palatal muscles of submucosal type cleft palate patients. Because of late detection, the treatment - for example, the operation or the speech therapy - for the submucosal type cleft palate patient usually becomes late. Some patients visited our hospital due to speech disorder nevertheless normal intraoral appearance. After precise intraoral examination, we found out submucosal cleft palate. We evaluated the speech before and after surgery of these patients. In this study, we want to find the objective characteristics of submucosal type cleft palate patients, comparing with the normal and the complete cleft palate patients. Experimental groups were 10 submucosal type cleft palate patients and 10 complete cleft palate patients who got the operation in our hospital. And, the controls were 10 normal person. The sentence patterns using in this study were simple 5 vowels. Using CSL program we evaluated the Formant, Bandwidth. We analized the spectral characteristics of speech signals of 3 groups, before and after the operation. In most cases, the formant scores were higher in experimental groups (complete cleft palate group and submucosal type cleft palate group) than controls. There were small differences when speeching /a/, /i/, /e/ between experimental groups and control groups, large differences when speeching /o/, /u/. After surgery the formant scores were decreased in experimental groups (complete cleft palate group and submucosal type cleft palate group). In bandwidth scores, there were no significant differences between experimental groups and controls.]]>
Cleft Palate ; Humans ; Palatal Muscles ; Speech Therapy

BACKGROUND AND OBJECTIVES: We aimed to introduce a new surgical method (Palatal Muscle Resection, PMR) for the treatment of snoring patients. This study contained the surgical technique of PMR and the objective and subjective outcomes of PMR. SUBJECTS AND METHOD: Twenty-one patients with snoring were examined (19 male, 2 female) in a prospective manner. Questionnaires based on the Epworth Sleepiness Scale (ESS) were completed by patients and their respective bed partners before and after PMR. Five patients who underwent PMR have completed pre and post operative (after 4 weeks) polysomnographic (PSG) studies. Visual Analogue Scale (VAS) was analyzed 1, 2, 3, and 7 days after the surgery. Statistical analysis was performed using the Wilcoxon signed rank test. RESULTS: Subjective questionnaires showed statistically significant improvements (ESS; from 10.7 to 6.7). The VAS was decreased from 4.3 in 1 dayto 2 in 7 days. CONCLUSION: The PMR is a simple and painless office-based method to treat snoring. Long term follow up studies with more patients would be required.
Follow-Up Studies ; Humans ; Male ; Muscles ; Palatal Muscles ; Prospective Studies ; Surveys and Questionnaires ; Snoring

BACKGROUND: The study was performed in order to determine the risk factors for difficult tracheal intubation in obstructive sleep apnea patients. METHODS: For 115 male patients with obstructive sleep apnea syndrome and who were undergoing palatal muscle resection (PMR), we investigated the correlation between their age, height, weight, body mass index (BMI), their Epworth Sleepiness Scale (ESS), their apnea-hypopnea index (AHI), their neck circumference and the difficulty of tracheal intubation. RESULTS: The factors significantly related to difficult tracheal intubation in obstructive sleep apnea patients were a high AHI and a large neck circumference. There was no significant correlation between weight, BMI, arterial hypertension, ESS and difficult tracheal intubation in obstructive sleep apnea patients. CONCLUSIONS: In this study, a high AHI and a large neck circumference can predict difficult tracheal intubation in obstructive sleep apnea patients.
Body Weight ; Humans ; Hypertension ; Intubation ; Male ; Neck ; Palatal Muscles ; Risk Factors ; Sleep Apnea, Obstructive

Pain on the soft palate and pharynx can originate in several associated structures. Therefore, diagnosis of patients who complain of discomfort in these areas may be difficult and complicated. Pterygoid hamulus bursitis is a rare disease showing various symptoms in the palatal and pharyngeal regions. As such, it can be one of the reported causes of pain in these areas. Treatment of hamular bursitis is either conservative or surgical. If the etiologic factor of bursitis is osteophytic formation on the hamulus or hypertrophy of the bursa, resection of the hamulus is usually the preferred surgical treatment. We report on a case of bursitis that was managed successfully by surgical treatment and a review of the literature.
Bursitis ; Facial Pain ; Humans ; Hypertrophy ; Palatal Muscles ; Palate ; Palate, Soft ; Pharynx ; Rare Diseases

