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

OBJECTIVETo determine the factors affecting post-operative velopharyngeal function of cleft palate patients aged over two years old.

METHODSThe data on 245 patients, including first visit case records and those in the database, were searched and recorded. Post-operative velopharyngeal function and clinical features, such as cleft ratio, adequate ratio, diagnosis, operative age and method, were analyzed retrospectively.

RESULTSCleft ratio and adequate ratio in the velopharyngeal competence (VPC) group were not statistically different from those in the velopharyngeal incompetence (VPI) group. The difference in VPC rate in different age groups and diagnosis was not significant. The post-operative VPC rates under different methods were significantly different.

CONCLUSIONThe current therapeutic schedule for patients younger than two years old is inappropriate for patients older than two years old. Cleft ratio is not the main factor affecting postoperative velopharygeal function. Sommerlad-Levator Veli Palatini reconstructional operation combined with sphincter pharyngoplasty can obviously improve the velopharyngeal function of patients aged 2 years old and up. This method should be applied in primary palatoplasty.

Child, Preschool ; Cleft Palate ; Female ; Humans ; Infant ; Male ; Palatal Muscles ; Pharynx ; Postoperative Period ; Reconstructive Surgical Procedures ; Retrospective Studies ; Velopharyngeal Insufficiency

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

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

OBJECTIVE: To explore the denervation change of Tensor Veli Palati in patients with OSAHS by determine the mRNA and protein expression of NCAM. METHOD: The OSAHS group was consisted of 30 OSAHS patients and the normal control group was consisted of 10 chronic tonsillitis patients without OSAHS. Real-time quantitative RT-PCR and Western blot methods were used to determine the NCAM expression in specimens. RESULT: (1) The mRNA and protein expression level of NCAM in the OSAHS group increased significantly compared with that in control group (P < 0.05). (2) There was positive correlation between AHI and the protein expression level of NCAM in the OSAHS group (r = 0.803, P < 0.01). CONCLUSION These results indicate that the denervation change of tensor veli palati appear in OSAHS patients, and the severity of OSAHS are relevant with the degree of denervation.
Adult ; Case-Control Studies ; Denervation ; Humans ; Male ; Middle Aged ; Palatal Muscles ; innervation ; Sleep Apnea, Obstructive ; metabolism ; Young Adult

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

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare the surgical outcomes of uvulopalatal flap (UPF) and palatal muscle resection (PMR) techniques in the treatment of obstructive sleep apnea (OSA). SUBJECTS AND METHOD: Forty-three consecutive patients (40 men and 3 women) with OSA were included. Only patients with Fujita type I obstruction were enrolled in this study. Patients with macroglossia or retrognathia were excluded from the study. Twenty patients underwent a UPF and twenty-three patients underwent a PMR. In both groups, nasal surgery was performed if necessary. Questionnaires based on Visual Analogue Scale (VAS) about snoring, apnea, morning headache, tiredness, daytime sleepiness and Epworth Sleepiness Scale (ESS) were analyzed before and after each surgical treatment. Preoperative and postoperative polysomnography (PSG) were completed by every patient. RESULTS: In UPF group, every aspect of VAS except morning headache was significantly improved after surgery. In PMR group, every aspect of VAS and ESS were significantly improved after surgery. Comparing the surgical outcomes between two groups, every VAS and ESS showed much better result in PMR than UPF group. In both UPF and PMR group, the mean apnea-hypopnea index decreased significantly after surgery. However, there's no significant difference between two groups in the PSG findings. CONCLUSION: PMR could be a better surgical technique than UPF with respect to subjective outcome although both UPF and PMR are effective surgical techniques for the treatment of OSA with Fujita type I obstruction.
Apnea ; Headache ; Humans ; Macroglossia ; Male ; Nasal Surgical Procedures ; Palatal Muscles ; Palate, Soft ; Polysomnography ; Surveys and Questionnaires ; Retrognathia ; Sleep Apnea, Obstructive ; Snoring ; Surgical Procedures, Operative

Congenital Abnormalities ; Contracture ; Dental Occlusion ; Ear, External ; Facial Asymmetry ; Humans ; Imidazoles ; Jaw ; Malocclusion ; Mandible ; Maxilla ; Muscles ; Nitro Compounds ; Osteogenesis, Distraction ; Osteotomy ; Palatal Expansion Technique ; Skeleton ; Transplants

OBJECTIVE: To explore apoptosis changes of dilator muscles in the upper airway by detecting the expression of Bax, Bcl-2 in tensor veli palatini in patients with OSAHS. METHOD: The expression of Bax and Bcl-2 were detected in tensor veli palatini in 30 cases with OSAHS and 10 cases chronic tonsillitis without OSAHS by immunohistochemistry and image analytical system, and the results were analyzed. RESULT: (1) The expression levels of Bax in the OSAHS group increased significantly compared to control group (P < 0.05), but there were no significant differences of Bcl-2 expression between two groups, the ratio of Bax/Bcl-2 increased significantly (P < 0.05). (2) There were positive correlations between AHI and the expression levels of Bax (r = 0.697, P < 0.01) respectively in the test group. CONCLUSION The results indicate that apoptosis occurred in tensor veli palatini in patients with OS AHS, and the more severity of OSAHS, the more apoptosis.
Adult ; Airway Resistance ; Case-Control Studies ; Humans ; Male ; Middle Aged ; Palatal Muscles ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Sleep Apnea, Obstructive ; metabolism ; pathology ; Young Adult ; bcl-2-Associated X Protein ; metabolism

OBJECTIVE: The analyze the relationship between secretory otitis media (SOM) and injury of tensor veli palatini (TVP) muscle injury after radiotherapy, then to explore the pathogenesis of SOM in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. METHOD: The cross section area (CSA) of TVP and medial pterygoid (MP) muscle were measured in MRI of 32 patients with NPC before and after radiotherapy, meanwhile the incidence of SOM were surveyed after radiotherapy, then to analyze the relationship between the change of TVP and the incidence of SOM after radiotherapy. RESULT: Of 48 ears without SOM before radiotherapy, 27 ears developed post-irradiation SOM, including 24 ears with TVP atrophy and 3 ears without TVP atrophy, and 21 ears had no post-irradiation SOM, including 8 ears with TVP atrophy and 13 ears without TVP atrophy. chi2 test showed significant difference (P < 0.01). It indicated that post-irradiation SOM have correlation with TVP atrophy. The more possibility of TVP atrophy occurred after long time radiotherapy. CONCLUSION The atrophy of TVP in patients with NPC usually occurs 6 months after radiotherapy, and this may result in the post-irradiation SOM. The pathogenesis of post-irradiation SOM need further study functionally.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; radiotherapy ; Otitis Media with Effusion ; etiology ; Palatal Muscles ; pathology ; Palate, Soft ; pathology