Adult ; Female ; Foreign Bodies ; surgery ; Humans ; Neck ; Oropharynx ; surgery

Foreign Bodies ; surgery ; Humans ; Oropharynx ; Punctures ; methods ; Ultrasonography

A variety of residual defects containing many sulci and fossae in the oropharyngeal cavity make it extremely difficult to achieve an adequate flap design as well as the functional reconstruction of the complex defects after ablation surgery for oropharyngeal tumors. This study attempted to standardize flap design for the different types of defects in order to produce a better functional reconstruction of intra-oral defects. The oropharyngeal defects were classified into 6 Zones. When the defect involves only the mouth floor, it was classified as Zone 1. A hemi tongue was classified as Zone 2. A defect involving the mouth floor and a part of the tongue was classified as Zone 3. A defect involving the mouth floor, a part of the tongue and the tonsil was classified as Zone 4. A defect involving the mouth floor, a part of the tongue, tonsil and soft palate was classified as Zone 5. A defect involving the pharyngeal wall was classified as Zone 6. The following four types of forearm free flap designs were applied to each defective Zone accordingly: Type I flap design - an unilobed design for reconstructing Zone 1, 2 and 6 defects, Type II design - bilobed design for reconstructing Zone 3 defects, Type III design - trilobed design for reconstructing Zone 4 defects and Type IV design for reconstructing Zone 5 defects. During 1999 to 2002, 91 patients with oropharyngeal defects underwent a reconstruction using these standardized forearm free flap designs. The Type I design was used in 41 cases, the Type II design in 18 cases, the Type III design in 10 cases and the Type IV design in 22 cases. In all patients, the decannulation was successful, and the swallowing and deglutination functions were within the normal parameters. There was less nasal escape of the voice and the regurgitation of food than that observed using the conventional flap design method. Effective and functional reconstructions with minimal morbidities are possible with the application of the standardized forearm free flap design in oropharyngeal defects.
Human ; Oropharyngeal Neoplasms/*surgery ; Oropharynx/*surgery ; *Reconstructive Surgical Procedures/methods ; *Surgical Flaps

OBJECTIVE: To compare the mitigation role of nasopharyngeal and oropharyngeal airway in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with upper airway obstruction after multiple plane operation. Observed parameters included life quality, the clinical value and reliability of nasopharyngeal and oropharyngeal airway. METHOD: The nasopharyngeal airway group, 56 patients with PSG in patients diagnosed with severe OSAHS, after setting nasopharyngeal airway. Oropharyngeal airway group, 45 cases of OSAHS by PSG confirmed severe patients home after oropharyngeal airway, the same as the other treatment groups. Line postoperative ECG, oxygen saturation and hemodynamic monitoring. Two groups were compared in 24 h breathing difficulties, low oxygen saturation, hemodynamics, pharyngeal pain and discomfort of the situation. RESULT: The multiplane after 24 h, the nasopharyngeal airway in patients hemodynamics HR (82.3 +/- 2.65) times/min, SBP(124.5 +/- 13.95) mmHg, DBP (76.2 +/- 8.1) mmHg, RPP(10282.0 +/- 1481.7), port pharyngeal airway in patients hemodynamics HR (93.4 +/- 2.89)times/min, SBP (135.1 +/- 16.5) mmHg, DBP (92.25 +/- 11.25) mmHg. There was significant difference between the two group (P < 0.05); pharyngeal pain nasopharyngeal airway group (1.71 +/- 0.45) points, oropharyngeal airway group (310) points, there was significant difference between the two (P < 0.05); nasopharyngeal airway breathing difficulties Group 0, 0 oropharyngeal airway group, no significant difference between the two (P > 0.05); the lowest oxygen saturation nasopharyngeal airway group (95.2 +/- 1.6)%, oropharyngeal airway group (95.41 +/- 1.34)%, no significant difference between the two (P > 0.05). 24 h before and after surgery between patients with the same group in the hemodynamic parameters (HR,SBP,DBP,RPP), pharyngeal pain, lowest oxygen saturation difference was statistically significant areas (P < 0.05). CONCLUSION Ventilation tube in the nasopharynx and oropharynx in patients with severe OSAHS the same period of postoperative respiratory management plane could well lift the upper airway obstruction. However, nasopharyngeal ventilation tube has a better hemodynamic stability and tolerance, it can reduce patient suffering and increased health and safety from, it is a more safe, minimally invasive and effective method.
Adult ; Airway Obstruction ; prevention & control ; Catheterization ; methods ; Humans ; Male ; Middle Aged ; Nasopharynx ; surgery ; Oropharynx ; surgery ; Sleep Apnea, Obstructive ; surgery

