-
Journal of Clinical Medicine Oct 2023OSA is a common problem in children and adolescents. Angle class II malocclusion, a tendency toward the vertical type of growth, causes a decrease in the volume of the...
BACKGROUND
OSA is a common problem in children and adolescents. Angle class II malocclusion, a tendency toward the vertical type of growth, causes a decrease in the volume of the oral air space, increasing the risk of OSAS. The aim of this study was to evaluate the relationship between cephalometric and OSA parameters, to develop collaborative approaches between orthodontists and somnologists in the treatment of adolescents with OSA.
METHODS
We analyzed data from 41 adolescents with OSA. Their mean age was 15.8 ± 1.08 years. Orthodontic and polysomnographic examinations of patients were conducted. Statistical analysis was performed in SPSS 19.0.0.
RESULTS
Most often in patients with distal occlusion, a violation of the harmony in the development of the dental system was observed. The sagittal incisive fissure, characteristic of a distal occlusion, was absent due to the palatal inclination of the upper incisors in 25 (60.98%) patients. The SNB was 79.4 ± 3.1°, indicating a distal position of the mandible relative to the anterior cranial base. The SNA exceeded the normal value, which is one of the prerequisites for mandibular retrognathia. The ANB angle was 4.3 ± 1.9°. Tonsillar hypertrophy affected 6 patients, 21 had adenoid hypertrophy, and 3 had both of them. Movements of the masticatory muscles during sleep were recorded in 22.0% of patients.
CONCLUSION
To improve the quality of diagnosis and treatment of OSA, a multidisciplinary approach is needed that will correct the processes of child growth and development.
PubMed: 37959316
DOI: 10.3390/jcm12216851 -
The Cleft Palate-craniofacial Journal :... May 2022The purpose of this study was to examine the surgical impact of the pedicled buccal fat pad (BFP) flap on the levator veli palatini (LVP) muscle and surrounding... (Observational Study)
Observational Study
OBJECTIVE
The purpose of this study was to examine the surgical impact of the pedicled buccal fat pad (BFP) flap on the levator veli palatini (LVP) muscle and surrounding velopharyngeal (VP) anatomy following primary palatoplasty using magnetic resonance imaging (MRI).
DESIGN
Observational, prospective.
SETTING
MRI studies were completed at 3 different facilities. All participants with BFP flap were operated on by the same surgeon.
PARTICIPANTS
Five pediatric participants with cleft palate with or without cleft lip (CP±L) who underwent primary palatoplasty with BFP flap placement. Comparison groups consisted of 10 participants: 5 with CP±L who did not receive the BFP flap and 5 healthy controls.
INTERVENTIONS
All participants underwent nonsedated MRI 2 to 5 years postoperatively.
MAIN OUTCOMES AND MEASURES
Anatomical measures of the velopharynx and LVP among the 3 participant groups.
RESULTS
Median values were significantly different among groups for velar length ( = .042), effective velar length ( = .048), effective VP ratio ( = .046), LVP length ( = .021), extravelar LVP length ( = .009), and LVP origin-origin distance ( = .030). Post hoc analysis revealed a statistically significant difference between the BFP and traditional repair groups for effective VP ratio ( = .040), extravelar LVP length ( = .033), and LVP length ( = .022).
CONCLUSIONS
This study provides preliminary support that the BFP flap creates a longer velum, with increased distance between the posterior hard palate and the LVP, and a larger effective VP ratio compared to traditional surgical techniques. Future research is needed to determine whether this procedure provides a more favorable mechanism for VP closure.
Topics: Adipose Tissue; Child; Cleft Palate; Humans; Palatal Muscles; Palate, Soft; Prospective Studies; Velopharyngeal Insufficiency
PubMed: 33973484
DOI: 10.1177/10556656211014070 -
Journal of Pharmacy & Bioallied Sciences Jul 2023OSMF is now recognized worldwide as an Indian disease. Blanching and rigidity of the oral mucosa, impaired mobility of the soft palate and tongue, difficulty opening the...
BACKGROUND
OSMF is now recognized worldwide as an Indian disease. Blanching and rigidity of the oral mucosa, impaired mobility of the soft palate and tongue, difficulty opening the mouth, burning sensation, lack of gustatory sensation, and mild deafness due to Eustachian tube dysfunction. Soft palatal muscles often affect Eustachian tube function.
