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Biomolecules Oct 2021This study aimed to analyze the effects of fibrin constructs enhanced with laminin-nidogen, implanted in the wounded rat soft palate. Fibrin constructs with and without...
This study aimed to analyze the effects of fibrin constructs enhanced with laminin-nidogen, implanted in the wounded rat soft palate. Fibrin constructs with and without laminin-nidogen were implanted in 1 mm excisional wounds in the soft palate of 9-week-old rats and compared with the wounded soft palate without implantation. Collagen deposition and myofiber formation were analyzed at days 3, 7, 28 and 56 after wounding by histochemistry. In addition, immune staining was performed for a-smooth muscle actin (a-SMA), myosin heavy chain (MyHC) and paired homeobox protein 7 (Pax7). At day 56, collagen areas were smaller in both implant groups (31.25 ± 7.73% fibrin only and 21.11 ± 6.06% fibrin with laminin-nidogen)) compared to the empty wounds (38.25 ± 8.89%, < 0.05). Moreover, the collagen area in the fibrin with laminin-nidogen group was smaller than in the fibrin only group ( ˂ 0.05). The areas of myofiber formation in the fibrin only group (31.77 ± 10.81%) and fibrin with laminin-nidogen group (43.13 ± 10.39%) were larger than in the empty wounds (28.10 ± 11.68%, ˂ 0.05). Fibrin-based constructs with laminin-nidogen reduce fibrosis and improve muscle regeneration in the wounded soft palate. This is a promising strategy to enhance cleft soft palate repair and other severe muscle injuries.
Topics: Actins; Animals; Collagen; Fibrin; Fibrosis; Humans; Laminin; Membrane Glycoproteins; Muscle, Skeletal; Myofibrils; Myosin Heavy Chains; Paired Box Transcription Factors; Palate, Soft; Rats; Regeneration; Wound Healing
PubMed: 34680180
DOI: 10.3390/biom11101547 -
Scientific Reports Feb 2024Oral mucosal tissues heal rapidly with minimal scarring, although palatal mucosa can be associated with excessive fibrosis in response to injury. Investigations on the...
Oral mucosal tissues heal rapidly with minimal scarring, although palatal mucosa can be associated with excessive fibrosis in response to injury. Investigations on the balance between neovascularization and tissue repair suggests regulation of angiogenesis is an important determinant of repair versus scarring. Associated with pericyte mediated fibrosis in kidney injury, FoxD1 is implicated in growth centres during cranio-facial development, although which cell lineages are derived from these embryonic populations in development and in adult animals is unknown. Using a lineage tracing approach, we assessed the fate of embryonic Foxd1-expressing progenitor cells and their progeny in palatal development and during wound healing in adult mice. During palatal development as well as in post-natal tissues, Foxd1-lineage progeny were associated with the vasculature and the epineurium. Post-injury, de novo expression of FoxD1 was not detectable, although Foxd1-lineage progeny expanded while exhibiting low association with the fibroblast/myofibroblast markers PDGFα, PDGFβ, vimentin, α-smooth muscle actin, as well as the neuronal associated markers S100β and p75NTR. Foxd1-lineage progeny were primarily associated with CD146, CD31, and to a lesser extent CD105, remaining in close proximity to developing neovascular structures. Our findings demonstrate that FoxD1 derived cells are predominantly associated with the palatal vasculature and provide strong evidence that FoxD1 derived cells do not give rise to populations involved directly in the scarring of the palate.
Topics: Animals; Mice; Cicatrix; Fibrosis; Forkhead Transcription Factors; Homeostasis; Kidney; Palate
PubMed: 38424240
DOI: 10.1038/s41598-024-55486-8 -
World Journal of Surgical Oncology Sep 2011The aim of this study was to present a rare neoplasm, Primary myoepithelial carcinoma arising from the palate, and to review its diagnostic criteria, pathologic and...
OBJECTIVES
The aim of this study was to present a rare neoplasm, Primary myoepithelial carcinoma arising from the palate, and to review its diagnostic criteria, pathologic and clinical characteristics, treatment options and prognosis.
CLINICAL PRESENTATION AND INTERVENTION
Myoepitheliomas are tumors arising from myoepithelial cells mainly or exclusively. Myoepitheliomas mostly occur in salivary glands, as well as in breast, skin, and lung. Case of myoepitheliomas in palate has rarely been reported. Myoepithelial carcinoma is malignant counterpart of myoepitheliomas. Adenomyoepithelioma is also a different disease from myoepitheliaomas. Immunohistochemically, tumor cells of myoepithelial carcinoma express not only epithelial markers such as cytokeratin, epithelial membrane antigen (EMA), but also markers of smooth muscle origin such as calponin. The immunohistochemical criteria of myoepithelial differentiation are double positive for both cytokeratins and one or more myoepithelial immunomarkers (i.e., S-100 protein, calponin, p63, GFAP, maspin, and actins). Myoepithelial carcinomas of salivary and breast demonstrate copy number gains and gene deletion. The overall prognosis of myoepithelial carcinoma is poor. There is rarely recurrence or metastasis in benign myoepithelial tumors. Complete excision with tumor-free margin is always the preferred treatment, while local radiation therapy and chemotherapy are suggestive treatment options. Here, a rare case of myoepithelial carcinoma arising from the palate has been described and discussed for the treatment and outcome. Pathological and clinical characters of myoepitheliomas are also compared and discussed.
