• Title/Summary/Keyword: Soft Palate

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Cleft Lip and Palate Repair Using a Surgical Microscope

  • Kato, Motoi;Watanabe, Azusa;Watanabe, Shoji;Utsunomiya, Hiroki;Yokoyama, Takayuki;Ogishima, Shinya
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.490-495
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    • 2017
  • Background Cleft lip and palate repair requires a deep and small surgical field and is usually performed by surgeons wearing surgical loupes. Surgeons with loupes can obtain a wider surgical view, although headlights are required for the deepest procedures. Surgical microscopes offer comfort and a clear and magnification-adjustable surgical site that can be shared with the whole team, including observers, and easily recorded to further the education of junior surgeons. Magnification adjustments are convenient for precise procedures such as muscle dissection of the soft palate. Methods We performed a comparative investigation of 18 cleft operations that utilized either surgical loupes or microscopy. Paper-based questionnaires were completed by staff nurses to evaluate what went well and what could be improved in each procedure. The operating time, complication rate, and scores of the questionnaire responses were statistically analyzed. Results The operating time when microscopy was used was not significantly longer than when surgical loupes were utilized. The surgical field was clearly shared with surgical assistants, nurses, anesthesiologists, and students via microscope-linked monitors. Passing surgical equipment was easier when sharing the surgical view, and preoperative microscope preparation did not interfere with the duties of the staff nurses. Conclusions Surgical microscopy was demonstrated to be useful during cleft operations.

A cephalometric study on the velopharyngeal changes after maxillary protraction (상악골 전방견인치료후 구개범인두 변화에 대한 단기간의 측모두부방사선 계측학적 연구)

  • Lee, Nam-Ki;Cha, Bong-Kuen
    • The korean journal of orthodontics
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    • v.36 no.2 s.115
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    • pp.161-169
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    • 2006
  • The purpose of this study was to investigate cephalometrically the short term static velopharyngeal changes in 25 patients (10 boys and 15 girls, aged from 5 years 9 months to 12 years 10 months in the beginning of treatment) with skeletal Class III malocclusions who underwent nonsurgical maxillary protraction therapy with a facemask. The linear, angular and ratio measurements were made on lateral cephalograms. Only the change in hard palatal plane angle was negatively correlated with the change in maxillary depth or N-perp to A (p<0.01). The change in velar angle showed a statistically significant increase (p<0.001). This change was influenced more by the soft palatal plane angle than by the hard palatal plane angle (p<0.001). The changes in soft tissue nasopharyngeal depth and hard tissue nasopharyngeal depth showed statistically significant increases (p<0.001). Correlations between the changes in soft tissue (or hard tissue) nasopharyngeal depth and the change in soft palatal plane angle were significant (p<0.05). The increase in hard palate length was statistically significant (p<0.001). The change in hard palate length was negatively correlated with the change in soft tissue nasopharyngeal depth (p<0.05). The change in need ratio S (C) showed a statistically significant increase (p<0.001). But this difference was within the normal range reported by previous studies. These findings indicate that the velopharyngeal competence was maintained even if the anatomical condition of the static velopharyngeal area were changed after maxillary protraction.

A Case of Amyotrophic Lateral Sclerosis with Unilateral Vocal Fold Palsy and Velopharyngeal Insufficiency (일측성 성대마비와 구개인두부전을 초기 증상으로 내원한 Amyotrophic Lateral Sclerosis 1 예)

  • 박경호;김동현;조승호;김형태
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.14 no.1
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    • pp.51-53
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    • 2003
  • Amyotrophic lateral sclerosis Is an unusual pattern of distal muscular atrophy with permanent bulbar sign. Vocal fold paralysis and velopharyngeal insufficiency(VPI) due to soft palate paralysis Is occasionally associated with distal muscular atrophy. Recently we experienced a case of amyotrophic lateral sclerosis whose symptom was initially expressed with hoarseness and VPI. So we report a case with review of literature.

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Low-Grade Fibromyxoid Sarcoma Arising in Posterior Nasal Cavity: Case Report and Review of the Literature (후비강에서 발생한 저등급의 섬유점액성 육종: 증례 보고 및 문헌 고찰)

  • Sohn, Jung Heob;Lee, Kijin;Cho, Kyoung Rai
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.11
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    • pp.624-629
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    • 2018
  • Low-grade fibromyxoid sarcoma (LGFMS), a soft tissue tumor that has high recurrence and metastasizing potential, rarely occurs in the head and neck region. Therefore, the treatment for LGFMS in the facial area is challenging in terms of cosmetic and functional maintenance. The authors report a case of LGFMS in the posterior nasal cavity. It was completely removed in parallel with the nasal endoscopic and oral approach, but the lower margin was closed by preserving the soft palate. The patient is well without any recurrence or metastasis after 5 years of follow-up.

