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BMC Oral Health Jan 2023The primary aim of this study was to evaluate the dentoalveolar, skeletal, pharyngeal airway, cervical posture, hyoid bone position, and soft palate effects of the...
BACKGROUND
The primary aim of this study was to evaluate the dentoalveolar, skeletal, pharyngeal airway, cervical posture, hyoid bone position, and soft palate effects of the Myobrace and Twin-block appliances. The second was to compare them in terms of ease of use by assessing the factors that may influence patient compliance.
METHODS
The study included thirty-six Class II division 1 patients (19 females, 17 males; mean age, 12.14 ± 1.23) who had previously been treated in the Orthodontic Clinic at Sivas Cumhuriyet University Faculty of Dentistry. The patients were divided into two groups: Group 1: Myobrace (n = 18), and Group 2: twin block (n = 18). The effects of the appliances on the skeletal, dentoalveolar, soft tissue, craniocervical, and other anatomic structures were assessed using 46 measurements (22 linear and 24 angular), on pre and post-treatment cephalometric radiographs. AudaxCeph 5.0 software (Ljubljana, Slovenia) was used for the analysis. To analyze the changes after one year of treatment, a paired sample t-test and Wilcoxon signed-rank test were used. Intergroup comparison was performed using the Student t-test and the Mann-Whitney U test.
RESULTS
In the Myobrace and Twin-block groups, there was a significant increase in SNB (°) (p = 0.004, p = 0.001), IMPA (°) (p = 0.005, p = 0.001) and a significant drop in U1/SN (°) (p = 0.021, p = 0.005). The lengths of Cd-Gn (mm), Go-Pg (mm), and Cd-Go (mm) increased significantly in the Twin-block group (p = 0.003, p = 0.010, p = 0.001), whereas the Myobrace group did not change. Similarly, there was no significant difference in pharyngeal and soft palate measurements in the Myobrace group but a statistically significant decrease in SP length and angle in the Twin-block group (p = 0.001, p = 0.006). Increases in SN/OPT (°) (p = 0.032, p = 0.001) and SN/CVT (°) (p = 0.012, p = 0.001) were statistically significant in both groups. Myobrace was more difficult to use while sleeping, whereas the twin block caused more nausea.
CONCLUSIONS
Both appliances can be used for mandibular advancement. The Twin-block appliance, on the other hand, was more effective and patient-friendly.
Topics: Male; Female; Humans; Child; Adolescent; Hyoid Bone; Retrospective Studies; Mandible; Cadmium; Malocclusion, Angle Class II; Palate, Soft; Posture; Cephalometry
PubMed: 36717838
DOI: 10.1186/s12903-023-02773-x -
The Journal of Veterinary Medical... Sep 2021Pharyngeal collapsibility has been used as diagnostic criteria in dogs, whereas the normal range and quantitative method have not been studied. Dynamic and static...
Pharyngeal collapsibility has been used as diagnostic criteria in dogs, whereas the normal range and quantitative method have not been studied. Dynamic and static computed tomography (CT) was performed in 23 normal Beagle dogs to quantify the nasopharyngeal collapsibility at different locations. Using dynamic CT, maximum and minimum nasopharyngeal cross-sectional areas (CSAs) were measured at the level of the cranial end of the soft palate, pterygoid hamulus, foramen lacerum, bony labyrinth, and caudal end of the soft palate. The ratio of all maximum and minimum CSA to nasopharyngeal CSA at the level of the caudal hard palate (rCSAmax and rCSAmin) and the nasopharyngeal collapsibility were calculated. The differences of rCSAmax, rCSAmin, and nasopharyngeal collapsibility were analyzed at various locations. The nasopharyngeal collapsibility at the level of foramen lacerum, bony labyrinth, and caudal end of soft palate were higher than the others. At the level of the caudal end of the soft palate, rCSAmin was lower than that of the foramen lacerum and bony labyrinth, whereas rCSAmax at foramen lacerum was higher than that of the caudal end of the soft palate. These results indicated that the nasopharynx at the level of foramen lacerum and caudal end of the soft palate were considered notable locations for evaluating collapsibility. Dynamic CT could show the nasopharyngeal dynamic profile and will be an adequate modality for evaluating nasopharynx. Our results will be helpful for further comparative studies in dogs with and without nasopharyngeal collapse.
Topics: Animals; Dogs; Nasopharynx; Palate, Hard; Palate, Soft; Skull; Tomography, X-Ray Computed
PubMed: 34248083
DOI: 10.1292/jvms.21-0216 -
International Journal of Environmental... Apr 2020Vocabulary skills in infants with cleft lip and/or palate (CL/P) are related to various factors. They remain underexplored among Mandarin-speaking infants with CL/P....
