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Advances in Clinical and Experimental... 2015Disorders in the orofacial complex as well as muscle hypotension in children with Down syndrome can be corrected through orofacial therapy that makes use of a palatal...
BACKGROUND
Disorders in the orofacial complex as well as muscle hypotension in children with Down syndrome can be corrected through orofacial therapy that makes use of a palatal plate.
OBJECTIVES
The aim of this paper was to present how parents of children with DS assess the availability of treatment and the therapeutic effects of orthodontic palatal plate therapy on the tongue position and mimetic muscle tension in their children; and to determine whether implementing full Castillo-Morales therapy and using only a palatal plate lead to substantially different results.
MATERIAL AND METHODS
The study was conducted on 100 children with DS between the ages of two months and two years (44 boys, 56 girls) who were treated by means of stimulating plate therapy. The study analyzed responses obtained from the parents to questions included in a questionnaire completed at every visit over a period of two years.
RESULTS
The study found that in 50 patients with DS who underwent palatal plate rehabilitation there was a visible improvement of the mimetic muscles, tongue retraction and lip closure.
CONCLUSIONS
Early orthodontic palatal plate therapy ought to be an integral part of the multidisciplinary rehabilitation of patients with DS.
Topics: Adult; Child, Preschool; Down Syndrome; Equipment Design; Facial Muscles; Female; Humans; Infant; Lip; Male; Orthodontic Appliances; Parents; Recovery of Function; Surveys and Questionnaires; Time Factors; Tongue; Tongue Habits; Treatment Outcome
PubMed: 25931364
DOI: 10.17219/acem/40451 -
Movement Disorders : Official Journal... Aug 2012Palatal tremor is characterized by rhythmic movements of the soft palate and can be essential or symptomatic. Some patients can have palatal movements as a special skill...
BACKGROUND
Palatal tremor is characterized by rhythmic movements of the soft palate and can be essential or symptomatic. Some patients can have palatal movements as a special skill or due to palatal tics. Psychogenic palatal tremor is recognized but rarely reported in the literature.
METHODS
We retrospectively evaluated all patients with palatal tremor seen in our center over a period of 10 years.
RESULTS
Of 17 patients with palatal tremor, we identified 10 patients with isolated palatal tremor. In 70% of those the diagnosis of psychogenic palatal tremor could be made. Of the remainder, 2 had palatal tics and 1 essential palatal tremor.
CONCLUSIONS
We suggest that psychogenic palatal tremor may be underrecognized and propose that targeted clinical examination of positive signs for psychogenic movement disorders in these patients is essential. The correct identification of such patients has important clinical and scientific implications.
Topics: Adult; Age of Onset; Anti-Dyskinesia Agents; Botulinum Toxins, Type A; Cognitive Behavioral Therapy; Electromyography; Female; Glial Fibrillary Acidic Protein; Humans; Male; Mental Disorders; Palatal Muscles; Psychophysiologic Disorders; Tics; Tremor
PubMed: 22434706
DOI: 10.1002/mds.24948 -
Respiration; International Review of... 2012Histopathological alterations and a reduced number of capillaries have been observed in the palate muscles of snorers with obstructive sleep apnea syndrome (OSAS). These...
BACKGROUND
Histopathological alterations and a reduced number of capillaries have been observed in the palate muscles of snorers with obstructive sleep apnea syndrome (OSAS). These changes may create a substrate for decreased microcirculation, impaired aerobic metabolism and muscle dysfunction and contribute to upper airway obstruction during sleep.
OBJECTIVES
The aim was to analyze mitochondria distribution and oxidative enzyme activity in relation to capillary supply in the palate muscles of patients with a history of long-term snoring and OSAS.
METHODS
Palatopharyngeus (PP) and uvula (UV) muscle samples were obtained from 8 patients undergoing uvulopalatopharyngoplasty due to habitual snoring and OSAS. The muscles were analyzed with enzyme- and immunohistochemistry and morphometry.