Major concerns in cleft palate repair are improved speech results and adequate maxillary growth. In these respects, Furlow's double reversing Z-plasty which requires minimal hard palatal dissection and redirects palatal muscles to produce an overlapping muscle sling is theoretically optimal method to close the cleft palate. However, it often requires backcut around the maxillary tubercle even dissection around the pedicle on oral mucosal Z-plasty flap. Raw surface heals secondarily but leads to scarring within the soft palate. In the current study, IIpatients all had incomplete cleft palate and were operated double reversing Z-palatoplasty using intraoperative rapid mucosal expansion (IRME), from November, 1996 till July, 1997. With the IRME, we reduced the incidence of backcut or dissection on the oral mucosal flap. Only three patients need small backcut incision and two of these were closed primarily with V-Y fashion. To examine the histologic changes and expansion rate with the IRME, same procedures were performed to palatal mucosa of three cats. Expanded mucosal size was increased to 33.3% and histologically, change of mucosal architecture was not found except capillary dilatation. As a result, intraoperative mucosal expansion offers sufficient mucosal size, reduce incidence of backcut, therefore minimizes palatal scar formation. Balanced maxillofacial growth and normal occlusion are expected with this procedure.
Animals ; Capillaries ; Cats ; Cicatrix ; Cleft Palate ; Dilatation ; Humans ; Incidence ; Mucous Membrane ; Palatal Muscles ; Palate, Soft

OBJECTIVETo study the relationship between velopharyngeal morphology and velopharyngeal function in operated cleft palate patients with velopharyngeal competence (VPC) with levator veli palatini retropositioning according to Sommerlad.

METHODSThree groups were included in the study. The experimental group comprised 18 incomplete cleft patients (group T1) repaired with VPC repaired with levator veli palatini retropositioning according to Sommerlad and 14 incomplete cleft patients (group T2) with velopharyngeal incompetence (VPI) repaired with Langenbeck's technique. The control group was composed of 13 normal adults. The outcome of the velopharyngeal function by nasopharyngoscopy and lateral cephalogram was assessed. Skeletal landmarks and measurements were derived from the tracing of lateral cephalograms. The measurements included velar length, pharyngeal depth, and adequate ratio of velar length to pharyngeal depth. The cranial base, cervical vertebrae, posterior nasal spine, and the position of the posterior pharyngeal wall (PPW) in the pharyngeal triangle were also analyzed. All data were subjected to student's t-test of statistical significance.

RESULTSAll 18 subjects in group T1 obtained complete velopharyngeal closure. Velopharyngeal closure in seven, five, and two subjects in group T2 was 70%, 50% to 70%, and less than 50%, respectively, according to the results of nasopharyngoscopy. The lateral velar length (25.7 mm + 2.3 mm) in group T1 was similar to that of the control group (29.9 mm + 2.7 mm) (P > 0.05). The pharyngeal depth in group T1 was shorter than that in the other two groups, and the adequate ratio (1.43 + 0.26) was similar to that in the normal group (1.45 + 0.26). Group T2 had a significantly short velar length (22.9 mm + 2.3 mm) and normal pharyngeal depth, resulting in a small length/depth ratio (0.95 + 0.14) than that in group T1 and the control group. PPW in the pharyngeal triangle was positioned superiorly in group T2 compared with the control group.

CONCLUSIONThe velopharyngeal morphology of operated cleft palate patients with VPC with levator veli palatini retropositioning according to Sommerlad was found to be similar to that of the normal control group. VPI cleft palate patients are characterized by a shorter palate, smaller adequate ratio (< 1.0), slightly counterclockwise-rotated pharyngeal triangle, and superiorly positioned PPW.

Adult ; Cleft Palate ; Humans ; Palatal Muscles ; Palate, Soft ; Pharynx ; Velopharyngeal Insufficiency

Habitual snoring is common among males, especially among those who are overweight, and gets worse with the age. Snoring Is related to physical obstruction of breathing during sleep. This obstruction occurs when the palatal muscles, uvula muscles, and sometimes tonsiles relax during deep sleep and acts as vibrators. We have treated, with laser assisted uvulopalatoplasty(LAUP), twenty patients who suffer from snoring. CO2 laser was used and approximately I5-30 minutes of operation time was required. There were no singnificant complications, such as bleeding and asphyxia, in the 20 patients treated with LAUP. Results observed in the short term showed that 90% of the patients treated with LAUP considered thems to be essentially improved. Two patients developed scars at the posterior pillars. LAUP is a relatively simple and safe method which is performed at the hospital on an outpatient basis under local anesthesia.
Anesthesia, Local ; Asphyxia ; Cicatrix ; Hemorrhage ; Humans ; Lasers, Gas ; Male ; Muscles ; Outpatients ; Overweight ; Palatal Muscles ; Palatine Tonsil ; Respiration ; Snoring* ; Uvula

OBJECTIVEThe aim of this investigation was to examine the anatomic basis of palatopharyngeus and clinical implications for sphincter pharyngoplasty.