BACKGROUND
Vocabulary skills in infants with cleft lip and/or palate (CL/P) are related to various factors. They remain underexplored among Mandarin-speaking infants with CL/P. This study identified receptive and expressive vocabulary skills among Mandarin-speaking infants with unrepaired CL/P prior to cleft palate surgery and their associated factors.
METHODS
This is a cross-sectional study involving patients at the Cleft Lip and Palate Center of the Stomatological Hospital of Xi'an Jiaotong University between July 2017 and December 2018. The Putonghua Communicative Development Inventories-Short Form (PCDI-SF) was used to assess early vocabulary skills.
RESULTS
A total of 134 children aged 9-16 months prior to cleft palate surgery were included in the study. The prevalences of delays in receptive and expressive vocabulary skills were 72.39% (95% CI: 64.00-79.76%) and 85.07% (95% CI: 77.89-90.64%), respectively. Multiple logistic regression identified that children aged 11-13 months (OR = 6.46, 95% CI: 1.76-23.76) and 14-16 months (OR = 24.32, 95% CI: 3.86-153.05), and those with hard/soft cleft palate and soft cleft palate (HSCP/SCP) (OR = 5.63, 95% CI: 1.02-31.01) were more likely to be delayed in receptive vocabulary skills.
CONCLUSIONS
Delays in vocabulary skills were common among Mandarin-speaking CL/P infants, and age was positively associated with impaired and lagging vocabulary skills. The findings suggest the necessity and importance of early and effective identification of CL/P, and early intervention programs and effective treatment are recommended for Chinese CL/P infants.
Topics: Child Development; Cleft Lip; Cleft Palate; Cross-Sectional Studies; Female; Humans; Infant; Male; Palate, Soft; Speech; Vocabulary
PubMed: 32357522
DOI: 10.3390/ijerph17093015 -
Journal of Biomechanics Jul 2018Highly compliant tissue supporting the pharynx and low muscle tone enhance the possibility of upper airway occlusion in children with obstructive sleep apnea (OSA). The...
Highly compliant tissue supporting the pharynx and low muscle tone enhance the possibility of upper airway occlusion in children with obstructive sleep apnea (OSA). The present study describes subject-specific computational modeling of flow-induced velopharyngeal narrowing in a female child with polycystic ovarian syndrome (PCOS) with OSA and a non-OSA control. Anatomically accurate three-dimensional geometries of the upper airway and soft-palate were reconstructed for both subjects using magnetic resonance (MR) images. A fluid-structure interaction (FSI) shape registration analysis was performed using subject-specific values of flow rate to iteratively compute the biomechanical properties of the soft-palate. The optimized shear modulus for the control was 38 percent higher than the corresponding value for the OSA patient. The proposed computational FSI model was then employed for planning surgical treatment for the apneic subject. A virtual surgery comprising of a combined adenoidectomy, palatoplasty and genioglossus advancement was performed to estimate the resulting post-operative patterns of airflow and tissue displacement. Maximum flow velocity and velopharyngeal resistance decreased by 80 percent and 66 percent respectively following surgery. Post-operative flow-induced forces on the anterior and posterior faces of the soft-palate were equilibrated and the resulting magnitude of tissue displacement was 63 percent lower compared to the pre-operative case. Results from this pilot study indicate that FSI computational modeling can be employed to characterize the mechanical properties of pharyngeal tissue and evaluate the effectiveness of various upper airway surgeries prior to their application.
Topics: Adenoidectomy; Adolescent; Biomechanical Phenomena; Computer Simulation; Female; Humans; Magnetic Resonance Imaging; Palate, Soft; Pharynx; Pilot Projects; Polycystic Ovary Syndrome; Sleep Apnea, Obstructive
PubMed: 29793766
DOI: 10.1016/j.jbiomech.2018.05.013 -
Journal of Plastic Surgery and Hand... Dec 2023The aim of this systematic review was to determine whether one-stage palatoplasty for children born with cleft lip and palate shows overall advantages in outcome...
The aim of this systematic review was to determine whether one-stage palatoplasty for children born with cleft lip and palate shows overall advantages in outcome compared with two-stage palatoplasty. The included studies were controlled studies of syndromic and non-syndromic children born with unilateral cleft lip and palate, bilateral cleft lip and palate, or isolated cleft palate. The interventions studied were one-stage palatoplasty and two-stage palatoplasty starting with the soft palate. The outcomes were facial growth, speech, hearing, presence of fistulae, other complications related to surgery, health-related quality of life, and health economics. In total, 14 original studies were included. Results were dichotomized into showing advantage for one- or two-stage palatoplasty for the respective outcome and compared with the results from six included systematic reviews. No overall advantage for either surgical strategy was found for any of the outcome measures. The certainty of evidence was highest for the presence of fistulae, followed by facial growth and speech. For several outcomes, the quality of the existing evidence was too low to allow for any conclusions to be drawn. Neither one- nor two-stage palatoplasty showed significant advantages in clinical outcomes compared with the other. Other aspects such as ethics, economics, or surgeon's preference might hence be of more importance. Homogenous choices of outcome measures and defined minimal clinically important differences would facilitate further research.