RESULTS
Abnormalities in the internal organization of mitochondria and oxidative activity were observed in 39 ± 15% of the fibers in the PP and 4 ± 3% in the UV, but not in control samples. The majority of these fibers had a lobulated contour and trabecular internal organization of mitochondria. The number of capillaries around abnormal fibers (PP 0.9 ± 0.3, UV 0.4 ± 0.1) was lower than in fibers of a normal appearance in both patients (PP 1.4 ± 0.6, UV 1.2 ± 0.3) and references (PP 2.7 ± 0.7, UV 1.9 ± 0.9) (p < 0.05).
CONCLUSIONS
Abnormal mitochondrial distribution, a low capillary supply and signs of impaired oxidative activity suggest that muscle dysfunction of the palate muscles in long-term snorers may contribute to the upper airway obstruction during sleep. The cause of these abnormalities remains unclear, but local muscle and nerve trauma due to vibration and stretch is a possible etiology.
Topics: Adenosine Triphosphatases; Biopsy; Capillaries; Case-Control Studies; Electron Transport Complex IV; Female; Fibrosis; Humans; Immunohistochemistry; Male; Microcirculation; Middle Aged; Mitochondria, Muscle; Muscle Fibers, Skeletal; Myofibrils; NADH Tetrazolium Reductase; Otorhinolaryngologic Surgical Procedures; Palatal Muscles; Palate, Soft; Pharynx; Sleep Apnea, Obstructive; Snoring; Succinate Dehydrogenase; Uvula
PubMed: 22378021
DOI: 10.1159/000336040 -
Medicina (Kaunas, Lithuania) Jul 2023The current paper presents a case of a 33-year-old female with an uncommon localization of a leiomyoma in the oral cavity-the anterior palatal fibromucosa and the...
The current paper presents a case of a 33-year-old female with an uncommon localization of a leiomyoma in the oral cavity-the anterior palatal fibromucosa and the incisive papilla. The patient referred to the Oro-Maxillo-Facial Surgery Clinic of Emergency City Hospital Timisoara, Romania, complaining of a slight discomfort in the act of mastication and the occurrence and persistence of a diastema between the upper central incisors, due to the presence of a nodule located in the anterior palatal mucosa, between the upper central incisors, without any changes of the subjacent bone structure in the anterior hard palate visible on a cone beam computed tomography image (CBCT). The lesion was removed using a surgical excisional biopsy and a histopathological examination was performed using morphological Hematoxylin-Eosin (HE) staining and additional immunohistochemical (IHC) reactions, in order to confirm the diagnosis. On microscopic examination, bundles of spindle cells were found with eosinophilic cytoplasm and vesicular nuclei, with finely granular chromatin. The immunohistochemical reactions were positive for smooth muscle actin (SMA) and desmin and negative for vimentin. The treatment of choice for leiomyoma of the oral cavity is surgical excision with clear margins, followed by periodical clinical monitoring.
Topics: Female; Humans; Adult; Leiomyoma; Palate, Hard; Biopsy; Incisor; Cone-Beam Computed Tomography
PubMed: 37512157
DOI: 10.3390/medicina59071346 -
Journal of Anatomy May 2022The extinct freshwater choristoderan reptiles Champsosaurus and Simoedosaurus are characterised by large body size and an elongated snout. They have often been...
Feeding behaviour and functional morphology of the neck in the long-snouted aquatic fossil reptile Champsosaurus (Reptilia: Diapsida) in comparison with the modern crocodilian Gavialis gangeticus.
