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https://www.readbyqxmd.com/read/27809898/efficacy-and-mechanism-of-mandibular-advancement-devices-for-persistent-sleep-apnea-after-surgery-a-prospective-study
#1
Huiping Luo, Xulan Tang, Yuanping Xiong, Lili Meng, Hongliang Yi, Shankai Yin
BACKGROUND: To explore the feasibility, the efficacy, and the mechanism of mandibular advancement devices (MAD) in the treatment of persistent sleep apnea after surgery. METHODS: Nineteen patients who failed uvulopalatopharyngoplasty (UPPP) or UPPP plus genioglossus advancement and hyoid myotomy (GAHM) were given a non-adjustable MAD for treatment. All patients had polysomnography (PSG) at least 6 months post-UPPP with and without the MAD. Seventeen patients had computed tomography (CT) examinations...
November 3, 2016: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27792421/velopharyngeal-changes-after-maxillary-distraction-in-cleft-patients-using-a-rigid-external-distraction-device-a-retrospective-study
#2
Mahasen Taha, Yasser M Elsheikh
OBJECTIVE:  To evaluate early and late velopharyngeal changes in cleft lip and palate (CLP) patients after use of the Rigid External Distractor (RED) device and to correlate these changes to the amount of maxillary advancement. MATERIALS AND METHODS:  Thirty Class III CLP patients were included in the study. Maxillary advancement was performed using the RED device in combination with titanium miniplates and screws for anchorage. Lateral cephalograms, nasometer, and nasopharyngoscope records were taken before distraction, immediately after distraction, and 1 year after distraction...
November 2016: Angle Orthodontist
https://www.readbyqxmd.com/read/27790589/the-soft-palate-friendly-speech-bulb-for-velopharyngeal-insufficiency
#3
Sukhdeep Singh Kahlon, Monaliza Kahlon, Shilpa Gupta, Parvinder Singh Dhingra
Velopharyngeal insufficiency is an anatomic defect of the soft palate making palatopharyngeal sphincter incomplete. It is an important concern to address in patients with bilateral cleft lip and palate. Speech aid prosthesis or speech bulbs are best choice in cases where surgically repaired soft palate is too short to contact pharyngeal walls during function but these prosthesis have been associated with inadequate marginal closure, ulcerations and patient discomfort. Here is a case report of untreated bilateral cleft lip and palate associated with palatal insufficiency treated by means of palate friendly innovative speech bulb...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27787538/injection-pharyngoplasty-with-autologous-fat-as-treatment-for-stress-velopharyngeal-insufficiency-in-brass-and-woodwind-musicians
#4
Mausumi N Syamal, Paul C Bryson
Importance: Stress velopharyngeal insufficiency (SVPI) is an uncommon but often career-threatening condition affecting professional brass and woodwind musicians. Objectives: To review the evaluation of and treatment for SVPI in professional musicians with lipoinjection to the posterior pharyngeal wall. Design, Setting, and Participants: A retrospective medical record and literature review. Two professional musicians with SVPI treated with autologous lipoinjection to the posterior pharyngeal wall were included...
October 27, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27763974/superiorly-based-pharyngeal-flap-for-the-surgical-treatment-of-velopharyngeal-insufficiency-and-speech-outcomes
#5
Cori Rogers, Petros Konofaos, Robert D Wallace
A retrospective chart review comparing pre and postoperative speech in 19 patients who underwent pharyngeal flap surgery for the diagnosis of velopharyngeal insufficiency. Eighteen of the patients had a history of cleft palate. Patients were assigned a speech grade between 1 and 5 based on the objective and subjective quality of their speech. Comparison of pre and postoperative speech showed significant improvement in speech quality from a mean grade of 3.37 to 2.00 (P < 0.001). This study demonstrates that a wide, superiorly based pharyngeal flap did lead to significant improvement in speech outcomes in this group of patients independent of gender or age...
October 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27750489/isolated-cleft-palate-requires-different-surgical-protocols-depending-on-cleft-type
#6
Anna Elander, Christina Persson, Jan Lilja, Hans Mark
A staged protocol for isolated cleft palate (CPO), comprising the early repair of the soft palate at 6 months and delayed repair of the eventual cleft in the hard palate until 4 years, designed to improve maxillary growth, was introduced. CPO is frequently associated with additional congenital conditions. The study evaluates this surgical protocol for clefts in the soft palate (CPS) and for clefts in the hard and soft palate (CPH), with or without additional malformation, regarding primary and secondary surgical interventions needed for cleft closure and for correction of velopharyngeal insufficiency until 10 years of age...
