Purpose: To create flow charts of eating and swallowing that make it easy to identify the cases requiring professional treatment including dysphagia rehabilitation during oral intake.Subjects: 28 patients (mean age: 78.7±11.3 years) with dysphagia who underwent videofluorography (hereinafter “VF”).Methods: We conducted various tests such as Repetitive Salvia Swallowing Test (RSST), Modified Water Swallowing Test (MWST) and Food Test (FT), and studied relationships between VF findings and Fujishima's grade of eating and swallowing capability.Results: After the examination of th results of RSST (sensitivity: 0.83, specificity: 0.22), MWST (sensitivity: 0.56, specificity: 0.72), FT (sensitivity: 0.33, specificity: 0.75), VF and grade of eating and swallowing capability of Fujishima, the use of MWST and FT was appropriate. However, four cases in which the results of MWST and FT were over the cut-off value had misswallowed water and food. We created the flowcharts considering that all of those 4 cases are also the cases that suffered from the consequences of cerebral strokes.

Objective: To evaluate the effects of rapid maxillary expansion (RME) on nasal patency and nasomaxillary dimensions in children and adolescents with mouthbreathing through 8 years of clinical follow-up. Methods: RME was performed using a Hyrax orthodontic appliance in 28 mouth-breathers (6–13 years old).During follow-up, objective tests of nasal respiratory function were conducted, such as acoustic rhinometry, which provided the minimum cross-sectional areas of the nasal cavity, and active anterior computed rhinomanometry, which measured inspiratory nasal resistance. The tomographic widths of the coronal sections of the nose and maxilla were also measured. Fisher’s exact test and the Mann–Whitney U test were used to compare categorical and numerical variables, respectively, in mouth-breathers with and without allergic rhinitis.Temporal evolution was assessed using generalized estimating equation models.Statistical significance was set at P < 0.05. Results: There was a reduction in inspiratory resistance after RME with a stable improvement in nasal patency during the 8-year follow-up period (P = 0.0179). All nasal and maxillary tomographic widths showed statistically significant increases in the short-term (P < 0.0001), and most of them showed significant increases in the long-term when compared with the pre-expansion period. Tomographic measurements were not influenced by allergic rhinitis. Conclusions Our study showed that RME promoted and maintained the widening of the posterior maxillary structure in children and adolescents with mouth-breathing, with a decrease in inspiratory nasal resistance during the 8-year follow-up period. These findings highlight the importance of RME in mouth-breathers with maxillary atresia.

Objective: To evaluate the effects of rapid maxillary expansion (RME) on nasal patency and nasomaxillary dimensions in children and adolescents with mouthbreathing through 8 years of clinical follow-up. Methods: RME was performed using a Hyrax orthodontic appliance in 28 mouth-breathers (6–13 years old).During follow-up, objective tests of nasal respiratory function were conducted, such as acoustic rhinometry, which provided the minimum cross-sectional areas of the nasal cavity, and active anterior computed rhinomanometry, which measured inspiratory nasal resistance. The tomographic widths of the coronal sections of the nose and maxilla were also measured. Fisher’s exact test and the Mann–Whitney U test were used to compare categorical and numerical variables, respectively, in mouth-breathers with and without allergic rhinitis.Temporal evolution was assessed using generalized estimating equation models.Statistical significance was set at P < 0.05. Results: There was a reduction in inspiratory resistance after RME with a stable improvement in nasal patency during the 8-year follow-up period (P = 0.0179). All nasal and maxillary tomographic widths showed statistically significant increases in the short-term (P < 0.0001), and most of them showed significant increases in the long-term when compared with the pre-expansion period. Tomographic measurements were not influenced by allergic rhinitis. Conclusions Our study showed that RME promoted and maintained the widening of the posterior maxillary structure in children and adolescents with mouth-breathing, with a decrease in inspiratory nasal resistance during the 8-year follow-up period. These findings highlight the importance of RME in mouth-breathers with maxillary atresia.

Objective: To evaluate the effects of rapid maxillary expansion (RME) on nasal patency and nasomaxillary dimensions in children and adolescents with mouthbreathing through 8 years of clinical follow-up. Methods: RME was performed using a Hyrax orthodontic appliance in 28 mouth-breathers (6–13 years old).During follow-up, objective tests of nasal respiratory function were conducted, such as acoustic rhinometry, which provided the minimum cross-sectional areas of the nasal cavity, and active anterior computed rhinomanometry, which measured inspiratory nasal resistance. The tomographic widths of the coronal sections of the nose and maxilla were also measured. Fisher’s exact test and the Mann–Whitney U test were used to compare categorical and numerical variables, respectively, in mouth-breathers with and without allergic rhinitis.Temporal evolution was assessed using generalized estimating equation models.Statistical significance was set at P < 0.05. Results: There was a reduction in inspiratory resistance after RME with a stable improvement in nasal patency during the 8-year follow-up period (P = 0.0179). All nasal and maxillary tomographic widths showed statistically significant increases in the short-term (P < 0.0001), and most of them showed significant increases in the long-term when compared with the pre-expansion period. Tomographic measurements were not influenced by allergic rhinitis. Conclusions Our study showed that RME promoted and maintained the widening of the posterior maxillary structure in children and adolescents with mouth-breathing, with a decrease in inspiratory nasal resistance during the 8-year follow-up period. These findings highlight the importance of RME in mouth-breathers with maxillary atresia.