METHODSDetailed dissections were performed on 17 sides of adult human head and neck specimens. The eight sides newborns' head and neck cadavers were also used in the study (4 normal and 4 cleft lip and palate). The observations of histologic serial sections were undertaken in six fetus head and neck specimens on coronal, transverse and sagittal direction.

RESULTSThe palatopharyngeus with three components of pharyngeal origins and two heads of velar insertions contributes the continuity between the velum and lateral pharyngeal wall and the bulk of muscle fibers were extended to the posterior tonsilar pillars with (27.58 +/- 6.73) mm length and (34.1 +/- 10.50) mm2 section area. The muscles were supplied dominantly from the branches of ascending pharyngeal artery and tonsilar artery and partly from the branches of ascending palatine artery and dorsal lingual artery. The muscles were innervated by the branches of pharyngeal plexus which focus on the level 10 mm to 25 mm below the hard palate and at the level of 15 mm below the hard palate there was at least one of the nerve branch entered the muscle.

CONCLUSIONThe palatopharyngeus muscle is not only a major musculature of lateral pharyngeal wall but also an important portion of the soft palate, participating the middle and posterior velum, which means that the muscle may play a significant effect in the velar function and pharyngeal wall movements. It is also a good donor site for palatopharyngeus flap. The sphincter pharyngoplasty has some influence to the blood supply and innervation of the muscles, which may result to blood reversion and denervation for the distal component of palatopharyngeal flap.

Adult ; Cadaver ; Head ; anatomy & histology ; Humans ; Infant, Newborn ; Neck ; anatomy & histology ; Palatal Muscles ; anatomy & histology ; Pharyngeal Muscles ; anatomy & histology

OBJECTIVETo observe the mobility of levator veli palatini muscle during speech in patients with repaired cleft palate and cleft lip.

METHODSMRI of the levator veli palatini muscle was taken during speech and breathing in three groups of patients: control group (cleft lip only, 8 cases), velopharyngeal incompetence (VPI) group (7 cases), velopharyngeal competence (VPC) group (10 cases). The length and the angle of the levator veli palatini muscle were compared.

RESULTSThe changes of the length and the angle during speech were not significantly different among the three groups (P > 0.05). The ratio of length changes when speaking "a", "i", and "m" are (13.5 ± 11.7)%, (11.1 ± 10.8)%, (8.2 ± 14.3)%. Mean angle of pronouncing "a", "i", and "m" are [(43.18 ± 4.984)°, (43.08 ± 4.879)°, (39.48 ± 5.046)°]. The levator veli palatini muscle contracted progressively form "m", "i", to "a".

CONCLUSIONSThe mobility of the levator veli palatini muscle in patients with repaired cleft palate and cleft lip only is basically the same.

Cleft Lip ; surgery ; Cleft Palate ; surgery ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Palatal Muscles ; pathology ; Speech ; Velopharyngeal Insufficiency

An 8-years old boy with facial asymmetry and unilateral posterior crossbite on the left side received orthopedic and orthodontic treatment. During the first phase of treatment, the narrow maxillary arch was expanded using an acrylic plate. Then, the acrylic plate was used as a bite block with occlusal indentations from the construction bite that was obtained with the incisors in a coincident dental midline. After the position of the mandible was stabilized, the second phase of orthodontic treatment was initiated using fixed appliances for detailing of the occlusion. Skeletal symmetry, ideal occlusion, and coincident dental midlines were thus achieved. Functionally, occlusal force balance and masticatory muscle activity were improved, and the chewing patterns were normalized.
Bite Force ; Electromyography ; Facial Asymmetry* ; Humans ; Incisor ; Male ; Malocclusion* ; Mandible ; Mastication ; Masticatory Muscles ; Orthopedics* ; Palatal Expansion Technique