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European Archives of... Sep 2022To assess the efficacy of posterior pharyngeal wall augmentation using septal or conchal cartilages with other bulks-according to the persistent gap and the individual... (Observational Study)
Observational Study
PURPOSE
To assess the efficacy of posterior pharyngeal wall augmentation using septal or conchal cartilages with other bulks-according to the persistent gap and the individual anatomy of each patient-in improving velopharyngeal function in patients who acquired persistent velopharyngeal insufficiency (VPI) post-adenoidectomy.
METHODS
Observational descriptive prospective case series of 24 patients (their ages ranged between 3 and 26 years) who developed persistent VPI post-adenoidectomy (more than 3 months) although they had normal speech resonance before adenoidectomy.
RESULTS
The present study demonstrated that statistically significant improvement in auditory perceptual assessment (APA) was found regarding all obligatory speech disorders and unintelligibility of speech. Significant improvement was observed in the degree of velar mobility, size of the persistent gap, and the gap distance between velum and posterior pharyngeal wall at rest and during phonation in post-operative evaluation versus pre-operative. A significant change was observed in the closure pattern of the velopharyngeal port (VPP) as all patients turned to coronal closure.
CONCLUSIONS
Posterior pharyngeal wall augmentation could be used in VPI post-adenoidectomy up to 7 mm and lead to better speech outcomes. Also, it revealed that using conchal and/or septal cartilage as a graft regardless of the patient's age is a safe procedure.
Topics: Adenoidectomy; Child, Preschool; Cleft Palate; Humans; Infant; Pharynx; Speech Disorders; Treatment Outcome; Velopharyngeal Insufficiency
PubMed: 35527305
DOI: 10.1007/s00405-022-07406-7 -
Biochemical and Biophysical Research... Feb 2020Tensin is a focal adhesion molecule that is known to regulate cell adhesion, migration, and proliferation. Although there are four tensin homologs (TNS1, TNS2, TNS3, and...
Tensin is a focal adhesion molecule that is known to regulate cell adhesion, migration, and proliferation. Although there are four tensin homologs (TNS1, TNS2, TNS3, and CTEN/TNS4) in mammals, only one tensin gene is found in Caenorhabditis elegans. Sequence analysis suggests that Caenorhabditis elegans tensin is slightly closer aligned with human TNS1 than with other human tensins. To establish the role of TNS1 in Caenorhabditis elegans, we have generated TNS1 knockout (KO) worms by CRISPR-Cas9 and homologous recombination directed repair approaches. Lack of TNS1 does not appear to affect the development or gross morphology of the worms. Nonetheless, defecation cycles are significantly longer in TNS1 KO worms. In addition, their pharyngeal pumping rate is markedly faster, which is likely due to a shorter pump duration in the KO worms. These findings indicate that TNS1 is not required for the development and survival of Caenorhabditis elegans but point to a critical role in modulating defecation and pharyngeal pumping rates.
Topics: Animals; CRISPR-Cas Systems; Caenorhabditis elegans; Caenorhabditis elegans Proteins; Defecation; Humans; Pharynx; Protein Domains; Sequence Homology, Amino Acid; Tensins
PubMed: 31784086
DOI: 10.1016/j.bbrc.2019.11.153 -
Laryngo- Rhino- Otologie Apr 2021Diseases occurring with an incidence of less than 1-10 cases per 10 000 individuals are considered as rare. Currently, between 5 000 and 8 000 rare or orphan... (Review)
Review
Diseases occurring with an incidence of less than 1-10 cases per 10 000 individuals are considered as rare. Currently, between 5 000 and 8 000 rare or orphan diseases are known, every year about 250 rare diseases are newly described. Many of those pathologies concern the head and neck area. In many cases, a long time is required to diagnose an orphan disease. The lives of patients who are affected by those diseases are often determined by medical consultations and inpatient stays. Most orphan diseases are of genetic origin and cannot be cured despite medical progress. However, during the last years, the perception of and the knowledge about rare diseases has increased also due to the fact that publicly available databases have been created and self-help groups have been established which foster the autonomy of affected people. Only recently, innovative technical progress in the field of biogenetics allows individually characterizing the genetic origin of rare diseases in single patients. Based on this, it should be possible in the near future to elaborate tailored treatment concepts for patients suffering from rare diseases in the sense of translational and personalized medicine. This article deals with orphan diseases of the lip, oral cavity, pharynx, and cervical soft tissues depicting these developments. The readers will be provided with a compact overview about selected diseases of these anatomical regions. References to further information for medical staff and affected patients support deeper knowledge and lead to the current state of knowledge in this highly dynamic field.