Objective: To evaluate the effects of rapid maxillary expansion (RME) on nasal patency and nasomaxillary dimensions in children and adolescents with mouthbreathing through 8 years of clinical follow-up. Methods: RME was performed using a Hyrax orthodontic appliance in 28 mouth-breathers (6–13 years old).During follow-up, objective tests of nasal respiratory function were conducted, such as acoustic rhinometry, which provided the minimum cross-sectional areas of the nasal cavity, and active anterior computed rhinomanometry, which measured inspiratory nasal resistance. The tomographic widths of the coronal sections of the nose and maxilla were also measured. Fisher’s exact test and the Mann–Whitney U test were used to compare categorical and numerical variables, respectively, in mouth-breathers with and without allergic rhinitis.Temporal evolution was assessed using generalized estimating equation models.Statistical significance was set at P < 0.05. Results: There was a reduction in inspiratory resistance after RME with a stable improvement in nasal patency during the 8-year follow-up period (P = 0.0179). All nasal and maxillary tomographic widths showed statistically significant increases in the short-term (P < 0.0001), and most of them showed significant increases in the long-term when compared with the pre-expansion period. Tomographic measurements were not influenced by allergic rhinitis. Conclusions Our study showed that RME promoted and maintained the widening of the posterior maxillary structure in children and adolescents with mouth-breathing, with a decrease in inspiratory nasal resistance during the 8-year follow-up period. These findings highlight the importance of RME in mouth-breathers with maxillary atresia.

Objective: To evaluate the effects of rapid maxillary expansion (RME) on nasal patency and nasomaxillary dimensions in children and adolescents with mouthbreathing through 8 years of clinical follow-up. Methods: RME was performed using a Hyrax orthodontic appliance in 28 mouth-breathers (6–13 years old).During follow-up, objective tests of nasal respiratory function were conducted, such as acoustic rhinometry, which provided the minimum cross-sectional areas of the nasal cavity, and active anterior computed rhinomanometry, which measured inspiratory nasal resistance. The tomographic widths of the coronal sections of the nose and maxilla were also measured. Fisher’s exact test and the Mann–Whitney U test were used to compare categorical and numerical variables, respectively, in mouth-breathers with and without allergic rhinitis.Temporal evolution was assessed using generalized estimating equation models.Statistical significance was set at P < 0.05. Results: There was a reduction in inspiratory resistance after RME with a stable improvement in nasal patency during the 8-year follow-up period (P = 0.0179). All nasal and maxillary tomographic widths showed statistically significant increases in the short-term (P < 0.0001), and most of them showed significant increases in the long-term when compared with the pre-expansion period. Tomographic measurements were not influenced by allergic rhinitis. Conclusions Our study showed that RME promoted and maintained the widening of the posterior maxillary structure in children and adolescents with mouth-breathing, with a decrease in inspiratory nasal resistance during the 8-year follow-up period. These findings highlight the importance of RME in mouth-breathers with maxillary atresia.

Results: The study included 101 patients (84 females) with a median follow-up period of 23.6±14.2 months. The persistence rate declined to 85.3%, 78.3%, 74.1%, 71.3%, and 69.3% at 12, 24, 36, 48, and 60 months, respectively. Age at the initiation of denosumab therapy differed significantly between non-persistent (n=31) and persistent (n=70) patients (81.3 vs. 72.8 years, p <0.01). Persistence was significantly lower in patients aged ≥80 years than in those aged <60 and 60–79 years (both p <0.01). The reasons for non-persistence of denosumab therapy were transfer to another hospital (n=13), interruption of outpatient visits (n=11), dental treatment (n=4), adverse events (n=2), and patient request (n=1). Conclusions Persistence was significantly lower in patients aged ≥80 years than in patients of other ages, and strategies promoting persistence are needed for these elderly patients.

Methods: The subjects were 23 children with LLD ≥20 mm (range, 27–65 mm) treated at Nagoya University Hospital between 2007 and 2017. Whole spine posteroanterior standing radiographs and whole lower limb radiographs in a supine position were recorded. Data were collected for demographics, LLD, Cobb angle, pelvic obliquity, and Nash/Moe index. Scoliosis was defined as a Cobb angle ≥10°. Leg length was measured from the top of the femoral head to the middle of the tibial plafond, and LLD was defined as the difference between the left and right leg lengths. Results: The patients (nine males and 14 females) had a mean age of 14.0 years (range, 5–18 years). The average LLD was 44.3±17.2 mm, with LLDs of 20 to 39 mm, 40 to 59 mm, and ≥60 mm in 13, five, and five subjects, respectively. The average Cobb angle was 13.0°±7.0°, and 15 subjects (65%) had scoliosis. Convexity of the scoliosis was to the short leg side in all cases. The Cobb angle was significantly related to the severity of the LLD (R=0.736, p<0.01), pelvic obliquity (R=0.966, p<0.01), and Nash/Moe index (p<0.05). Conclusions LLD is a common pediatric condition that can cause scoliosis of the spine. Severe scoliosis may develop if the LLD is ≥30 mm. Long-term studies are needed to examine the effect of LLD resolution on the elimination of scoliosis.