MATERIALS AND METHODS
Rama Dental College Hospital and research center Kanpur conducted a cross-sectional study. 60 OSMF patients were randomly selected for this study. Visible light was used for a detailed case history and clinical examination. OSMF was diagnosed by difficulty opening the mouth, blanched oral mucosa, and palpable fibrous bands. Burning, salivation, tongue protrusion, habits, and malignant changes were also diagnostic. ENT specialists used pure tone audiometry to examine the ear (PTA).
RESULTS
Out of 60 patients 59 were males and 1 female. The participants who took part in this study ranged in age from 18 to 65. Pure tone audiometry of 120 years, 84 (70%) revealed normal hearing, 10 (8.33%) revealed minimal hearing loss, 14 (11.67%) revealed mild hearing loss and 12 (10%) revealed moderate hearing loss.
CONCLUSION
In order to improve the success rate of treatment, the protocol for managing OSMF patients should therefore include ENT consultation and hearing impairment treatment.
PubMed: 37693991
DOI: 10.4103/jpbs.jpbs_206_23 -
Development (Cambridge, England) May 2022Tissue fusion frequently requires the removal of an epithelium that intervenes distinct primordia to form one continuous structure. In the mammalian secondary palate, a...
Tissue fusion frequently requires the removal of an epithelium that intervenes distinct primordia to form one continuous structure. In the mammalian secondary palate, a midline epithelial seam (MES) forms between two palatal shelves and must be removed to allow mesenchymal confluence. Abundant apoptosis and cell extrusion support their importance in MES removal. However, genetically disrupting the intrinsic apoptotic regulators BAX and BAK within the MES results in complete loss of cell death and cell extrusion, but successful removal of the MES. Novel static- and live-imaging approaches reveal that the MES is removed through streaming migration of epithelial trails and islands to reach the oral and nasal epithelial surfaces. Epithelial trail cells that express the basal epithelial marker ΔNp63 begin to express periderm markers, suggesting that migration is concomitant with differentiation. Live imaging reveals anisotropic actomyosin contractility within epithelial trails, and genetic ablation of actomyosin contractility results in dispersion of epithelial collectives and failure of normal MES migration. These findings demonstrate redundancy between cellular mechanisms of morphogenesis, and reveal a crucial and unique form of collective epithelial migration during tissue fusion.
Topics: Actomyosin; Animals; Apoptosis; Cleft Palate; Epithelial Cells; Epithelium; Mammals; Palate
PubMed: 35593401
DOI: 10.1242/dev.200181 -
Regenerative Therapy Dec 2023An oronasal fistula is a challenging post-operative complication of palatoplasty due to impaired velopharyngeal function or its high recurrence rate. Muscle...
INTRODUCTION
An oronasal fistula is a challenging post-operative complication of palatoplasty due to impaired velopharyngeal function or its high recurrence rate. Muscle repositioning, a key procedure in palatoplasty, causes dead space at the junction between the hard and soft palates. Consequently, thin oral and nasal mucosae are prone to break down and form fistulas. In this study, we used basic fibroblast growth factor-impregnated collagen gelatin sponge (bFGF-CGS) in primary palatoplasty to reduce fistula formation.
METHODS
This retrospective study assessed the complications and efficacy of bFGF-CGS to reduce fistula formation. Patients who underwent primary palatoplasty with bFGF-CGS were included. The same number of patients who underwent primary palatoplasty without bFGF-CGS was included as a control group. The outcomes included post-operative oronasal fistula formation, delayed healing, bleeding, and infection.
RESULTS
Both groups included 44 patients. Except for age at palatoplasty, there were no statistically significant demographic differences between the two groups; however, the rates of fistula formation in the study and control group were 2.3% and 13.6%, respectively. There were no infections among the patients.
CONCLUSIONS
The grafting of bFGF-CGS in primary palatoplasty was safe and probably effective in reducing post-operative oronasal fistula formation.
PubMed: 37559871
DOI: 10.1016/j.reth.2023.07.010 -
BMJ Case Reports Apr 2020An 80-year-old woman presented with a several-year history of progressive hair loss and scalp pruritus. No other rashes or muscle weakness were noted on examination....