Topics: Humans; Incidence; Mouth; Pharynx; Precision Medicine; Rare Diseases
PubMed: 34352905
DOI: 10.1055/a-1331-2851 -
The Laryngoscope Jun 2021To investigate perceptual speech outcomes following sphincter pharyngoplasty (SP) and to identify patient characteristics associated with velopharyngeal insufficiency...
OBJECTIVES/HYPOTHESIS
To investigate perceptual speech outcomes following sphincter pharyngoplasty (SP) and to identify patient characteristics associated with velopharyngeal insufficiency (VPI) resolution or improvement.
METHODS
Retrospective review of prospectively collected data was performed of consecutive patients that underwent SP for management of VPI between 1994 and 2016 at a single tertiary care pediatric hospital. Demographic data, nasendoscopic findings, and speech characteristics were recorded using a standardized protocol. Pre- and post-operative VPI was graded on a five-point Likert scale. Frequency of post-operative VPI resolution and improvement was assessed and associations with patient characteristics were analyzed. The association between odds of VPI resolution or improvement and five patient characteristics identified a priori was performed controlling for confounding factors.
RESULTS
Two-hundred ninety-six subjects were included. All patients had at least minimal VPI pre-operatively; 72% were graded moderate or severe. Sixty-four percent experienced resolution and 83% improved at least one point on the VPI-severity scale. Of the five patient characteristics, only history of cleft palate repair was significantly associated with decreased odds of VPI improvement but not resolution when controlling for other variables.
CONCLUSIONS
Sphincter pharyngoplasty resulted in resolution of VPI in 64% and improvement in 83% of subjects. Children with a history of cleft palate had significantly decreased odds of VPI improvement compared to those without a history of cleft palate. Neither syndrome diagnosis nor 22q11 deletion had a significant association with speech outcomes after sphincter pharyngoplasty.
LEVEL OF EVIDENCE
4 Laryngoscope, 131:E2046-E2052, 2021.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Infant; Male; Pharynx; Retrospective Studies; Speech; Velopharyngeal Insufficiency; Young Adult
PubMed: 33103775
DOI: 10.1002/lary.29189 -
Scientific Reports Feb 2020This study aimed to evaluate the usefulness of the biphasic 2-deoxy-2-[18 F]fluoro-D-glucose positron emission tomography/computed tomography ([18 F]FDG PET/CT)...
This study aimed to evaluate the usefulness of the biphasic 2-deoxy-2-[18 F]fluoro-D-glucose positron emission tomography/computed tomography ([18 F]FDG PET/CT) examinations in terms of distinguishing benign and malignant lesions within the pharynx. 139 patients underwent sequential biphasic [18 F]FDG PET/CT examinations at 60 and 90 minutes (min) post intravenous injection (p.i.) of the [18 F]FDG. We evaluated the metabolic activity of 93 malignant lesions and 59 benign findings within pharynx as well as 70 normal blood vessels. We evaluated the maximal and mean standardized uptake value (SUVmax, SUVmean) and the retention index (RI-SUVmax). We used the receiver operating characteristics (ROC) analysis to obtain the prognostic metabolic indices cut-off which may differentiate between benign and malignant lesions. The SUVmax value cut-off at 60 and 90 min p.i. differentiating between normal and abnormal metabolic activity in the pharynx was 1.9 and 2.0, respectively. When compared benign and malignant lesions, the SUVmax on initial and delayed scans were 3.1 and 3.6, respectively. In this material, the increase of the SUVmax value over time of 1.7% suggested abnormality, while RI-SUVmax of 5.7% indicated malignant etiology. The biphasic [18 F]FDG PET/CT study protocol is useful in better stratification of normal and abnormal glucose metabolism activity in the pharynx.