We designed a study to determine if the tracheal tube cuff inflation in the oropharynx improves the success rate of blind nasotracheal intubation in normal, paralyzed patients because of lacking of controlled study about it. In prospective, randomized fashion, 100 ASA I or II patients undergoing elective oral surgery were studied. The trachea was intubated once keeping the tracheal tube cuff deflated throughout the maneuver and once using the technique of tracheal tube cuff inflation in the oropbarynx. A maximum of two attempts was allowed for each technique. If the first attempt was failed, the second attempt was tried with an addition of application of thyroid cartilage compression in each technique. Witb the tracheal tube cuff inflated, the success rate was significantly higher than the cuff-deflated technique(p<0.05). A application of thyroid cartilage compression increased the success rate of the blind nasotracheal intubation in each technique, but it was more useful in the cuff inflation technique(p<0.05). Time taken to intubate the trachea was longer in the cuff inflation technique. We suggest that, in normal paralyzed patients, the tracheal tube cuff inflation in the oropharynx increases the success rate of blind nasotracheal intubation.
Humans ; Inflation, Economic* ; Intubation* ; Oropharynx* ; Prospective Studies ; Surgery, Oral ; Thyroid Cartilage ; Trachea

INTRODUCTION: To evaluate the 3-dimensional changes in the pharyngeal airway of skeletal class III patients after bimaxillary surgery. MATERIALS AND METHODS: The study sample consisted of 18 Korean patients that had undergone maxillary setback or posterosuperior movement and mandibular bilateral sagittal split osteotomy setback surgery due to skeletal class III malocclusion (8 males, 10 females; mean age of 28.7). Cone beam computed tomography was taken 1 month before and 6 months after orthognathic surgery. Preoperative and postoperative volumes of the nasopharyngeal, oropharyngeal, and laryngopharyngeal airways and minimum axial areas of the oropharyngeal and laryngopharyngeal spaces were measured. Moreover, the pharyngeal airway volume of the patient group that had received genioplasty advancement was compared with the other group that had not. RESULTS: The nasopharyngeal and laryngopharyngeal spaces did not show significant differences before or after surgery. However, the oropharyngeal space volume and total volume of pharyngeal airway decreased significantly (P<0.05). The minimum axial area of the oropharynx also decreased significantly. CONCLUSION: The results indicate that bimaxillary surgery decreased the volume and the minimum axial area of the oropharyngeal space. Advanced genioplasty did not seem to have a significant effect on the volumes of the oropharyngeal and laryngopharyngeal spaces.
Cone-Beam Computed Tomography ; Genioplasty ; Humans ; Male ; Malocclusion ; Oropharynx ; Orthognathic Surgery ; Osteotomy ; Pharynx

Extensive surgical resection of the aerodigestive track can result in a large and complex defect of the oropharynx, which represents a significant reconstructive challenge for the plastic surgery. Development of microsurgical techniques has allowed for free flap reconstruction of oropharyngeal defects, with superior outcomes as well as decreases in postoperative complications. The reconstructive goals for oral and oropharyngeal defects are to restore the anatomy, to maintain continuity of the intraoral surface and oropharynx, to protect vital structures such as carotid arteries, to cover exposed portions of internal organs in preparation for adjuvant radiation, and to preserve complex functions of the oral cavity and oropharynx. Oral and oropharyngeal cancers should be treated with consideration of functional recovery. Multidisciplinary treatment strategies are necessary for maximizing disease control and preserving the natural form and function of the oropharynx.
Carotid Arteries ; Free Tissue Flaps* ; Head and Neck Neoplasms ; Mouth ; Oropharyngeal Neoplasms ; Oropharynx ; Postoperative Complications ; Surgery, Plastic