CONCLUSION
The case report serves to increase awareness and improve the index of diagnosis and treatment of myoepitheliomas.
Topics: Aged; Biomarkers, Tumor; Biopsy; Calcium-Binding Proteins; Combined Modality Therapy; Diagnosis, Differential; Follow-Up Studies; Humans; Immunohistochemistry; Keratins; Male; Microfilament Proteins; Muscle Proteins; Myoepithelioma; Palatal Neoplasms; S100 Proteins; Calponins
PubMed: 21917131
DOI: 10.1186/1477-7819-9-104 -
The Laryngoscope Feb 2014Abnormal kinematics during swallowing can result in aspiration, which may become life threatening. We tested the role of palatal sensation in the motor control of...
OBJECTIVES/HYPOTHESIS
Abnormal kinematics during swallowing can result in aspiration, which may become life threatening. We tested the role of palatal sensation in the motor control of pharyngeal swallow in infants.
STUDY DESIGN
In eight infant pigs, we reduced palatal sensation using local anesthesia (PLA) and measured the impact on swallowing kinematics and airway protection.
METHODS
The pigs drank milk containing barium while we simultaneously recorded videofluoroscopy and electromyography from fine wire bipolar electrodes in several hyolaryngeal muscles. We compared these results to control feedings and feedings following palatal saline injections.
RESULTS
After PLA, four pigs had extreme jaw movements and abnormal tongue movement uncharacteristic of sucking. For this reason, we evaluated differences between these group B pigs and the others that could suck normally after PLA (group A). In the four group A pigs, after PLA there was less hyoid elevation (P < .001) but normal jaw and tongue movements. In group B, in addition to greater jaw movement (P < .001) there was more anterior and superior tongue movement (P < .001) and a larger range of hyoid movement (P < .001).
CONCLUSIONS
The airway was protected in all of the pigs, indicating that these changes allowed successful adaptation to the reduction in palatal sensation. However, the oral and pharyngeal phases of the swallow were functionally linked, and trigeminal sensation influenced the motor control of the pharyngeal swallow.
LEVEL OF EVIDENCE
N/A.
Topics: Age Factors; Anesthesia, Local; Animals; Biomechanical Phenomena; Deglutition; Palate; Pharynx; Sus scrofa
PubMed: 23686446
DOI: 10.1002/lary.24204 -
Frontiers in Neurology 2021Myofascial pain in the masticatory region, generally referred to as headache, is a common temporomandibular disorder (TMD) characterized by the hypersensitive regions of...
Myofascial pain in the masticatory region, generally referred to as headache, is a common temporomandibular disorder (TMD) characterized by the hypersensitive regions of the contracted skeletal muscle fibers. A correct clinical treatment of myofascial pain has the potential to modify the functional activation of cerebral networks associated with pain and unconscious teeth clenching, specifically the pain network (PN) and default mode network (DMN). In this study, research is presented as a case series of five patients with myofascial pain: three were diagnosed with intra- and extra-articular disorders, and two were diagnosed with only extra-articular disorders. All five patients received gnathological therapy consisting of passive splints and biofeedback exercises for tongue-palatal vault coordination. Before and after treatment, patients underwent pain assessments (through measures of visual analog scales and muscular palpation tests), nuclear magnetic resonance of the temporomandibular joint, and functional nuclear magnetic resonance of the brain. In each patient, temporomandibular joint nuclear magnetic resonance results were similar before and after the gnathological treatment. However, the treatment resulted in a considerable reduction in pain for all patients, according to the visual analog scales and the palpation test. Furthermore, functional nuclear magnetic resonance of the brain clearly showed a homogeneous modification in cerebral networks associated with pain (i.e., PN and DMN), in all patients. In conclusion, gnathological therapy consisting of passive aligners and biofeedback exercises improved myofascial pain in all five patients. Most importantly, this study showed that all five patients had a homogeneous functional modification of pain and default mode networks. Using passive splints in combination with jaw exercises may be an effective treatment option for patients with TMD. This research could be a starting point for future investigations and for clinicians who want to approach similar situations.
