibular Dystonia (보툴리눔 톡신을 이용한 구강하악 근긴장이상증의 치료 증례)

  • Ryu, Ji-Won;Hong, Seong-Ju;Bae, Kook-Jin;Yoon, Chang-Lyuk;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.421-427
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    • 2009
  • Oromandibular dystonia is a focal neurological movement disorder characterized by involuntary sustained and often painful muscle contraction, usually producing repetitive movements or abnormal positions of the mouth, jaw and.or tongue. Patients suffering from oromandibular dystonia often experience difficulties in chewing, swallowing and speaking, resulting from the impairment of mandibular movements. At present there is no etiologic treatment for oromandibular dystonia, because the pathophysiology of primary and focal dystonia is still incompletely understood. Many treatments such as medication, behavioral therapy, surgery are suggested to decrease the involuntary movements. But these success rates are relatively low and they have a lot of complications. many studies suggested that chemodenervation with botulinum toxin is the most effective treatment for oromandibular dystonia. We reported the 2 cases which were treated oromandibular dystonia with botulinum toxin and reviewed the orofacial movement disorders(especially oromandibular dystonia) and botulinum toxin treatment for oromanfibular dystonia.

A Clinical Study for 157 Cases of CVA by Sasang Constitutional Medicine (사상의학적(四象醫學的) 중풍치험(中風治驗) 157례(例)에 대(對)한 임상적(臨床的) 연구(硏究))

  • Choi, Jae-young;Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.10 no.2
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    • pp.431-453
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    • 1998
  • 1. Background and Purpose: We intended to make the standards of CVA management of Sasang Constitutional Medicine and be helpful to understand the constitutional symptoms through a clinical study of CVA. 2. Methods: We studied 157 CVA inpatients(79 men and 78 women) who were in constitutional clinic of Dongguk Pundang Oriental Hospital during 1 year from March 1997 to February 1998. We investigated and analysed the characteristics, past histories, symptoms and progresses of patients. 3. Results: The results of constitutional analysis showed 88 Taeumin(56.1%), 48 Soyangin(30.6%) and 21 Soeumin(13.4%). The frequency of strokes was much the same between male and female and the greater part of cases were 50-70 of age. The CVA cases were classified into 119 cerebral infarction(75.8%), 11 cerebral hemorrhage(7.0%), 1 subarachnoid hemorrhage(0.6%) and 26 trasient ischemic attack. From the standards of symptom management, there were abnormality of a coated tongue(63.1%) in most cases, sleeping disorders(48.4%), excremental disorders(44.7%) and urinary disorders(36.9%) on admission. With regard to the rate of improvement in the standards of CVA management, excremental disorders improved 87.1% and emotional disorder 81.0%, swallowing disorder 78.7% and so on.

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Maxillary complete denture with posterior zirconia occlusion and mandibular implant support fixed prostheses in completely edentulous patients with orofacial dystonia (구강안면 근긴장이상을 가진 완전 무치악 환자에서 구치부 지르코니아 교합면을 갖는 상악 총의치와 하악 임플란트 지지 고정성 보철물의 수복)

  • Jong-Min Seo;Chang-Mo Jeong;So-Hyoun Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.237-249
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    • 2023
  • Orofacial dystonia is a neuromotor disorder that causes irregular or repetitive movements of the face, lips, tongue, and jaw involuntarily, also called tic disorder. Edentulous patients with these symptoms experience functional and aesthetic problems, including difficulty using complete dentures, speech and swallowing difficulties, and orofacial pain. In this case, for a patient with orofacial dystonia who experienced complete edentulism at a relatively young age, restorative treatment was performed with a maxillary complete denture with bilateral posterior zirconia occlusal surfaces and a mandibular implant-supported fixed prosthesis, and continuous smile training was performed. The aim was to improve the aesthetics of facial muscles. As a result of the treatment, the patient was very satisfied with not only improved chewing function and aesthetics, but also regained psychological stability and was able to lead a normal daily life, so we would like to report this.

Self-inflicted Tongue Ulceration in a Patient with Tourette Syndrome: A Case Report (뚜렛 증후군 환자에서 자해로 인한 혀 손상 : 증례 보고)

  • Lee, Kkotnim;Kim, Miae;Hwang, Inkyung;Park, Jihyun;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.3
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    • pp.327-333
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    • 2016
  • Tourette's syndrome is a chronic neuropsychiatric disorder characterized by the presence of vocal and multiple motor tics. Tics are defined as brief, intermittent, repetitive, unpredictable, purposeless, and stereotyped movements or sounds. Some patients experience physical pain from intense and complex tics. In addition, motor tics can result in self-injury which is a common feature of Tourette's syndrome. A 9-year-old boy was referred by the department of neuropsychiatry because of a severe tongue laceration. His parents reported that he had been biting his tongue irregularly for 2 months before referral and suffered from an intense burning sensation. The repeated biting resulted in ulcers on the tongue, which quickly worsened and led to progressive difficulty chewing and swallowing food. We offered to give him a two-piece removable appliance to limit tongue biting; it was made of soft silicone and fitted to both the maxillary and mandibular arches. As we emphasized that the device could help alleviate his pain, he agreed to accept it and adapted well. Just 3 weeks later, his tongue lesions had healed significantly.

