• The korean journal of orthodontics
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• v.40 no.2
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• pp.66-76
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• 2010

Objective: Obstructive sleep apnea (OSA) is a common disorder which is characterized by a recurrence of entire or partial collapse of the pharyngeal airway during sleep. A given tidal volume must traverse the soft tissue tube structure of the upper airway, so the tendency for airway obstruction is influenced by the geometries of the duct and characteristics of the airflow in respect to fluid dynamics. Methods: Individualized 3D FEA models were reconstructed from pretreatment computerized tomogram images of three patients with obstructive sleep apnea. 3D computational fluid dynamics analysis was used to observe the effect of airway geometry on the flow velocity, negative pressure and pressure drop in the upper airway at an inspiration flow rate of 170, 200, and 230 ml/s per nostril. Results: In all 3 models, large airflow velocity and negative pressure were observed around the section of minimum area (SMA), the region which narrows around the velopharynx and oropharynx. The bigger the Out-A (outlet area)/ SMA-A (SMA area) ratio, the greater was the change in airflow velocity and negative pressure. Conclusions: Pressure drop meaning the difference between highest pressure at nostril and lowest pressure at SMA, is a good indicator for upper airway resistance which increased more as the airflow volume was increased.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.3
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• pp.307-313
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• 2018

The respiratory function is relevant to the craniofacial growth and orthodontic diagnosis. The size of the pharyngeal airway was measured in lateral cephalometric view in children visited Kyung Hee University Hospital from January 2015 to August 2017. A total of 74 healthy children (36 boys and 38 girls) aged 7 - 11 years (mean, 8.5 years) with a normodivergent facial pattern were divided into three groups according to anteroposterior jaw relation measuring A point-Nasion-B point (ANB) angle. Lateral cephalometric data were used to measure the airway dimensions. The dimensions of the middle airway were significantly lower, reducing the upper airway space, in large ANB angle group than in other children, suggesting that children with large ANB angle have narrower airway space than others.

• The korean journal of orthodontics
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• v.25 no.1 s.48
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• pp.19-29
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• 1995

This study was performed to compare the size of soft palate, tongue and airway according to the types of the malocclusion and evaluate the correlation between the size of soft palate, tongue, airway and dentofacial skeleton respectively. The sample of this study was 98 malocclusion female patients between the ages 12 and 17 years. The lateral cephalometric radiographs were taken and the distance, angle, ratio and area of the dentofacial skeleton, soft palate, tongue and airway were measured and evaluated statistically. The results obtained were as follows: 1. There was significant difference in SNB, ANB, facial angle, facial convexity, A-B plane angel, Y axis to FH, SN-MP, Wits appraisal, ODI and APDI according to the types of malocclusion. 2. The hyoid bone was more posteriorly positioned in Class II malocclusion group than other two groups and superio-inferior position of the hyoid bone was not different according to the malocclusion types. 3. The nasopharyngeal area of Class II and Class III malocclusion group was smaller than that of Class I malocclusion group, and the pharyngeal area of Class II malocclusion group was smaller than that of Class I and Class III maocclusion group. There was no difference of the area of the soft palate, tongue, oropharynx and hypopharynx according to malocclusion types. 4. The ramal height and mandibular body length(Go-Me) showed positive correlation with the area of tongue, nasopharynx, oropharynx, and pharynx. SNA did not correlated with the area of tongue and airway but SNB showed positive correlation with the area of hypopharynx and pharynx. The anterior, posterior facial height, upper and lower central incisor position to facial plane showed positive correlation with tongue area.