PubMed: 33912123
DOI: 10.3389/fneur.2021.629211 -
The Cleft Palate-craniofacial Journal :... Jan 2013Background : No studies have reported the circumference and diameter of the levator veli palatini muscle at multiple points along its length and from both views (frontal...
Background : No studies have reported the circumference and diameter of the levator veli palatini muscle at multiple points along its length and from both views (frontal and lateral). The purpose of this study was to provide quantitative data regarding the levator muscle morphology along the length of the muscle using magnetic resonance imaging and advanced three-dimensional computer technology. Methods : Ten Caucasian male subjects participated in the study. Subjects were scanned using a Siemens 3 T Trio. Levator muscle measures were obtained using a two-dimensional image plane. A three-dimensional model was used to measure the circumference and muscle diameter (in two directions) at six points along the length of the levator muscle. Results : Levator muscle length ranged from 41.67 mm to 52.85 mm across all subjects. Mean extravelar muscle length was 30.55 mm (SD, 2.8 mm) and 30.01 mm (SD, 2.9 mm) for right and left muscles. The mean circumference at the origin was 18.90 mm (SD, 2.6 mm). At the second point, the muscle circumference mean increased slightly (mean, 22.40 mm; SD, 4.9 mm). The means for the remainder of the measures (points 3, 4, 5, and 6) were consistent, showing little to no change. Conclusion : Circumference and diameter values were similar to those reported in previous literature. The muscle did diverge at the point where the muscle bundle entered the velum, as it has been previously described. Instead, the muscle diverges near the midline insertion becoming sparser (smaller superior-to-inferior diameter).
Topics: Humans; Magnetic Resonance Imaging; Palatal Muscles; Software
PubMed: 22023112
DOI: 10.1597/11-125 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2020The extinct nonavian dinosaur Tyrannosaurus rex, considered one of the hardest biting animals ever, is often hypothesized to have exhibited cranial kinesis, or, mobility...
The extinct nonavian dinosaur Tyrannosaurus rex, considered one of the hardest biting animals ever, is often hypothesized to have exhibited cranial kinesis, or, mobility of cranial joints relative to the braincase. Cranial kinesis in T. rex is a biomechanical paradox in that forcefully biting tetrapods usually possess rigid skulls instead of skulls with movable joints. We tested the biomechanical performance of a tyrannosaur skull using a series of static positions mimicking possible excursions of the palate to evaluate Postural Kinetic Competency in Tyrannosaurus. A functional extant phylogenetic bracket was employed using taxa, which exhibit measurable palatal excursions: Psittacus erithacus (fore-aft movement) and Gekko gecko (mediolateral movement). Static finite element models of Psittacus, Gekko, and Tyrannosaurus were constructed and tested with different palatal postures using anatomically informed material properties, loaded with muscle forces derived from dissection, phylogenetic bracketing, and a sensitivity analysis of muscle architecture and tested in orthal biting simulations using element strain as a proxy for model performance. Extant species models showed lower strains in naturally occurring postures compared to alternatives. We found that fore-aft and neutral models of Tyrannosaurus experienced lower overall strains than mediolaterally shifted models. Protractor muscles dampened palatal strains, while occipital constraints increased strains about palatocranial joints compared to jaw joint constraints. These loading behaviors suggest that even small excursions can strain elements beyond structural failure. Thus, these postural tests of kinesis, along with the robusticity of other cranial features, suggest that the skull of Tyrannosaurus was functionally akinetic. Anat Rec, 303:999-1017, 2020. © 2019 Wiley Periodicals, Inc.
Topics: Animals; Biomechanical Phenomena; Bite Force; Dinosaurs; Fossils; Movement; Palate; Phylogeny; Skull
PubMed: 31260190
DOI: 10.1002/ar.24219 -
Plastic and Reconstructive Surgery.... Feb 2017Restoration of proper anatomy and physiology is an integral part of cleft palate repair. The senior author has devised a new technique of radical release of greater...
BACKGROUND
Restoration of proper anatomy and physiology is an integral part of cleft palate repair. The senior author has devised a new technique of radical release of greater palatine vessels, which helps in achieving tension-free closure of palatal cleft. In addition, release and transposition of palatal muscles is performed without the use of operative microscope, resulting in improved palatal function. This technique is applicable to all types of clefts of the palate and can be performed on adult patients as well.
MATERIALS AND METHODS
This is a retrospective case series of cleft palate repairs performed over a period of 3 years. Single-stage repair with modified Bardach's technique for complete cleft palate and von Langenbeck's technique for incomplete cleft palate with radical release of greater palatine vessels and levator complex retropositioning was performed. The outcome measures were closure of palatal defect and speech production. A follow-up of at least 6 months was completed in each patient.
RESULTS
A total of 1568 patients were included in the study. Their age ranged from 9 months to 54 years. The overall fistula rate was 6.1%. Improvement of speech was observed even in adult patients.