Topics: Adult; Aged; Aged, 80 and over; Female; Fluorodeoxyglucose F18; Humans; Male; Middle Aged; Phantoms, Imaging; Pharynx; Positron Emission Tomography Computed Tomography; Prognosis; ROC Curve; Young Adult
PubMed: 32076053
DOI: 10.1038/s41598-020-59832-4 -
PLoS Computational Biology Mar 2021Vocalization in mammals, birds, reptiles, and amphibians occurs with airways that have wide openings to free-space for efficient sound radiation, but sound is also...
Vocalization in mammals, birds, reptiles, and amphibians occurs with airways that have wide openings to free-space for efficient sound radiation, but sound is also produced with occluded or semi-occluded airways that have small openings to free-space. It is hypothesized that pressures produced inside the airway with semi-occluded vocalizations have an overall widening effect on the airway. This overall widening then provides more opportunity to produce wide-narrow contrasts along the airway for variation in sound quality and loudness. For human vocalization described here, special emphasis is placed on the epilaryngeal airway, which can be adjusted for optimal aerodynamic power transfer and for optimal acoustic source-airway interaction. The methodology is three-fold, (1) geometric measurement of airway dimensions from CT scans, (2) aerodynamic and acoustic impedance calculation of the airways, and (3) simulation of acoustic signals with a self-oscillating computational model of the sound source and wave propagation.
Topics: Biomechanical Phenomena; Female; Humans; Male; Models, Biological; Pharynx; Sound Spectrography; Speech; Speech Acoustics; Trachea
PubMed: 33780433
DOI: 10.1371/journal.pcbi.1008744 -
Anatomical Record (Hoboken, N.J. : 2007) Aug 2022The nasopharynx has been understudied relative to neighboring anatomical regions. It is a highly complex, integrated space whose function, development, and evolution... (Review)
Review
The nasopharynx has been understudied relative to neighboring anatomical regions. It is a highly complex, integrated space whose function, development, and evolution remains unclear after nearly 5,000 years of study. Historically, most work on the nasopharynx was done with a focus on adjacent structures. It has most often been mentioned in relation to the middle ear (via the Eustachian tube) in ancient texts and has only later been given a designation as one of three portions of a tripartite pharynx among adult humans. As human dissection became practiced more widely in Renaissance Europe, understanding of the nasopharyngeal boundaries improved. With further advancements in the study of nasopharyngeal development, evolution, and anatomical variation from the 19th century up until the present, this region has been shown to be functionally vital and still complicated to define.
Topics: Adult; Dissection; Ear, Middle; Europe; Eustachian Tube; Humans; Nasopharynx
PubMed: 35666016
DOI: 10.1002/ar.25000 -
Veterinary Medicine and Science Jul 2024The public perception relating to the welfare of horses involved with equestrian sports is associated with training methods used and the presentation of horses at...
BACKGROUND/OBJECTIVES
The public perception relating to the welfare of horses involved with equestrian sports is associated with training methods used and the presentation of horses at events. In this context, very tight nosebands, which are intended to prevent the horse from opening its mouth, also attract a lot of attention. Various studies have evaluated the impact of tight nosebands on stress parameters, whereas the effect of tight nosebands on upper airway function is unknown. Therefore, the aim of the study was to use overground endoscopy to evaluate changes in pharyngeal and laryngeal function when a tight noseband is fitted. Moreover, the ridden horse pain ethogram (RHpE) was applied to investigate signs of discomfort (Dyson et al., 2018).
STUDY DESIGN
A randomized, blinded, and prospective study was performed.
