• Tuberculosis and Respiratory Diseases
• /
• 제40권4호
• /
• pp.442-448
• /
• 1993

Foreign body aspiration, although not an uncommon problem in children, is unusual in adults and is overlooked as a cause of airway obstruction. Small foreign bodies that lodge in the peripheral airway are often asymptomatic initially and can result in respiratory symptoms several years later. Especially in the cases of otherwise healthy subjects, even though manifested overt respiratory symptoms, diagnosis can be delayed due to lack of history of aspiration or unnoticed aspiration. A 57-year-old male was admitted to Yonsei University College of Medicine Severance hospital due to left upper chest pain for five months. on the past history he had been diagnosed as bronchiectasis about 20 years ago. He showed radiologically bead-like bronchostenosis and a calcific density protruding into the lumen of left upper lobar bronchus. Bronchoscopically broncholith was revealed with the finding of endobronchial obstruction of each upper and lingular division of left upper lobar bronchus due to mucoid impaction and surrounding inflammed bronchial mucosa. The preoperative diagnosis was broncholithiasis due to chronic inflammatory process. Lung perfusion scan shows absence of perfusion in left upper lobe. So left upper lobectomy was performed. But from the pathologic specimen an incisor tooth was emerged. Later a history of tooth extraction thirty years ago at dental clinic was found. We report a case of bronchial obstruction due to occult aspiration of a tooth with a review of the literatures.

• The korean journal of orthodontics
• /
• 제25권1호
• /
• pp.19-29
• /
• 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.

• Sleep Medicine and Psychophysiology
• /
• 제10권2호
• /
• pp.88-92
• /
• 2003

Sleep-disordered breathing (SDB), including snoring, sleep apnea and upper airway resistance syndrome are common problems in children. The pathophysiological mechanism of SDB in children is unclear but may include hypoxemia and changes in sleep architecture. Children with SDB show reduced neurocognitive function, and memory and attentional capacity. Furthermore, these children show increased problematic behaviour and reduced school performance. Whether early recognition and treatment of SDB in children may improve neurocognitive function and school performance remains to be fully evaluated in the future.

• Clinical and Experimental Pediatrics
• /
• 제48권5호
• /
• pp.512-517
• /
• 2005

Purpose : In adults, endoscopic tracheobronchial balloon dilatation and stenting have become valuable methods to establish and maintain an adequate airway lumen when tracheomalacia or neoplastic growth compromise the airways. But in children, only a few cases were reported due to technical problems. We report six children who were treated with stent implantation and describe the use and safety of airway stents. Methods : Six patients with severe airway obstruction were treated. We investigated the underlying medical problems, stenotic site, symptomatic improvement and complications, and the size and location of stent. Results : The median age of the six patients was 21 months. Three of them were mechanically ventilated and one had an endotracheal tube to maintain the patency of airway. Diagnoses were : congenital tracheal stenosis with or without bronchomalacia, granulation tissue formation after right upper lobectomy by bronchial carcinoid or after prolonged intubation, endobronchial tuberculosis, and airway compression by mediastinal undifferentiated sarcoma. Nitinol stents were implanted in the airway guided by bronchoscopy and fluoroscopy simultaneously. Three cases were placed in trachea, the others were in the bronchus. After stent implantation, all patients showed marked improvements of their airway obstructive symptoms. Four patients are doing well, although two expired due to underlying diseases. Four patients had granulation tissue formation around stents, but that was tolerable after removing the stent. Conclusion : We suggest that the use of expandible metallic stent implantation can offer safe therapeutic option even in extremely severe, life threatening and inoperable airway stenosis in children.

• Journal of Chest Surgery
• /
• 제30권8호
• /
• pp.843-846
• /
• 1997

Congenital bronchial atresia is one of the rare bronchopulmonary anomalies which is thought to be caused by a vascular insult of uncertain timing during fefal development. It is defined as an anomaly which does not have communication between a segmental or lobar bronchus a'nd the main airway. Because of the collateral ventilation, almost all of these cases show hyperlucency of the involved segment or lobe in chest roentgenogram. We report an extremely rare case of congenita bronchial atresia with collapse of the right upper lobe which was treated by surgical resection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제36권6호
• /
• pp.497-501
• /
• 2010

Primary nasal type natural killer (NK)/T cell (NKTC) lymphoma, a specific form of malignant lymphoma, has a higher geographic incidence in Oriental, Mexican, and South American populations than the Western population. In Koreans, it comprises 9-12% of all cases of non-Hodgkin's lymphoma. This type of lymphoma has also been named as angiocentic lymphoma and lethal midline granuloma because the most common site is the upper airway area and its clinical aggressiveness presents with a necrotic and destructive pattern. NKTC lymphoma can also be detected in different organs (testis, spleen, parotid gland, skin, gastroinstinal tract, central nervous system, lungs, bone marrow, etc.) other than the upper airway including the oral cavity. The lymphoma detected in the oral cavity shows various destructive and inflammatory changes, similar to the signs of inflammation and infection from periodontitis and pulpal disease, making a diagnosis difficult with just the clinical signs. For early detection, clinical, radiological, and pathological examinations are required. This report describes the clinical, radiological and histological characteristics with a case report for the early detection of NKTC lymphoma in the oral cavity.