CONCLUSIONS
Radical release of greater palatine artery and levator complex transposition can dramatically improve results of cleft palate repair. This technique helps in dynamic reconstruction of cleft palate and can be effectively applied in all age groups.
PubMed: 28280675
DOI: 10.1097/GOX.0000000000001235 -
The Journal of Craniofacial Surgery May 2017The purpose of this study was to examine differences in levator veli palatini (levator) morphology between adults with repaired cleft palate and adults with noncleft...
The purpose of this study was to examine differences in levator veli palatini (levator) morphology between adults with repaired cleft palate and adults with noncleft anatomy. Fifteen adult participants (10 with noncleft anatomy, 5 with repaired cleft palate) underwent 3-dimensional (3D) static magnetic resonance imaging (MRI). Image analyses included measures of total muscle volume and the circumference and diameter at 6 points along the length of the muscle. Differences between groups were analyzed using independent sample Mann-Whitney U tests (α < 0.05). Significant differences between groups were noted for measures of muscle volume, circumference at the origin and midline, anterior-posterior diameter at the origin and midline, and superior-inferior diameter at the point of insertion into the velum and midline. Differences in measures at other points along the levator muscle belly were not statistically significant. Limited sample size and gender differences may have impacted statistical findings. Overall, the levator muscle in adults with repaired cleft palate is significantly different than that of adults with noncleft anatomy. This study demonstrates the successful implementation of a method for 3D analysis of velopharyngeal (VP) musculature with potential clinical utility given continued technological advancements in MRI. Continued evaluation of pre- and postsurgical anatomy and short- and long-term outcomes may contribute to a better understanding of the effects of various types of palatoplasties on levator structure, which is important to VP function for speech.
Topics: Adult; Cleft Palate; Female; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Male; Organ Size; Orthognathic Surgical Procedures; Palatal Muscles; Palate, Soft; Postoperative Complications; Reproducibility of Results; Velopharyngeal Insufficiency
PubMed: 28060090
DOI: 10.1097/SCS.0000000000003373 -
European Archives of... Dec 2023To explore the feasibility of making a submental perforator flap distal to the connecting line between the mastoid and the sternoclavicular joint under the guidance of...
OBJECTIVES
To explore the feasibility of making a submental perforator flap distal to the connecting line between the mastoid and the sternoclavicular joint under the guidance of neck-enhanced CT and repairing the postoperative defect of upper airway malignancy.
MATERIALS AND METHODS
This study retrospectively analysed 19 cases of upper airway malignant tumours treated in our department from January 2021 to September 2022, including 17 males and 2 females, aged 43-70 years.
SITE OF LESIONS
15 cases were in the laryngopharynx, 2 cases in the nasal cavity and paranasal sinus and 2 cases on the soft palate. All the lesions were malignant and at stages TNM.
SURGICAL METHOD
The extended submental perforator flap (size 22-15 × 6-7 cm) was prefabricated distal to the connecting line between the mastoid and the sternoclavicular joint. After tumour resection, the flap was used to repair the postoperative defect. Fifteen cases of laryngopharyngeal malignant tumours were repaired using the extended submental perforator flap with the vascular pedicle located on the opposite side of the tumour body. Two cases of nasal cavity and paranasal sinus tumours were repaired using the extended submental perforator flap combined with the temporalis muscle flap. The soft palate was completely removed in two patients with soft palate cancer and repaired using the folded extended submental perforator flap.
RESULTS
Before the surgery, the reflux vein was observed by neck-enhanced CT, including 12 cases returning to the internal jugular vein and 7 cases to the external jugular vein. All 19 cases in which flaps were used survived, and 1 case had a postoperative infection. All the patients had nasal feeding removed after surgery. The tracheal cannula was removed from the patients with laryngeal preservation, and the pronunciation was satisfactory. Among them, patients with soft palate cancer repair had mild nasal reflux symptoms with smooth breathing. During the follow-up period of 4-24 months, 18 patients had no tumour recurrence or metastasis, and 1 patient had cervical lymph node metastasis.
CONCLUSIONS
This study highlights the use of a submental perforator flap distal to the connecting line between the mastoid and the sternoclavicular joint to repair postoperative defects for upper airway malignancy as an innovative surgical approach that provides more tissue and good arteriovenous blood supply to adjacent sites. This method has high clinical value and provides an effective option for repairing postoperative defects of upper airway malignancy.
Topics: Male; Female; Humans; Perforator Flap; Plastic Surgery Procedures; Skin Transplantation; Retrospective Studies; Neoplasm Recurrence, Local; Palatal Neoplasms; Treatment Outcome
PubMed: 37530858
DOI: 10.1007/s00405-023-08131-5