Reconstruction of Hard Palatal Defect using Staged Operation of the Prelaminated Radial Forearm Free Flap (부분층 피부이식으로 전판상화된 전완유리피판을 이용한 경구개 결손의 재건)

  • Choi, Eui Chul;Kim, Jun Hyuk;Nam, Doo Hyun;Lee, Young Man;Tak, Min Sung
    • Archives of Craniofacial Surgery
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    • v.11 no.1
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    • pp.53-57
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    • 2010
  • Purpose: The radial forearm fasciocutaneous free flap is currently considered as the ideal free flap for reconstruction of mucosal and soft tissue defects of the palate. But the availability of stably attached oral and nasal mucosal lining is needed. In addition to this, for better operation field, operating convenience and esthetics, we planned a prelaminated radial forearm free flap. Methods: A 64-year-old male patient was admitted due to a $4{\times}4.5cm$ full through defect in the middle of the hard palate caused by peripheral T cell lymphoma with actinomycosis. In the first stage, the radial forearm flap was elevated, tailored to fit the hard palate defect, and then it positioned up-side down with split thickness skin graft. Two weeks later, the prelaminated radial forearm free flap was re-elevated and transferred to the palatal defect. One side covered with grafted skin was used to line the nasal cavity, and the other side (the cutaneous portion of the radial forearm flap) was used to line the oral cavity. Results: The prelamination procedure was relatively easy and useful. The skin graft was well taken to the flap. After 2nd stage operation, the flap survived uneventfully. There was no prolapse of the inset flap into the oral cavity and the cutaneous portion of the flap was mucosalized. The procedure was very successful and the patient can enjoy normal rigid diet and speech. Conclusion: The use of prelaminated radial forearm free flap for hard palate reconstruction is an excellent method to restore oral function. Based upon the result of this case, microvascular free flap transfer with prelaminated procedure is a valid alternative to the prosthetic obturator for palatal defect that provides an improved quality of life. It should be considered as an integral component of head and neck cancer therapy and rehabilitation.

Immediate effects of mandibular posterior displacement on the pharyngeal airway space: A preliminary study

  • Choi, Yeonju;Kim, Yong-Il;Kim, Seong-Sik;Park, Soo-Byung;Son, Woo-Sung;Kim, Sung-Hun
    • The korean journal of orthodontics
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    • v.50 no.2
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    • pp.129-135
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    • 2020
  • Objective: This study aimed to evaluate the immediate effects of mandibular posterior displacement on the pharyngeal airway space (PAS) by using cephalometric evaluations and to investigate how the surrounding structures are schematically involved. Methods: In this retrospective study, 38 subjects with functional Class III malocclusion and two lateral cephalograms were selected. The first lateral cephalogram was taken with the mandible in the habitual occlusal position, and the second in anterior edge-to-edge bite. Paired t-test was used to analyze changes in the PAS, hyoid bone, tongue, and soft palate, followed by mandibular posterior displacement. Pearson's correlation analysis was used to determine the relationship between the amount of mandibular posterior displacement and other variables. Results: A statistically significant decrease was observed in the PAS following mandibular posterior displacement. Along with mandibular posterior displacement, the tongue decreased in length (p < 0.001) and increased in height (p < 0.05), while the soft palate increased in length, decreased in thickness, and was posteriorly displaced (p < 0.001). The hyoid bone was also posteriorly displaced (p < 0.05). There was no correlation between the amount of mandibular posterior displacement and the measured variables. Conclusions: The PAS showed a statistically significant decrease following mandibular posterior displacement, which was a consequence of retraction of the surrounding structures. However, there were individual variances between the amount of mandibular posterior displacement and the measured variables.

The Study of A.T.P. for Treatment of 20 Cases of Neurogenic Disordors in E.N.T. Field (Adenosin triphosphate로 치료한 이비인후과영역의 신경질환 20례)

  • 박재훈;김춘길;주양자
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1972.03a
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    • pp.3.2-3
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    • 1972
  • Recently the adenosinetriphosphates have massive highlight due to their high energy source for treat and maintained all the cell mechanism in the individual. When the A. T.P. release the terminal phosphate, produces about 8,000 calories instead of the 3,000 calories from common chemical bonds. The high energy-P bond enables the cell to accumulate a great amount of energy in a very small space and the keep it ready to be used as soon as it is needed. The presence of A.T.P. explains why some important cellular functions such as nerve conduction can go on for some time even with complete inhibition of respiration. In recent years the A.T.P. were used in many clinical field with good effects. In this report was used A.T.P. 20mg+Vit $B_1$ 50mg+20% Dextrose 20㏄ through intravenousely for E.N.T. neurologic patient, such as neurogenic hearing impairment, tinnitus, dizziness, soft palate paralysis. By the injection 40% of neurogenic hearing impairment patients were improved and 62% tinnitus patients were improved and all the soft palate paralysis patient were completely recovered.