DENTAL CARIES TREATMENT IN FEEDING PROBLEM PATIENT WITH CONGENITAL ESOPHAGEAL ATRESIA : A CASE REPORT (선천성 식도폐쇄를 가진 식이장애 환아의 치아우식 치료 증례 보고)

  • Heo, Seon-Jae;Lee, Mi-Yeon;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.6-10
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    • 2016
  • Esophageal atresia is the abnormal development of the esophagus that connects the mouth to the stomach. This birth defect results in the incomplete connection of the esophagus to the stomach causing an inability to swallow properly and breathing difficulties. Surgery is the only treatment for esophageal atresia. Patients undergone an esophageal reconstruction usually suffer from gastroesophageal reflex. A 5-year old boy with congenital esophageal atresia and Sciwitar syndrome visited Seoul National University Dental Hospital because generalized excessive loss of tooth structure. The patient had history of multiple operations for reconstruct esophagus. He had little food intake experience thought oral and had difficulty to swallowing. The patient was generalized severe erosive and decayed state. For patient, the dental procedure under general anesthesia was scheduled due to the multiple caries with erosion and poor cooperation. Under general anesthesia, pulpectomy and restoration as well as extraction was performed. Gastroesophageal reflex is potentially serious condition, with various extraesophageal adverse effects such as dental erosion. To prevent progression of dental caries, dietary counselling and oral hygiene instruction should be reinforced. Also, restorations to erosive teeth will maintain esthetics and function and preserve pulp vitality.

DENTAL TREATMENT OF PEDIATRIC EPIDERMOLYSIS BULLOSA PATIENTS : CASE REPORTS (수포성 표피 박리증 환자의 치과적 관리 : 증례보고)

  • Han, Eun-Ok;Kim, Seong Hee;Kim, Shin;Jeong, Tae-Sung
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.2
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    • pp.122-126
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    • 2012
  • Epidermolysis bullosa (EB) is a genetic disorder, characterized by blisters on skin and mucosal surfaces even upon light mechanical damage. EB is caused by genetic mutations in at least seven proteins on the basement membrane zone, which is the boundary between the epidermis and the dermis. There are many types of EB differing in clinical and genetic aspects, and the prognosis varies depending on the EB type. There are largely three types of EB, categorized by the electron-microscopic location of the blisters. The blisters form within the epidermis in epidermolysis bullosa simplex, in the lamina lucida in junctional epidermolysis bullosa, and just beneath the basal lamina in dystrophic epidermolysis bullosa. To date, there is no medication or treatment that cures EB or completely prevents the blisters, so generally symptomatic treatment is performed. EB patients must always be cautious, for blisters can form at the slightest injuries, and the patients must be dealt with gently. Injuries and infections have to be prevented and treated, and deficient nutrients must be supplied during dental treatment period. Some patients may experience pain when swallowing food or dental treatment due to blisters and resulting scars in the mouth, pharynx, and esophagus. Recently, two pediatric patients were diagnosed with EB at Pusan National University Hospital and visited the Department of Pediatric Dentistry for oral care and dental treatment. The treatment results are reported here.

A case of postoperative nasopharyngeal reflux associated with retropharyngeal lymphangioma in newborn infant (수술 후 비인두 역류가 동반된 신생아의 후인두림프관종 1례)

  • Koo, Kyo Yeon;Lee, Jun Seok;Lee, Soon Min;Park, Min Soo;Namgung, Ran;Park, Kook In;Lee, Chul;Yoon, Choon Sik;Jung, Woo Hee;Choi,, Hong Shik
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.258-261
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    • 2010
  • Lymphangioma is a rare benign congenital tumor of the lymphatic system, which is commonly diagnosed before 2 years of age. In the natronal report, cystic lymphangioma was usually reported as a huge translucent mass located in the head and neck area. It's occurrence in retropharyngeal space with respiratory obstruction and swallowing difficulty in neonate is extremely rare and postoperative nasopharyngeal reflux has rarely been reported. Complete resection is the standard therapy. However, involvement of the upper airway may be determining prognosis in the extensive lymphangiomas because of the difficulty of complete excision. We present a case of cystic lymphangioma in neonate which was initially asymptomatic but gradually progressed to cause respiratory obstruction due to enlargement. After resection, nasopharyngeal reflux developed with dysfunction of the soft palate and gradually improved with conservative care over 5 months.

Usefullness of Injection Laryngoplasty with Calcium Hydroxyapatite in Unilateral Vocal Cord Paralysis (일측 성대마비 환자에서 Calcium-Hydroxyapatite를 이용한 성대 주입술의 유용성)

  • Lee, Jae-Hoon;Kim, Sung-Won;Oh, Jung-Ho;Kim, Seung-Tae;Lee, Kang-Dae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.2
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    • pp.119-125
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    • 2011
  • Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

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Case Report on Dysphagia Related to The Wallenberg's Syndrome Improved by Acupuncture Therapy (침구치료를 통한 Wallenberg's syndrome 환자의 연하장애 치험례)

  • Yun Jone-Min;Park Sae-Wook;Lee Sun-Woo;Son Ji-Woo;Kim Yong-Jeong;Lee Seung-Eon;Cho Chang-Hyun;Cho Yoon-Soong;Lee In;Moon Byung-Soon;Lee Min-Goo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.6
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    • pp.1701-1705
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    • 2005
  • Dysphagia is Swallowing disorder characterized by difficulty in oral preparation for the swallow or in moving material from the mouth to the stomach. Dysphagia is the one of the most symptom of CVA and predisposes to medical complications such as aspiration pneumonia in poststroke patients. This study was designed to report the clinical effects of acupuncture for dysphagia on a patient with Wallenberg's syndrome. 8 acupoint were used and videofluoroscopic evaluation were performed. According to the above evaluation, 'Oral transit time' decreased within 1.5 sec and 'Coating of pharyngeal wall after swallow' were disappeared. The above results suggest that acupuncture is beneficial for dysphagia.