BACKGROUND: The purpose of this retrospective study was to develop a two- and three-dimensional analysis of the airway using cone-beam computed tomography (CBCT) and to determine whether the airway space would be changed in mandibular prognathism after bimaxillary surgery involving maxillary posterior impaction. METHODS: Patients requiring orthognathic surgery from 2012 to 2014 were recruited for this study. CBCT scans were obtained at three points: preoperatively (T0), immediate postoperatively (T1), and after 6 months postoperatively (T2). The nasopharynx, oropharynx, and hypopharynx were measured on the CBCT scan for each patient in a repeatable manner. With the midsagittal plane, linear measurements in the middle of each were obtained. For the CBCT, volumetric measurements of each and total airway were obtained. RESULTS: A total of 22 consecutive patients (11 men and 11 women) were included in the present study. The total volume was significantly reduced (p < .001). However, the change of the diameter and volume of the nasopharynx was not statistically significant (p = .160, p = .137, respectively). In the oropharynx, the change of both the diameter and volume showed statistical significance between preoperatively and immediate postoperatively (p < .001, p = .001, respectively) and also preoperatively and after 6 months postoperatively (p = .001, p = .010, respectively). In the hypopharynx, the change of both the diameter and volume showed statistical significance between preoperatively and immediate postoperatively (p = .001, p < .001, respectively) and also preoperatively and after 6 months postoperatively (p = .001, p < .001, respectively). CONCLUSIONS: The bimaxillary surgery involving maxillary posterior impaction can reduce the volume of airway in the patients of mandibular prognathism. Although total airway volume was reduced significantly, the changes in the volume and diameter of the nasopharynx were not statistically significant. The maxillary posterior impaction affects on the nasopharyngeal airway minimally.
Airway Management ; Cone-Beam Computed Tomography ; Humans ; Hypopharynx ; Male ; Nasopharynx ; Oropharynx ; Orthognathic Surgery ; Prognathism* ; Retrospective Studies

The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice. Despite wide spread use the definitive role of the laryngeal mask airway is yet to be established. In some situations, such as after failed tracheal intubation or in oral surgery its use is controversial. There are several unresolved issues, for example the effect of the laryngeal mask on regurgitation and whether or not cricoids pressure prevents placement of mask. We review the techniques of insertion, details of misplacement, and complications associated with use of the laryngeal mask. We then attempt to clarify the role of laryngeal mask in air way management during anesthesia, discussing the advantages and disadvantages as well as indications and contraindications of its use in oral and maxillofacial surgery.
Airway Management ; Airway Obstruction ; Anesthesia ; Beauty ; Intubation ; Laryngeal Masks ; Larynx ; Masks* ; Neck ; Oropharynx ; Pharynx ; Surgery, Oral

OBJECTIVE: Lateral cephalometric radiographs have been the main form of resource for assessing two dimensional anteroposterior airway changes. The purpose of this study was to evaluate the three dimensional volumetric change in the upper airway space in Class III malocclusion patients who underwent mandibular setback surgery. METHODS: Three dimensional cone-beam computed tomographs (CBCT) and their three dimensional reconstruction images were analyzed. The samples consisted of 20 adult patients (12 males and 8 females) who were diagnosed as skeletal Class III and underwent mandibular setback surgery. CBCTs were taken at 3 stages - Baseline (1.8 weeks before surgery), T1 (2.3 months after surgery), and T2 (1 year after surgery). Pharyngeal airway was separated according to the reference planes and reconstructed into the nasopharynx, the oropharynx and the hypopharynx. Measurements at Baseline, T1, and T2 were compared between groups. RESULTS: The result showed the volume of the pharyngeal airway decreased significantly 2.3 months after surgery (p < 0.001) and the diminished airway did not recover after 1 year post-surgery. The oropharynx was the most decreased area. CONCLUSIONS: These findings suggest that mandibular setback surgery causes both short-term and long-term decrease in the upper airway space.
Adult ; Cone-Beam Computed Tomography ; Humans ; Hypopharynx ; Male ; Malocclusion ; Nasopharynx ; Oropharynx ; Orthognathic Surgery