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MYOEPITHELIOMA ON SOFT PALATE -A CASE REPORT- (연구개에 발생한 근상피종 1예 -증례보고-)

  • Choi, Y.S.;Kim, J.K.;Kim, H.J.;Suh, C.H.;Cha, I.H.;Yoon, J.H.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.1
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    • pp.115-119
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    • 1996
  • Myoepithelioma is composed exclusively of myoepithelial cells. Myoepithelial cells are ectodermally derived contractile cells that can be routinely identified in many normal tissues having secretory function such as major and minor salivary glands, lacrimal gland and sweat gland. Tumors composed exclusively of myoepithelial cells, so-called myoepitheliomas, are rare-less than 1% of all salivary gland tumors. Grossly, these tumors are well demarcated. The external surface is smooth and may be bosselated. The cut surface is white and homogenous. Microscopically, these tumors are surrounded by a thin fibrous capsule. They are composed of benign-appearing spindle- shaped and/or polygonal cells. Mitoses are rare. Frequently these tumors contain myxomatous stroma which is susceptible to alcial blue stain. Clinically, myoepitheliomas present as slow-glowing, painless masses and can not distinguished from pleomorphic adenomas. Treatment is the same as for pleomorphic adenoma, and the surgical excision should include a margin of normal tissue. Although the majority of myoepitheliomas have behaved in a beingn manner, pleomorphism and mitotic activity have been associated with local aggressiveness.

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Surgical Correction of Canine Brachycephalic Syndrome Including Resection of Elongated Soft Palate and Everted Laryngeal Saccules Using Harmonic Scalpel: A Retrospective Study of 21 Cases

  • Shin, Jung-In;Kim, Minkyung;Kim, Jong-Hoon;Lee, Chaeyeong;Kim, Young-Hwan;You, Young-Sung;Lee, Dong-Bin;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.39 no.1
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    • pp.1-8
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    • 2022
  • The current, retrospective study aimed to assess the short-term prognosis and postoperative complications associated with the surgical correction of elongated soft palate using harmonic scalpel and to compare the postoperative complications associated with the application of harmonic scalpel and traditional surgery using Metzenbaum scissors. Harmonic scalpel was used to perform staphylectomy in 21 dogs. A total of ten dogs underwent sacculectomy; six dogs with harmonic scalpel and four dogs using Metzenbaum scissors. Stenotic nares were corrected by wedge resection. Postoperative complications were recorded through monitoring and radiographic examinations. Telephone interviews were conducted on the first, third, and seventh day after discharge and continued until the resolution of postoperative complications. Postoperative edema at the surgical site was identified and mitigated within a day or two. Snoring and dyspnea improved dramatically in the group that underwent staphylectomy alone. Moreover, three dogs presented with postoperative gastrointestinal complications, especially retching. The symptoms persisted for seven days and ten days in two dogs that underwent sacculectomy with harmonic scalpel and for two days in one dog that underwent sacculectomy with Metzenbaum scissors. The clinical signs and symptoms of brachycephalic syndrome disappeared without recurrence. Harmonic scalpel provides a hemostatic effect during staphylectomy, is convenient, and does not cause postoperative complications. Conversely, the use of harmonic scalpel during sacculectomy necessitated a longer period for the resolution of complications without any significant hemostatic efficacy, compared to traditional surgery.

Insertions of the striated muscles in the skin and mucosa: a histological study of fetuses and cadavers

  • Ji Hyun Kim;Gen Murakami;Jose Francisco Rodriguez-Vazquez;Ryo Sekiya;Tianyi Yang;Sin-ichi Abe
    • Anatomy and Cell Biology
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    • v.57 no.2
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    • pp.278-287
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    • 2024
  • Striated muscle insertions into the skin and mucosa are present in the head, neck, and pelvic floor. We reexamined the histology of these tissues to elucidate their role in transmission of the force. We examined histological sections of 25 human fetuses (gestational ages of ~11-19 weeks and ~26-40 weeks) and 6 cadavers of elderly individuals. Facial muscle insertion or terminal almost always formed as an interdigitation with another muscle or as a circular arrangement in which muscle fiber insertions were sandwiched and mechanically supported by other muscle fibers (like an in-series muscle). Our examination of the face revealed some limited exceptions in which muscle fibers that approached the dermis were always in the nasalis and mentalis muscles, and often in the levator labii superioris alaeque nasi muscle. The buccinator muscle was consistently inserted into the basement membrane of the oral mucosa. Parts of the uvulae muscle in the soft palate and of the intrinsic vertical muscle of the tongue were likely to direct toward the mucosa. In contrast, the pelvic floor did not contain striated muscle fibers that were directed toward the skin or mucosa. Although 'cutaneous muscle' is a common term, the actual insertion of a muscle into the skin or mucosa seemed to be very rare. Instead, superficial muscle insertion often consisted of interdigitated muscle bundles that had different functional vectors. In this case, the terminal of one muscle bundle was sandwiched and fixed mechanically by other bundles.