Topics: Child; Humans; Cleft Palate; Cleft Lip; Quality of Life; Treatment Outcome; Palate, Soft
PubMed: 38095226
DOI: 10.2340/jphs.v58.13368 -
BMJ Case Reports Jun 2015A 2-day-old neonate was transferred to a specialist paediatric otolaryngology centre with stridor at rest, feeding difficulties and an apparent mass in the oropharynx....
A 2-day-old neonate was transferred to a specialist paediatric otolaryngology centre with stridor at rest, feeding difficulties and an apparent mass in the oropharynx. The newborn displayed evidence of respiratory distress, however, she remained self-ventilating. MRI highlighted a fat-containing lesion in the postnasal space with no intracranial extension. A CT scan under general anaesthesia showed no underlying bony abnormality, and hence an examination of the nasopharynx, oropharynx and microlaryngoscopy and bronchoscopy were performed. The macroscopically hairy lesion arising from the superior aspect of the soft palate was resected. Histology displayed a benign growth measuring 28×17×12 mm in keeping with a hairy polyp. This is one of very few cases, to the best of our knowledge, in which a hairy polyp (bigerminal choristomas) has resulted in stridor in the first few days of life. Nasal masses in neonates, although a rare phenomenon, remain clinically important as they are obligate nasal breathers.
Topics: Choristoma; Female; Hair; Humans; Infant, Newborn; Magnetic Resonance Imaging; Oropharynx; Palate, Soft; Physical Examination; Polyps; Respiration; Respiratory Sounds; Tomography, X-Ray Computed
PubMed: 26055604
DOI: 10.1136/bcr-2015-209825 -
Medical Science Monitor : International... Jul 2020BACKGROUND Chronic intermittent hypoxia (CIH) is a key feature of obstructive sleep apnea (OSA) syndrome. The pathogenesis of CIH-induced soft palate lesion is not well...
BACKGROUND Chronic intermittent hypoxia (CIH) is a key feature of obstructive sleep apnea (OSA) syndrome. The pathogenesis of CIH-induced soft palate lesion is not well understood. Understanding the mechanisms of CIH-induced soft palate damage could provide new strategies for clinical treatment. MATERIAL AND METHODS Twenty male Sprague‑Dawley rats were randomized into a control group (n=10) and experimental group (n=10). The experimental group were exposed to CIH for 28 days. The control experiments were run in parallel. Morphological changes of CIH-induced soft palate were examined by hematoxylin and eosin. Peripheral nerves and vascular associated markers were analyzed by western blot and immunohistochemical staining. LC3B expression and transmission electron microscopy analysis was detected to investigate the destiny of cells in CIH-induced soft palate. RESULTS Histological studies demonstrated the thicken mucosal layer, muscular changes consistent with glands hyperplasia, and loose connective tissues of the soft palate in CIH induced rat models. CIH exposure significantly decreased the expression of annexin V but did not change argin level, suggesting that sensory nerves not motor nerves were damaged when exposed to intermittent hypoxia. Moreover, in response to CIH, the vascular vessel around the nerves and muscles became enlarged and caveolin-1 was overexpressed. Autophagy occurs in response to CIH-induced neuromuscular and vascular endothelial injury. CONCLUSIONS Sensory nerves and endothelial dysfunction contributed to the morphological damage of soft palate under intermittent hypoxia. Autophagy as a compensatory mechanism protects against CIH-induced injury. These findings have important implications for understanding mechanisms contributing to the increased soft palate lesion in patients with OSA.
Topics: Animals; Autophagy; Endothelial Cells; Hypoxia; Male; Palate, Soft; Rats; Rats, Sprague-Dawley; Sensory Receptor Cells; Sleep Apnea, Obstructive; Vascular Diseases
PubMed: 32616707
DOI: 10.12659/MSM.920878 -
American Journal of Veterinary Research Jan 2021To fluoroscopically evaluate the effects of head posture and sedation on the laryngopharyngeal anatomic structures in dogs.
OBJECTIVE
To fluoroscopically evaluate the effects of head posture and sedation on the laryngopharyngeal anatomic structures in dogs.
ANIMALS
6 clinically normal Beagles (mean age, 6.2 years; mean weight, 10.4 kg).