The extinct freshwater choristoderan reptiles Champsosaurus and Simoedosaurus are characterised by large body size and an elongated snout. They have often been considered as eco-analogues of crocodilians based on superficial similarities. The slender-snouted Champsosaurus has been described as a 'gavial-like reptile', which implies it feeds underwater with a lateral swipe of the head and neck, as in the living slender-snouted crocodilians such as Gavialis gangeticus. In contrast, the short-snouted Simoedosaurus is often compared with short-snouted living crocodilians and is considered to take single prey items. However, the neck mobility and flexibility needed for feeding movements are poorly understood even in extant crocodilians. This study explores the relationship between cervical morphology and neck flexion, focusing particularly on lateral and dorsal movements in G. gangeticus by comparison with shorter-snouted crocodilians. The paper also describes a method to estimate the maximum angle of neck dorsiflexion in choristoderes based on the cervical morphology of extant crocodilian species. Three indices were used in this study, of which Index 3 is newly proposed, to compare cervical morphology and intervertebral joint flexibility: (1) Enclosed zygapophyseal angles (EZA) as an index of dorsoventral/ bilateral flexibility, (2) moment arm (M) of dorsiflexor muscles as an Index of resistance against ventroflexion and (3) the orientations of zygapophysial facets for a maximum angle of dorsiflexion. These Indices were validated using µCT scanning of fresh specimens of G. gangeticus and Caiman latirostris in lateral and dorsal flexion. A unique mechanism of lateral flexion was identified in G. gangeticus that uses a combination of the following features: (1) lateral flexion mainly restricted to the anterior cervical vertebrae (v2/v3: high EZA, with more horizontal zygapophyses) and (2) high degree of dorsiflexion at the v3/v4 and v4/v5 joints with potential for dorsal flexibility through the middle-posterior neck, which is used in inertial feeding. In contrast, Champsosaurus and Simoedosaurus possess relatively short cervical vertebrae, as in short-snouted crocodilians. The middle-posterior cervical vertebrae of Champsosaurus are specialised for lateral flexion (high EZA), and there is only limited capacity for dorsiflexion throughout the neck. Like G. gangeticus, therefore, Champsosaurus may have used its slender snout to grab fish from shoals using lateral sweeping motions of the head and neck, but the movement is through the neck, not the craniocervical joint. However, inertial feeding is less likely to have occurred in this genus, and the aligned palatal dentition may have aided the lingual transport of prey into the mouth. Simoedosaurus, on the other hand, appears to have been less specialised, with a neck that combined lateral and dorsolateral flexion, a move that could have been effective in catching both terrestrial and aquatic prey. Where these two choristoderan genera occurred in the same place, they may have divided their niche by prey types.
Topics: Alligators and Crocodiles; Animals; Feeding Behavior; Fossils; Head; Neck
PubMed: 34865223
DOI: 10.1111/joa.13600 -
Journal of Speech, Language, and... Jun 2020Purpose The purpose of this study was to identify predictors of levator veli palatini (LVP) muscle shortening and maximum contraction velocity in adults with normal...
Purpose The purpose of this study was to identify predictors of levator veli palatini (LVP) muscle shortening and maximum contraction velocity in adults with normal anatomy. Method Twenty-two Caucasian English-speaking adults with normal speech and resonance were recruited. Participants included 11 men and 11 women ( = 22.8 years, = 4.1) with normal anatomy. Static magnetic resonance images were obtained using a three-dimensional static imaging protocol. Midsagittal and oblique coronal planes were established for visualization of the velum and LVP muscle at rest. Dynamic magnetic resonance images were obtained in the oblique coronal plane during production of "ansa." Amira 6.0.1 Visualization and Volume Modeling Software and MATLAB were used to analyze images and calculate LVP shortening and maximum contraction velocity. Results Significant predictors ( < .05) of maximum LVP shortening during velopharyngeal closure included mean extravelar length, LVP origin-to-origin distance, velar thickness, pharyngeal depth, and velopharyngeal ratio. Significant predictors ( < .05) of maximum contraction velocity during velopharyngeal closure included mean extravelar length, intravelar length, LVP origin-to-origin distance, and velar thickness. Conclusions This study identified six velopharyngeal variables that predict LVP muscle function during real-time speech. These predictors should be considered among children and individuals with repaired cleft palate in future studies.
Topics: Adult; Child; Cleft Palate; Female; Humans; Magnetic Resonance Imaging; Male; Muscle Contraction; Palatal Muscles; Palate, Soft; Pharynx; Speech
PubMed: 32539646
DOI: 10.1044/2020_JSLHR-20-00013 -
Progress in Orthodontics 2015Rapid maxillary expansion (RME) is an effective orthopedic procedure that can be used to address problems concerned with the growth of the midface. This procedure also... (Review)
Review
Rapid maxillary expansion (RME) is an effective orthopedic procedure that can be used to address problems concerned with the growth of the midface. This procedure also may produce positive side effects on the general health of the patient. The aim of the present consensus paper was to identify and evaluate studies on the changes in airway dimensions and muscular function produced by RME in growing patients. A total of 331 references were retrieved from a database search (PubMed). The widening of the nasal cavity base after midpalatal suture opening in growing patients allows the reduction in nasal airway resistance with an improvement of the respiratory pattern. The effects of RME on the upper airway, however, have been described as limited and local, and these effects become diminished farther down the airway, possibly as a result of soft-tissue adaptation. Moreover, limited information is available about the long-term stability of the airway changes produced by RME. Several studies have shown that maxillary constriction may play a role in the etiology of more severe breathing disorders such as obstructive sleep apnea (OSA) in growing subjects. Early orthodontic treatment with RME is able to reduce the symptoms of OSA and improve polysomnographic variables. Finally, early orthopedic treatment with RME also is beneficial to avoid the development of facial skeletal asymmetry resulting from functional crossbites that otherwise may lead to functional and structural disorders of the stomatognathic system later in life.