October 18, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27729138/palatal-eversion-for-the-treatment-of-combined-nasopharyngeal-stenosis-and-tonsillar-pillars-adhesion
#7
Gamal Abdel-Fattah
OBJECTIVE: Rarely the tonsillar pillars and the soft palate became adherent to the posterior nasopharyngeal wall by strong fibrous tissue due to excessive dissection and cauterization during surgery leading to nasopharyngeal stenosis. Therefore, many treatment modalities are being tried to cure this problem. The aim of this study is to explore our results of modifying the basic technique to accommodate those patients with combined nasopharyngeal stenosis and tonsillar pillars adhesions in one stage...
November 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27727413/improvement-of-quality-of-speech-in-patients-with-velo-pharyngeal-insufficiency-corrected-using-a-buccinator-myomucosal-flap
#8
D K Dias, P D Fernando, R D Dissanayake
INTRODUCTION: Oro-facial clefts involving the palate is the commonest structural defect causing velopharyngeal insufficiency (VPI) and poor intelli gibility of speech. Proper repair of the soft palateis a surgical challenge. Posterior-based buccinator myomucosal flap (BMF) is used to lengthen the soft palate of patients who undergo primary palatoplasty at Teaching Hospital, Karapitiya (THK). BMF is a good choice for the repair of medium sized mucosal defects in the oral cavity since it has appropriate thickness, contains mucous membrane with mucous glands and has a rich blood supply...
2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/27712815/velopharyngeal-dysfunction-evaluation-and-treatment
#9
Jeremy D Meier, Harlan R Muntz
Velopharyngeal dysfunction (VPD) can significantly impair a child's quality of life and may have lasting consequences if inadequately treated. This article reviews the work-up and management options for patients with VPD. An accurate perceptual speech analysis, nasometry, and nasal endoscopy are helpful to appropriately evaluate patients with VPD. Treatment options include nonsurgical management with speech therapy or a speech bulb and surgical approaches including double-opposing Z-plasty, sphincter pharyngoplasty, pharyngeal flap, or posterior wall augmentation...
November 2016: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/27712812/evaluation-of-speech-and-resonance-for-children-with-craniofacial-anomalies
#10
Ann W Kummer
Children with craniofacial anomalies often demonstrate disorders of speech and/or resonance. Anomalies that affect speech and resonance are most commonly caused by clefts of the primary palate and secondary palate. This article discusses how speech-language pathologists evaluate the effects of dental and occlusal anomalies on speech production and the effects of velopharyngeal insufficiency on speech sound production and resonance. How to estimate the size of a velopharyngeal opening based on speech characteristics is illustrated...
November 2016: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/27711915/palatal-motion-after-primary-and-secondary-furlow-palatoplasty
#11
Pamela A Rudnicki, Christopher Tsang, Mark A Vecchiotti, Andrew R Scott
Importance: Indications for Furlow palatoplasty include primary repair of cleft palate as well as secondary repair, or secondary palatoplasty for treatment of velopharyngeal insufficiency. Speculation exists surrounding the benefit of secondary Furlow palatoplasty in cases of a previously well-reconstructed palate or a short but otherwise anatomically normal soft palate because it has been theorized that reorientation of a previously reconstructed or normal muscular levator sling should in fact worsen palatal motion...
October 6, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27703866/hypernasality-associated-with-basal-ganglia-dysfunction-evidence-from-parkinson-s-disease-and-huntington-s-disease
#12
Michal Novotný, Jan Rusz, Roman Čmejla, Hana Růžičková, Jiří Klempíř, Evžen Růžička
BACKGROUND: Although increased nasality can originate from basal ganglia dysfunction, data regarding hypernasality in Parkinson's disease (PD) and Huntington's disease (HD) are very sparse. The aim of the current study was to analyze acoustic and perceptual correlates of velopharyngeal seal closure in 37 PD and 37 HD participants in comparison to 37 healthy control speakers. METHODS: Acoustical analysis was based on sustained phonation of the vowel /i/ and perceptual analysis was based on monologue...