• Journal of Dental Rehabilitation and Applied Science
• /
• 제34권3호
• /
• pp.239-245
• /
• 2018

If complication arises after glossectomy which leads to trouble in forming food bolus or transfer of the food, it is possible that either food bolus may block the airway or dysphagia may occur as the food bolus goes down into the airway. To solve the issue, palatal augmentation prosthesis could be used. In this case, the patient with an oral cancer is having difficulties swallowing food after glossectomy. Through taking impressions of polishing surface of his denture referring his tongue movement, the complete denture for the upper jaw was created using the concept of palatal augmentation prosthesis. This new upper denture increases the palatal-tongue contact pressure, allowing the patient to perform better swallowing and better pronunciation.

• Korean Journal of Head & Neck Oncology
• /
• 제12권2호
• /
• pp.224-229
• /
• 1996

Head and neck arteriovenous malformation usually forms huge mass, cause profuse bleeding or potenially compromise the airway. This bleeding is vulnerable to be uncontrollable and life­threatening. Sometimes it has a high mortality. Although surgical resection is possible in some cases, the morbidity such as a defects of soft tissue is very high and its reconstruction is very difficult. The authors report an 11 year old female patient in whom occlusion of arteriovenous malformation with glue after transcutaneous embolization made a satisfactory results. At the beginning, she was transferred for massive oral bleeding. The bleeding was persistent and it was not possible to remove the packing in spite of many times of embolizations through feeding arteries. The massive bleeding trom the left upper alveolar mucosa compromised the airway and tracheotomy was done. Whenever the hypovolemic shock was occurred in a short time, blood transfusion and cardiopulmonary resucitation were done. To embolize the vascular mass of arteriovenous malformation, as a final trial before operation, the spinal needle was administered through the left upper gingiva under the fluoroscopy. The glue was injected on the target. The bleeding was stopped and we have noticed the absence of nidus on follow-up angiography after 3 weeks. We experienced that some cases of arteriovenous malformation in head & neck revealing the bleeding could be treated with transcutaneous embolization instead of surgical resection.

• The Journal of the Korean dental association
• /
• 제52권10호
• /
• pp.602-614
• /
• 2014

Obstructive sleep apnea syndrom(OSAS) is defined by total or partial collapse of the upper airway during sleep. In the presence of specific anatomic features, OSAS is potentially amenable to surgical treatment. Initially, the only treatment available for these patients was a tracheotomy that bypassed the obstruction and resulted in a 100% cure. However, this was not readily accepted by most patients, and surgical methods other than tracheotomy were developed to successfully maintain adequate upper airway patency during sleep by comparing to postoperative polysomnography(AHI,RDI etc). In this paper, I would like to provide an overview of some of the multilevel surgical techniques available for treating OSAS as well as the necessary preoperative considerations.

• Journal of Oral Medicine and Pain
• /
• 제24권1호
• /
• pp.69-80
• /
• 1999

OBJECTIVES: This study was designed to measure the minimal cross-sectional areas and volumes of the pharynx in snoring patients and normal subjects and to see if there is an increase in the minimal cross-sectional areas and volumes of the pharynx with advancement of the mandible. METHODS: The pharyngeal computed tomography and 3-dimensional reconstruction were used to measure the cross-sectional areas and volumes of the nasopharynx, oropharynx, and hypopharynx with the jaw in normal position and in protrusive position in 7 patients with snoring and 7 control subjects while they were awake. RESULTS: The oropharynx was revealed to have the most narrow site in the pharynx and there was a tendency for the snorers to have a smaller nasopharyngeal and oropharyngeal cross-sectional area than normal subjects but not statistically significant. There were no significant differences in the volumes of the nasopharynx and oropharynx between the two groups. With advancement of the jaw the minimal cross-sectional area of oropharynx was significantly increased, and the volume was also increased but not significantly. The minimal cross-sectional areas and volumes of nasopharynx as well as hypopharynx were not significantly influenced by the advancement of the mandible. CONCLUSIONS: There was a tendency for snorers to have a smaller oropharynx than normal subjects and the oropharyngeal lumen was increased with the advancement of the mandible in both snorers and normal subjects.