Topics: Airway Resistance; Facial Asymmetry; Health Promotion; Health Status; Humans; Maxillofacial Development; Nasal Cavity; Oral Health; Palatal Expansion Technique; Respiration; Sleep Apnea, Obstructive
PubMed: 26446931
DOI: 10.1186/s40510-015-0105-x -
Tremor and Other Hyperkinetic Movements... Dec 2020Ear click is a rare type of objective tinnitus, classically described with associated palatal tremor/myoclonus (PT).
BACKGROUND
Ear click is a rare type of objective tinnitus, classically described with associated palatal tremor/myoclonus (PT).
CASE REPORT
A 15-year-old boy reported a constant bilateral ear clicking for 4 years, that could be stopped at will for a few seconds. Clinically, the ear clicks were audible without visible eardrum or palatal movement, and could be entrained by the examiner. Brain MRI was normal.
DISCUSSION
We propose to classify this as isolated ear clicks with partial voluntary control, putting it into context with other subcategories of "essential" or "isolated" PT.
Topics: Adolescent; Humans; Male; Palatal Muscles; Tinnitus; Tremor
PubMed: 33362949
DOI: 10.5334/tohm.574 -
European Journal of Paediatric Dentistry Jun 2023This study aimed to characterise the palatal vault evolution during the first years of life, both in terms of shape and size.
AIM
This study aimed to characterise the palatal vault evolution during the first years of life, both in terms of shape and size.
MATERIALS
The study sample was composed of 168 healthy children aged less than 4 years. Twenty-one measurements of distances and 6 angles were taken from 7 fixed landmarks set on the palatal vaults 3D surfaces reconstructed from CT-scans. To analyse only the shape evolution, the "sizefree" log-shape ratio of those measurements were computed and the global shape of the palatal vault and their transversal curve were plotted. Statistical analyses were performed to highlight the shape and size differences separately.
CONCLUSION
The shape and size evolution of the palatal vault during the first years of life was not only correlated with deciduous dentition development. We assumed that the progressive orofacial muscles activation and tongue movements in the oral cavity may also explain these results as they induced strains on the palatal vault, warping it in various ways.
Topics: Humans; Child; Palate; Tomography, X-Ray Computed
PubMed: 37184237
DOI: 10.23804/ejpd.2023.1663 -
Head and Neck Pathology Mar 2018A 70-year-old male presented with a slow growing, dome shaped and painless mass of the hard palate. The mass was excised. Histopathological examination confirmed the...
A 70-year-old male presented with a slow growing, dome shaped and painless mass of the hard palate. The mass was excised. Histopathological examination confirmed the diagnosis of a angioleiomyoma (vascular leiomyoma). A leiomyoma is an uncommon benign tumor of smooth muscle differentiation. True leiomyomas of the oral cavity are rare and most oral tumors are derived from the smooth muscle of walls of blood vessels. Therefore, they are called vascular leiomyomas or angioleiomyomas. Clinically, they may resemble a myriad other conditions both benign and malignant. A definitive diagnosis depends upon histopathological examination of the biopsied tissue in correlation with the tumor cell immunohistochemistry. Tumors are excised and recurrence is rare. The histopathological findings and differential diagnosis of a case of a palatal angioleiomyoma are discussed.
Topics: Aged; Angiomyoma; Humans; Male; Mouth Neoplasms; Palate, Hard
PubMed: 28589436
DOI: 10.1007/s12105-017-0827-9