• The korean journal of orthodontics
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• v.33 no.4 s.99
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• pp.293-305
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• 2003

The pharynx have significant locations and functions because it forms a part of the unit in which respiration and deglutition are carried out. Because of the closed relationship between the pharynx and the dentofacial and craniofacial structure, many studies are carried out on this subjects. The purpose of this study were to compare the airway size including pharynx, soft palate, tongue and hyoid bone between normal and hyperdivergent skeletal pattern and to evaluate the change of those size in different age. The sample of this study were consisted of 51 subjects in normal group, 52 subjects in hyperdivergent group. Each was divided into two subgroups by age , child group(9-l2yr old) and adult group(18yr old over). The lateral cephalometric radiographs were taken and the distance, angle and ratio of the facial skeleton, pharynx, soft palate, tongue and hyoid bone were measured and evaluated statistically. The result obtained were summarized as follows : 1 SN-Mn angle, FMA, and Pal-Mn angle were significantly larger in child group than adult group, but the lower anterior facial height(LAFH) and facial height ratio(FHR) were significantly smaller in child group than adult group. Occlu-Mn angle was significantly steep in hyperdivergent group than normal, but not significantly different between child group and adult group. 2. Hyperdivergent group and child group had the stronger correlation between SN-Mn angle, FMA, Pal-Mn angle, LAFH and FHR and airway size than normal group and adult group. Hyperdivevgent child group had significant negative correlation between SN-Mn angle, FMA, Pal-Mn angle and sagittal skeletal dimension of nasopharynx and sagittal depth of nasopharyngeal lumen. Significant positive correlation were seen between LAFH and vertical measurement of airway. 3. There was no difference of the linear measurement of airway size between hyperdivergent group and normal group. 4. Adult group had smaller posterior pharyngeal wall, target nasopharyngeal depth longer nasopharyngeal height and longer pharyngeal length than child group. 5. The sagittal measurement of hyoid bone had no difference between child group and adult group. But adult group had larger vertical measurement of hyoid bone than child group.

• The Journal of the Korean dental association
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• v.56 no.5
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• pp.278-286
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• 2018

Food intake and swallowing are complicated and intriguing series of movements involving voluntary and involuntary activities of cranial and spinal nerves and muscles. They have two most important functions, that is, food passage from the oral cavity to stomach and airway protection. Tongue, buccinators, and hyoid bone and its muscular attachments are anatomic structures for swallowing of special interests. The swallowing process of liquid is commonly divided into oral preparatory, oral propulsive, pharyngeal, and esophageal stages according to the location of the bolus. The movement of the food in the oral cavity and to the oropharynx differs between eating solid food and drinking liquid.

• Phonetics and Speech Sciences
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• v.2 no.2
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• pp.79-83
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• 2010

As bolus enters the pharynx during the swallow, laryngeal closure takes place by approximating the epiglottis to the arytenoid Laryngeal Closure Duration(LCD) is the duration of contact between the arytenoids and the epiglottis from the first contact to the last(Logemann et al, 2000). Epiglottic inversion continues pharyngeal swallow stage is completed in order to protect the airway. The purpose of this study is to measure layrngeal closure duration (LCD) in three groups of subjects: a) 10 stroke patients who aspirate before and during the swallow(aspirators), b) 10 stroke patients who do not aspirate during the swallow c)10 normal control subjects. Means and standard deviation of LCD was analyzed in both 5ml and 10 ml thin liquids using 100msec timer in videoflouroscopic swallowing examination. The mean for each group was 0.15 seconds shorter from aspirators to control group. There was a significant difference between aspirators and normal subjects for laryngeal closure duration during the swallow. Laryngeal closure duration after a stroke lead to aspiration. However, only one of this temporal problem may not be enough to aspiration.

• Medical Lasers
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• v.8 no.2
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• pp.84-86
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• 2019

Pyriform sinus cyst is a rare disease. This disease can be found by chance or appear as lymph nodes with cancer, infections, shortness of breath, or airway compromise, and can be an unusual cause of dysphonia. This paper presents a case of a pyriform sinus cyst in the pharyngeal wall of the left pyriform sinus, which presented as neck discomfort in a 63-year-old female. The plan was to remove this cyst with a transoral CO₂ laser because a CO₂ laser is a useful tool for removing cysts without bleeding and consuming time. The excision was performed successfully. Transoral laser pyriform sinus cyst excision is a simple, safe, and effective method for the treatment of pyriform sinus cysts. This procedure is likely to be used as a selective treatment when managing this condition.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.7-14
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• 2001

