Humans ; Palate, Soft ; surgery ; Sleep Apnea Syndromes ; surgery ; Uvula ; surgery

OBJECTIVETo investigate the mechanism of new bone formation in the distraction osteogenesis (DO) for correction of cleft palate (CP) in rhesus.

METHODSCP was created by operation in 23 rhesus. The CP was corrected with DO in 21 animals as experimental group. The distraction rate was 0.8 mm per day, two times a day. The bone fragments were fixed after cleft closure, every 3 animals were sacrificed to get specimen after 1, 2, 4, 6, 8, 12, 24 weeks of fixation. 6 days before sacrifice, tetracycline was administrated for labeling (30 mg/kg).

RESULTSThe hard and soft tissue def of fixation. At the same time, the bone volume and calcification between the distraction gap increased. The cleft in the control group could not b ect was successfully closed with DO by intramembrane osteogenesis. The new formed bone was remodeling and became maturation during the period e corrected spontaneously.

CONCLUSIONSThe DO can successfully correct both the soft and hard tissue defect in CP by intramembrane osteogenesis. The fixation is important for remodeling and maturation of the new formed bone.

Animals ; Biomarkers ; Cleft Palate ; pathology ; surgery ; Macaca ; Osteogenesis, Distraction ; Palate, Hard ; pathology ; Palate, Soft ; pathology

OBJECTIVE: The purpose of this study was to evaluate the upper airway dimensional change according to maxillary superior movement after orthognathic surgery and to identify the relationship between the amount of maxillary movement and upper airway dimensional changes. METHODS: The samples consisted of 24 adult patients (9 males and 15 females) who had a skeletal discrepancy and had received presurgical orthodontic treatment. They underwent Le Fort I superior impaction osteotomy and mandibular setback surgery. Cephalometric x-rays were taken at 3 stages - T0 (before orthognathic surgery), T1 (just or within 2 weeks after orthognathic surgery), T2 (6 months after surgery) RESULTS: 1, Pharyngeal airway space (PAS (R)-nasopharynx) was decreased after surgery (T1) but recovered at 6 months after surgery; 2, Pharyngeal airway space (PAS (NL)-palatal plane) was increased after surgery and at 6 months after surgery; 3, Pharyngeal airway space (PAS (OL)-occlusal plane) was increased at T1 and was decreased at T2; 4, Soft palate thickness was increased at T1 but it became the same or thinner at T2; 5, There is no statistically significant relation between the amount of maxillary superior movement and pharyngeal airway space. CONCLUSIONS: These findings suggested that the maxillary superior movement of about an average of 4.40 +/- 1.14 mm did not affect upper pharyngeal airway space changes.
Adult ; Humans ; Male ; Orthognathic Surgery ; Osteotomy ; Palate, Soft

OBJECTIVE: To analyze velopharyngeal closure patterns and speech characteristics of patients with congenital velopharyngeal insufficiency. METHODS: Patients visiting the Department of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University between 2009 and 2017 were reviewed. Outcomes of subjective speech evaluation, including resonance, consonant articulation, and correction rate, were analyzed. Furthermore, the mobility of soft palate and pharyngeal walls under nasopharyngeal fiberscope were analyzed retrospectively. RESULTS: A total of 47 cases were retrieved and subjected to nasopharyngeal fiberscopic examination. Among them, 29 (61.7%) demonstrated a circular closure pattern, 16 (34.0%) showed a coronal pattern, and 2 (4.3%) had a sagittal pattern. Furthermore, 25 (53.2%) presented medium soft-palate mobility, 22 (46.8%) had weak lateral pharyngeal wall mobility, and 41 (87.2%) had no posterior pharyngeal wall mobility. Among all of the patients, 23 (48.9%) presented medium hypernasality, accounting for the highest proportion. Consonant misarticulation occurred in 89.4% of the cases. The articulation manners with the highest correction rate were in the following order: nasal, lateral, fricatives, stops, and affricates. The articulation places with the highest correction rate were in the following order: bilabial, alveolar, velar, and linguadental. CONCLUSIONS Circular closure was the most prevalent velopharyngeal closure pattern among patients with congenital velopharyngeal insufficiency, and consonant omission was the most common articulation abnormality.
China ; Cleft Palate/surgery* ; Humans ; Palate, Soft ; Pharynx ; Retrospective Studies ; Speech ; Treatment Outcome ; Velopharyngeal Insufficiency

OBJECTIVE: To explore the curative effect of velopharyngoplasty (VPP) combined with hard palate shorting and soft palate forward in the treatment of type II moderately severe obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: Thirty-two patients with OSAHS with and the obstructed surface located in soft palate were subjected to VPP combined with hard palate shorting and soft palate forward. The ESS scores, result of PSG included AHI and the lowest oxyhemoglobin saturation before and after operation were compared. RESULT: The effective rate of VPP was 78.12% this group. The grade of ESS, PSG and the lowest oxyhemoglobin saturation was statistically significant before and after the operation (P < 0.05). In the other 7 cases whose AHI decrease less than 50%, the grade of ESS, AHI and the lowest oxyhemoglobin saturation was also statistically significant. CONCLUSION VPP combined with hard palate shorting and soft palate forward can improve the surgical effective rate obviously for OSAHS patients.
Adult ; Female ; Humans ; Male ; Middle Aged ; Palate, Hard ; surgery ; Palate, Soft ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Syndrome

OBJECTIVETo compare results of the growth and development of the upper dental arch and the velopharyngeal closure of the cleft patients treated by two methods.

METHODSThe dental cast of patient and X-ray films were measured and the statistical medical records were analyzed.