An 80-year-old woman presented with a several-year history of progressive hair loss and scalp pruritus. No other rashes or muscle weakness were noted on examination. Scalp biopsy showed interface dermatitis, dense perivascular and periadnexal lymphocytic infiltrate, mucin and scarring alopecia. Laboratory analysis did not show evidence of myositis. The patient was started on hydroxychloroquine for possible cutaneous lupus erythematosus. On follow-up, she presented with a new violaceous rash on the superior eyelids and a well-defined oval patch on the mid-hard palate suspicious for dermatomyositis. Myositis-specific autoantibodies revealed presence of anti-transcriptional intermediary factor-1γ (anti-TIF1γ) in the serum. Anti-TIF1γ autoantibody-positive dermatomyositis is a newly recognised subtype of dermatomyositis that is highly associated with amyopathic disease and has an increased risk of malignancy, making prompt diagnosis crucial. This case highlights the utility of a thorough oral exam in patients suspected to have connective tissue disease as the distinctive ovoid palatal patch is nearly pathognomonic for anti-TIF1γ dermatomyositis.
Topics: Aged, 80 and over; Autoantibodies; Dermatologic Agents; Dermatomyositis; Diagnosis, Differential; Erythema; Exanthema; Female; Humans; Methotrexate; Palate, Hard; Transcription Factors
PubMed: 32332045
DOI: 10.1136/bcr-2019-234111 -
Stem Cell Research & Therapy Nov 2020Bone reconstruction in congenital craniofacial differences, which affect about 2-3% of newborns, has long been the focus of intensive research in the field of bone...
BACKGROUND
Bone reconstruction in congenital craniofacial differences, which affect about 2-3% of newborns, has long been the focus of intensive research in the field of bone tissue engineering. The possibility of using mesenchymal stromal cells in regenerative medicine protocols has opened a new field of investigation aimed at finding optimal sources of multipotent cells that can be isolated via non-invasive procedures. In this study, we analyzed whether levator veli palatini muscle fragments, which can be readily obtained in non-invasive manner during palatoplasty in cleft palate patients, represent a novel source of MSCs with osteogenic potential.
METHODS
We obtained levator veli palatini muscle fragments (3-5 mm), during surgical repair of cleft palate in 5 unrelated patients. Mesenchymal stromal cells were isolated from the muscle using a pre-plating technique and other standard practices. The multipotent nature of the isolated stromal cells was demonstrated via flow cytometry analysis and by induction along osteogenic, adipogenic, and chondrogenic differentiation pathways. To demonstrate the osteogenic potential of these cells in vivo, they were used to reconstruct a critical-sized full-thickness calvarial defect model in immunocompetent rats.
RESULTS
Flow cytometry analysis showed that the isolated stromal cells were positive for mesenchymal stem cell antigens (CD29, CD44, CD73, CD90, and CD105) and negative for hematopoietic (CD34 and CD45) or endothelial cell markers (CD31). The cells successfully underwent osteogenic, chondrogenic, and adipogenic cell differentiation under appropriate cell culture conditions. Calvarial defects treated with CellCeram™ scaffolds seeded with the isolated levator veli palatini muscle cells showed greater bone healing compared to defects treated with acellular scaffolds.
CONCLUSION
Cells derived from levator veli palatini muscle have phenotypic characteristics similar to other mesenchymal stromal cells, both in vitro and in vivo. Our findings suggest that these cells may have clinical relevance in the surgical rehabilitation of patients with cleft palate and other craniofacial anomalies characterized by significant bone deficit.
Topics: Animals; Cleft Palate; Humans; Infant, Newborn; Mesenchymal Stem Cells; Muscle, Skeletal; Osteogenesis; Palatal Muscles; Rats
PubMed: 33239080
DOI: 10.1186/s13287-020-02017-7 -
Journal of Speech, Language, and... Aug 2019Purpose The aim of this study was to develop a method able to quantify levator veli palatini (LVP) muscle shortening and contraction velocities using dynamic magnetic...