Purpose : The lateral cephalometric Korean norms of the skeletal and pharyngeal dimension were analyzed for the diagnosis of obstructive sleep apnea syndrome(OSAS). Materials and Methods : The lateral cephalometric radiographies were taken in male(n=53) and female(n=50), who had a normal profile, class I occlusion, normal ANB $(0{\sim}4^{\circ})$ and normal Wits $Appraisal(-4{\sim}0mm)$. The X-rays were traced by two oral and maxillofacial surgeons twice. The significant differences between male-female and examiners were tested. Results : The angle of mandibular line to Nasion-Sella line was $31.12^{\circ}/33.79^{\circ}$ (in male/in female, p=0.0018). The lower Gonion angle was $73.74^{\circ}/73.74^{\circ}(p=0.9978)$. The length of the soft palate was 36.93mm/34.35mm(p=0.0002). The pharyngeal airway space was 13.42mm/11.55mm at mandibular plane level(PAS(ML))(p=0.0025). The hyoid was placed inferiorly to mandibular plane 10.18mm/7.72mm(p=0.0051). The results from this study are to be used for the diagnosis of OSAS.

• The korean journal of orthodontics
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• v.30 no.5 s.82
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• pp.591-598
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• 2000

This study was designed to analysis the airway which affects to breathing, speech and facial growth pattern in unilateral cleft lip and palate patients. Upper airway and the position of hyoid bone pattern were analyzed on the lateral cephalometric radiographs of the 78 subjects of complete unilateral cleft lip and palate group and each group was divided two sub-groups by circumpubertal growth peak and gender. These data were statistically analyzed to examine the difference between pre-circumpubertal growth peak group and post-circumpubertal growth peak one, and between male and female group. The results of this study were as follows: 1. After circumpubertal growth peak stage, the position of hyoid bone was lower than before in both male and female group. 2. After circumpubertal growth peak stage, the measurement were increased in CV3ia-APH, PNS-ad which related to the volume of pharyngeal space. This was due to the decrease of adenoid and anteroiferior growth of mandible and affected to breathing and speech after circumpubertal growth peak. 3. During circumpubertal growth peak stage, all measurements increased more in male than female group, which due to the different amount of growth in different gender. 4. The position of hyoid bone was lower in male than female group in all age group. 5. After circumpubertal growth peak stage, CV3ia-APH increased more in male. This was due to the more growth in madible of male which resulted in the activation of digastric muscle.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.247-256
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• 2009

The purpose of this study was to investigate the changes of the pharyngeal space when the following appliances were inserted: the mandibular advancement appliance (MAA), tongue retaining appliance (TRA), and mandibular advancement-tongue retaining appliance (MATRA). Nine male dental students exhibiting Class I occlusion, normal body mass index (BMI), and no signs and symptoms of snoring were selected for this study. The three kinds of snoring appliances (MAA, TRA and MATRA) were fabricated for each subject. The mandibular advancement of the MAA and MATRA was set at a distance of 5 mm, and the TRA and MATRA were made to hold the tongue in front of the maxillary incisors by 10 to 20 mm. Lateral cephalometric radiographs of the following four states - with no appliance, MAA, TRA, and MATRA - were taken to examine any anatomical changes resulting from the application of the appliances. All four radiographs were traced and analyzed for twenty selected variables related to the pharyngeal space, cranio-cervical posture, and position of the soft palate and hyoid bone. According to the results of this study, there were significant increases in both the upper and lower oropharyngeal spaces when the mandible and tongue were protruded simultaneously, although there was a significant increase only in upper oropharyngeal space when the mandible or tongue was advanced separately. In conclusion, it is suggested that the MATRA may result in more positive effect on the control of snoring and OSA compared to a single use of the MAA or TRA, especially for the patients whose upper airway obstruction occurs in the lower oropharynx.