RESULTSThe transverse distance of upper dental arch was found to be wider in group A than in group B. The anterior-posterior distance of the dental arch in bilateral cleft group was shorter in group A than in group B. The difference of the two groups were gradually lessened as age increases. Bony bridge in alveolar gap was 63% and 83.3% in unilateral and bilateral cleft group respectively. 15% of cases in group A and 35.2% in group B needed pharyngeal flap.

CONCLUSIONSThe stable upper dental arch in group A can opposes the pressure from the lip muscles, this maintains the width of the arch. But A-P distance of upper dental arch in BCLP in group A should be followed up after the age of 9 years. Pharyngeal flap is needed less in group A than in group B.

Alveolar Process ; growth & development ; Child ; Child, Preschool ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Humans ; Infant ; Orthodontics, Corrective ; Palate, Soft ; surgery

OBJECTIVEThe purpose of this study was to retrospect the prognosis of simultaneous repair of cleft lip and closure of cleft hard palate with vomer flaps in patients with unilateral complete cleft lip and palate.

METHODSA retrospective study was carried out in 47 patients with unilateral complete cleft lip and palate and, simultaneously received repair of cleft lip and closure of cleft hard palate with vomer flaps. The duration of operation, as well as the blood loss during the operation was recorded, and compared with those patients who only received cleft lip repair.

RESULTSAll the operations were successful, and the wound healed well. The procedure of simultaneous repair of cleft lip and closure of cleft hard palate with vomer flaps did not prolong the operating time, compared with simple cleft lip repair. No blood transfusion was needed due to closure of cleft hard palates with vomer flaps.

CONCLUSIONSimultaneous repairs of cleft lip and closure of cleft hard palate with vomer flaps are safe for patients with unilateral complete cleft lip and palate.

Abnormalities, Multiple ; surgery ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Female ; Humans ; Infant ; Male ; Maxillofacial Development ; Palate, Hard ; surgery ; Palate, Soft ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

OBJECTIVE: Apneagraph can be used to discuss which the best operation scheme is for OSAHS. Effects of uvulopalatopharyngoplasty can be assessed by Apneagraph in obstructive sleep apnea hypopnea syndrome (OSAHS) patients. METHOD: Fifty-six patients with OSAHS received the modified UPPP operation were randomly selected in our hospital. The AG and PSG were applied for diagnosis and evaluation of operation effects. The sleepiness state was assessed by ESS (Epworth sleepiness scale) 6 months after the surgery, compared with the preoperative ESS scores using attest for statistical analysis. We used the SPSS19.0 software to carry our data analysis. RESULT: After 6 months, the evaluation of postoperative efficacy came out to be completely controlled in 42 cases (75%), significantly effective in 14 cases (25%), and uncured in 0 cases. Correlation between the transpalatal obstruction proportion and the AHI reduction percentage was significantly positive (r = 0.667). There were 38 patients with oropharynx obstruction percentage more than 73.35% presented completely controlled in 34 cases (89.47%), significantly effective in 4 cases (10.33%), and uncured in 0 cases. CONCLUSION AG has the dual functions of analyzing sleep-related respiratory disturbance events and determining upper airway obstruction sites. AG application in the postoperative evaluation of modified uppp has significantly objective guide significance. The modified UPPP for treatment of OSAHS can improve the operation effect. Patients with oropharynx obstruction percentage more than 73.5% don't need to receive the operation for treatment of retroglottal region.
Adult ; Cleft Palate ; surgery ; Female ; Humans ; Male ; Middle Aged ; Palate ; surgery ; Palate, Soft ; surgery ; Pharynx ; surgery ; Polysomnography ; Sleep Apnea, Obstructive ; physiopathology ; surgery ; Sleep Stages ; Treatment Outcome ; Young Adult

Humans ; Palate, Soft ; surgery ; Postoperative Complications ; prevention & control ; Sleep Apnea Syndromes ; surgery ; Uvula ; surgery

OBJECTIVE: To investigate the therapeutic efficacy of coblation-assisting uvulopalatopharyngoplasty (CAUPPP) combining with coblation-channeling of the tongue (CCT) for patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS). METHOD: A retrospective analysis was made on patients with severe OSAHS treated by CAUPPP combining with CCT. The adult with severe OSAHS were involved in the study and the apnea-hypopnea index (AHI) were beyond 40/h and lowest arterial oxygen saturation (LSaO2) were under or equal to 80%. Surgical approach: The UPPP was performed to decrease the size of soft palate with coblation and coblation-channeling in the soft palate and decrease the size of tongue by CCT. All patients were followed up for 6 to 12 months and underwent polysomnography (PSG). RESULT: Subjective symptoms of patients improved more significantly than that of preoperation. The function of soft palate is normal without significant nasopharyngeal regurgitation. Compared with the preoperative data, AHI values were significantly decreased (P<0.01) and the lowest oxygen saturations increased significantly (P<0.01) and the effective rate was 91.7%. CONCLUSION There are usually multiple obstruction levels in patients with severe OSAHS and the traditional surgical treatment is not ideal. This study demonstrated that with the assistance of coblation, combining CAUPPP with CCT for patients with severe OSAHS is an effective surgical method. It has less blood loss, minimally invasive, retained the normal function of the soft palate, etc., should be widely applied.
Adult ; Aged ; Catheter Ablation ; Female ; Humans ; Male ; Middle Aged ; Palate ; surgery ; Palate, Soft ; surgery ; Pharynx ; surgery ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery ; Tongue ; surgery ; Uvula ; surgery