Purpose The aim of this study was to develop a method able to quantify levator veli palatini (LVP) muscle shortening and contraction velocities using dynamic magnetic resonance imaging (MRI) throughout speech samples and relate these measurements to velopharyngeal portal dimensions. Method Six healthy adults (3 men and 3 women, M = 24.5 years) produced syllables representing 4 different manners of production during real-time dynamic MRI scans. We acquired an oblique-coronal slice of the velopharyngeal mechanism, which captured the length of the LVP, and manually segmented each frame. LVP shortening and muscle velocities were calculated from the acquired images. Results Using our method, we found that subjects demonstrated greater LVP shortening and higher maximum contraction velocities during fricative and plosive syllable production than during nasal or vowel syllable production. LVP shortening and maximum contraction velocity positively correlated with velopharyngeal port depth. Conclusions In vivo LVP function differs between manners of production, as expected, and an individual's velopharyngeal portal dimensions influence LVP function. These measures, contextualized with the force-length and force-velocity muscle relationships, provide new insight into LVP function. Future studies could use this method to investigate LVP function in healthy speakers and individuals with velopharyngeal dysfunction and how function relates to velopharyngeal anatomy.
Topics: Adult; Female; Healthy Volunteers; Humans; Magnetic Resonance Imaging; Male; Palatal Muscles; Pharyngeal Muscles; Speech; Speech Production Measurement; Young Adult
PubMed: 31390279
DOI: 10.1044/2019_JSLHR-S-18-0459 -
Journal of Medical Case Reports Jan 2023Collagenous fibroma or desmoplastic fibroblastoma is a rare benign fibrous tissue tumor. It usually presents as a painless, slowly growing mass. Collagenous fibroma... (Review)
Review
BACKGROUND
Collagenous fibroma or desmoplastic fibroblastoma is a rare benign fibrous tissue tumor. It usually presents as a painless, slowly growing mass. Collagenous fibroma arises ordinarily inside the subcutaneous tissues or skeletal muscles. Histopathologically, the tumor consists of scattered stellate and spindle cells in a hypovascular collagenous stroma without atypia or infiltration. The oral cavity is a very uncommon site for desmoplastic fibroblastoma. Only 15 published articles in the literature reported the intraoral location. We present a case of collagenous fibroma with a bilateral distribution on the hard palate. This is the second case of bilateral collagenous fibroma after a previously reported one in literature; however, our case was larger, occupying almost the whole palate. We discuss the management of this rare tumor and how we can reach definite diagnosis.
CASE PRESENTATION
A 37-year-old Caucasian female patient had a huge bilateral firm palatal mass that caused breathing problems. There was no history of trauma and the patient had no relevant medical history Total surgical excision under general anesthesia was carried out and histopathological examination suggested a benign mesenchymal tumor. Immunohistochemistry was necessary to confirm the tumor origin and to exclude aggressive fibromatosis. A diagnosis of bilateral collagenous fibroma was reached. Six months after surgery, there was no recurring lesion and the patient's health was good.
CONCLUSIONS
Collagenous fibroma is a benign fibrous tissue tumor of unknown cause that is treated with simple excision. The prognosis is good with no recurrence. Reaching an accurate diagnosis is mandatory to avoid aggressive treatment since collagenous fibroma may be misdiagnosed as aggressive fibromatosis in case of massive size. Clinicians and pathologists should be aware of this unusual tumor for conservative management without side effects.
Topics: Humans; Female; Adult; Fibroma, Desmoplastic; Fibromatosis, Aggressive; Palate, Hard; Fibroma; Soft Tissue Neoplasms
PubMed: 36609451
DOI: 10.1186/s13256-022-03691-2 -
Tremor and Other Hyperkinetic Movements... Jun 2020There is little published work describing the electrophysiological characteristics of essential palatal tremor, a condition now believed by many to be a functional...
BACKGROUND
There is little published work describing the electrophysiological characteristics of essential palatal tremor, a condition now believed by many to be a functional (psychogenic) movement disorder.
CASE REPORT
Here we combine electroencephalography and electromyography with time-locked video recordings to document two cases of essential palatal tremor in which a definitive diagnosis is achieved using these electrophysiological tools.
DISCUSSION
We believe that sharing how these objective tools can be used to diagnose a functional movement disorder, as well as providing more published evidence to support the functional origin of essential palatal myoclonus, will help to diagnose this condition in the future.
Topics: Contingent Negative Variation; Electroencephalography; Electromyography; Essential Tremor; Humans; Male; Middle Aged; Palatal Muscles; Somatoform Disorders
PubMed: 32775024
DOI: 10.5334/tohm.70