PROCEDURES
Each dog was sedated and placed in right lateral recumbency, and fluoroscopic examinations were performed with flexed, neutral, and extended head postures (FHP, NHP, and EHP, respectively). During 3 respiratory cycles, the angle between the basisphenoid bone and nasopharyngeal dorsal border (ABN), thickness of the soft palate, diameter of the nasopharyngeal lumen (DNL), overlapping length between the epiglottis and soft palate, and distance between the epiglottis and tympanic bulla (DET) were measured and percentage difference in the DNL (PDNLD) during a respiratory cycle was calculated.
RESULTS
For the FHP, NHP, and EHP, median ABN was 91.50° (interquartile range [IQR], 86.75° to 95.00°), 125.00° (IQR, 124.50° to 125.50°), and 160.00° (IQR, 160.00° to 163.50°), respectively, with no significant differences between ABN and posture angle. For the FHP, median DNL and DET significantly decreased, compared with values for the NHP, and median thickness of the soft palette significantly increased. For the EHP, the minimal DNL and DET significantly increased, and the median overlapping length between the epiglottis and soft palate significantly decreased, compared with values for the NHP. The PDNLD significantly increased and decreased with FHP and EHP, respectively, compared with the PDNLD with NHP. Sedation did not affect upper airway structure changes.
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that head posture significantly affected the laryngopharyngeal structures in dogs. Fluoroscopic examination of the upper respiratory tract of a dog should be performed with an NHP to minimize posture-induced changes in measurements.
Topics: Animals; Dogs; Fluoroscopy; Head; Nasopharynx; Palate, Soft; Posture
PubMed: 33369497
DOI: 10.2460/ajvr.82.1.55 -
American Journal of Veterinary Research Jan 2016To histologically evaluate and compare features of myofibers within the elongated soft palate (ESP) of brachycephalic and mesocephalic dogs with those in the soft palate...
OBJECTIVE
To histologically evaluate and compare features of myofibers within the elongated soft palate (ESP) of brachycephalic and mesocephalic dogs with those in the soft palate of healthy dogs and to assess whether denervation or muscular dystrophy is associated with soft palate elongation.
SAMPLE
Soft palate specimens from 24 dogs with ESPs (obtained during surgical intervention) and from 14 healthy Beagles (control group).
PROCEDURES
All the soft palate specimens underwent histologic examination to assess myofiber atrophy, hypertrophy, hyalinization, and regeneration. The degrees of atrophy and hypertrophy were quantified on the basis of the coefficient of variation and the number of myofibers with hyalinization and regeneration. The specimens also underwent immunohistochemical analysis with anti-neurofilament or anti-dystrophin antibody to confirm the distribution of peripheral nerve branches innervating the palatine myofibers and myofiber dystrophin expression, respectively.
RESULTS
Myofiber atrophy, hypertrophy, hyalinization, and regeneration were identified in almost all the ESP specimens. Degrees of atrophy and hypertrophy were significantly greater in the ESP specimens, compared with the control specimens. There were fewer palatine peripheral nerve branches in the ESP specimens than in the control specimens. Almost all the myofibers in the ESP and control specimens were dystrophin positive.
CONCLUSIONS AND CLINICAL RELEVANCE
These results suggested that palatine myopathy in dogs may be caused, at least in part, by denervation of the palatine muscles and not by Duchenne- or Becker-type muscular dystrophy. These soft palate changes may contribute to upper airway collapse and the progression of brachycephalic airway obstructive syndrome.
Topics: Animals; Craniosynostoses; Dogs; Immunohistochemistry; Muscle, Skeletal; Palate, Soft
PubMed: 26709940
DOI: 10.2460/ajvr.77.1.77 -
Archives of Plastic Surgery Nov 2012Squamous cell carcinoma infrequently occurs at the soft palate. Although various methods can be used for reconstruction of soft palate defects that occur after resecting...
Squamous cell carcinoma infrequently occurs at the soft palate. Although various methods can be used for reconstruction of soft palate defects that occur after resecting squamous cell carcinoma, it is difficult to obtain satisfactory results from the perspective of the functional restoration of the soft palate. A combination of bilateral palatal mucomuscular flap for the oral side and superiorly based posterior pharyngeal flap for the nasal side were performed on two patients who were diagnosed with squamous cell carcinoma of the soft palate in order to reconstruct the soft palate defects after surgical resection. After surgery, the patients were followed-up for a mean period of 11 months. The flaps were well maintained in both patients. The donor site defects were epithelialized and completely recovered. Additionally, no recurrence of the primary sites was shown. Slight hyponasality was observed in the voice assessments that were conducted 6 months after surgery. No food regurgitation or aspiration was observed in the swallowing tests. We used a combination of bilateral palatal mucomuscular flap and superiorly based posterior pharyngeal flap to reconstruct the soft palate defects that occurred after resecting the squamous cell carcinomas. We reduced the donor site complications and achieved functionally satisfactory outcomes.
PubMed: 23233893
DOI: 10.5999/aps.2012.39.6.655