METHODS
Sixteen warmblood horses consisting of twelve mares and four geldings with a mean age of 11.63 ± 3.53 years were ridden on 2 consecutive days with either loose or tight nosebands (two fingers or no space between bridge of the nose and noseband, respectively) and inserted endoscope in a random order. Videos were taken in a riding arena during a standardized exercise protocol involving beginner level tasks for 30 min in all gaits. For video analysis, freeze frames were prepared and analyzed at the beginning of the expiration phase. Pharyngeal diameter was measured using the pharynx-epiglottis ratio. Other findings (swallowing, pharyngeal collapse, soft palate movements, and secretion) were also evaluated. Moreover, the RHpE was applied. Descriptive statistics and generalized linear mixed effects models were used. Results with a p-value < 0.05 were considered statistically significant.
RESULTS
While the pharynx-epiglottis ratio did not change significantly in horses ridden with loose versus tight nosebands, there was an increase in mean grade and total counts of parameters assessed in the pharyngeal region, for example, grade of secretion (1.5 [±SD 0.89] vs. 3.13 [±SD 0.96]; p = 0.0001), axial deviation of the aryepiglottic folds (0.29 [±SD 0.73] vs. 1.33 [±SD 1.44]; p = 0.01), and pharyngeal collapse (0.69 [±SD 0.87] vs. 1.88 [±SD 1.54]; p = 0.005) in horses ridden with tight nosebands. There was no RHpE score above 8 indicating musculoskeletal pain, but the RHpE scores were significantly higher in horses ridden with tight nosebands (p < 0.001).
MAIN LIMITATIONS
Video quality was limited when horses showed large amounts of secretion. Another limitation was the small number of horses.
CONCLUSIONS
Results add to the evidence obtained in other studies that tight nosebands do not only cause adverse reactions based on the RHpE score such as head behind the vertical or intense staring but also contribute to changes in the pharyngeal region, such as increased secretion and collapse of pharyngeal structures. This may provide further support for future decisions regarding regulations on nosebands.
Topics: Animals; Horses; Female; Male; Prospective Studies; Pharynx; Nose; Larynx; Physical Conditioning, Animal
PubMed: 38885311
DOI: 10.1002/vms3.1478 -
Brazilian Journal of Otorhinolaryngology 2023
Topics: Humans; Diversity, Equity, Inclusion; Otolaryngology; Nose; Pharynx
PubMed: 37678010
DOI: 10.1016/j.bjorl.2023.101319 -
Pulmonology 2019Upper airways (UA) include the nasal cavities, pharynx, and larynx, and its main function is to warm and filter the inspired air. UA dysfunction is in the pathogenesis... (Review)
Review
Upper airways (UA) include the nasal cavities, pharynx, and larynx, and its main function is to warm and filter the inspired air. UA dysfunction is in the pathogenesis of various disorders, such as obstructive sleep apnea syndrome (OSAS) and vocal cord dysfunction. In addition, in some neurodegenerative diseases (e.g. Amyotrophic Lateral Sclerosis - ALS), UA dysfunction may also compromise the effective use of ventilatory support (VS). In this context, the endoscopic evaluation of UA may be useful in understanding the OSAS mechanisms, in determining the causes for treatment-induced airway obstruction and even in helping to titrate noninvasive ventilation (NIV) in ALS patients with bulbar or pseudo-bulbar (spastic) dysfunction. Specifically, in OSAS patients, when residual obstructive events persist, although an optimal ventilatory mode has been apparently achieved, along with interface and equipment, the endoscopic evaluation of UA seems to be a valuable tool in understanding its mechanisms, even assisting adjustments to NIV parameters. In addition, it has also been described as being useful in laryngeal response to mechanical in-exsufflation (MI-E) and Exercise-Induced Laryngeal Obstruction (EILO). However, no protocol has yet been published or validated for this. For this reason, a literature review was conducted on UA function and its response to positive pressure and MI-E. Special emphasis has also been given to the current indication for video endoscopy in chronically ventilated patients.
Topics: Airway Obstruction; Deep Sedation; Endoscopy; Humans; Insufflation; Larynx; Nasal Cavity; Noninvasive Ventilation; Pharynx; Positive-Pressure Respiration; Sleep; Vocal Cord Dysfunction
PubMed: 31000441
DOI: 10.1016/j.pulmoe.2019.02.008