2016: PeerJ
https://www.readbyqxmd.com/read/27701628/effects-of-biofeedback-on-control-and-generalization-of-nasalization-in-typical-speakers
#13
Elizabeth S Heller Murray, Joseph O Mendoza, Simone V Gill, Joseph S Perkell, Cara E Stepp
Purpose: The purpose of this study was to determine the effects of biofeedback on control of nasalization in individuals with typical speech. Method: Forty-eight individuals with typical speech attempted to increase and decrease vowel nasalization. During training, stimuli consisted of consonant-vowel-consonant (CVC) tokens with the center vowels /a/ or /i/ in either a nasal or nonnasal phonemic context (e.g., /mim/ vs. /bib/), depending on the participant's training group...
October 4, 2016: Journal of Speech, Language, and Hearing Research: JSLHR
https://www.readbyqxmd.com/read/27698756/application-of-levator-veli-palatini-retropositioning-combined-with-buccinator-myomucosal-island-flap-for-congenital-cleft-palate
#14
Y J Wan, H C Zhang, Y Zhang, Y S Cheng, Y Zhang, C Wang
Congenital cleft palate causes a serious obstacle to children with regard to language and eating function. The aim of the current study was to examine the clinical application of a type of palatoplasty that has a reduced impact on the maxillary growth and good function in velopharyngeal competence. A total of 37 patients with cleft palate were treated with levator veli palatini retropositioning combined with Buccinator myomucosal island flap. The patients were successfully treated in the first phase and were followed up for 1-3 years...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27689965/maxillary-distraction-osteogenesis-versus-orthognathic-surgery-for-cleft-lip-and-palate-patients
#15
Dimitrios Kloukos, Piotr Fudalej, Patrick Sequeira-Byron, Christos Katsaros
BACKGROUND: Cleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of orofacial clefts is prolonged; it typically commences after birth and lasts until the child reaches adulthood or even into adulthood. Residual deformities, functional disturbances, or both, are frequently seen in adults with a repaired cleft. Conventional orthognathic surgery, such as Le Fort I osteotomy, is often performed for the correction of maxillary hypoplasia...
September 30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27669372/tooth-borne-anterior-maxillary-distraction-for-cleft-maxillary-hypoplasia-our-experience-with-147-patients
#16
Sunil Richardson, Dhivakar Selvaraj, Rakshit V Khandeparker, Nikkie S Seelan, Shweta Richardson
PURPOSE: To evaluate the results of anterior maxillary distraction for its efficacy and long-term stability in the management of cleft maxillary hypoplasia in a large series of patients with a long-term follow-up extending to 4 years. MATERIALS AND METHODS: One hundred sixty-four patients at least 10 years old with cleft maxillary hypoplasia who presented to the authors' unit from January 2009 through October 2014 were evaluated retrospectively, irrespective of gender, type of cleft lip and palate, and amount of advancement needed...
December 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27665319/-an-original-double-arched-radial-forearm-flap-for-soft-palate-reconstruction-case-report
#17
J Pauchot, D Feuvrier, I Pluvy, F Floret, O Mauvais
INTRODUCTION: Reconstruction of the soft palate after oncologic resection remains a surgical challenge. Speech and swallowing problems are the consequences of velopharyngeal incompetence following soft palate resection. Free tissue transfer like radial forearm flaps can be used in larger defects for complex reconstruction. The conformation of the flap in order to be closer to the shape of the soft palate improves the functional outcome. In the same way, we describe an original "double-arched" flap design...
December 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/27628607/proposal-for-a-new-exercise-method-for-dysphagia-with-velopharyngeal-inadequacy-a-case-of-bickerstaff-s-brainstem-encephalitis
#18
Yuji Koyama, Kayako Nitta, Michi Tochikura, Takashi Kasahara, Yutaka Kametsu, Minoru Toyokura, Yoshihisa Masakado
Bickerstaff's brainstem encephalitis is an autoimmune disease with the primary lesion situated in the brainstem and three cardinal signs: ophthalmoplegia; ataxia; and impaired consciousness. A 68-year-old man was started on rehabilitation exercise 3 months after onset of Bickerstaff's brainstem encephalitis, due to remnant dysarthria and dysphagia (Functional Oral Intake Scale, level 5) after the cardinal signs of Bickerstaff's brainstem encephalitis resolved. Exercise involved using a straw in the anterior midline between the dorsal tongue and hard palate...
2016: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/27619042/velopharyngeal-videofluoroscopy-providing-useful-clinical-information-in-the-era-of-reduced-dose-radiation-and-safety
#19
Pablo Antonio Ysunza, David Bloom, Kongkrit Chaiyasate, Matthew Rontal, Rachel VanHulle, Kenneth Shaheen, Donald Gibson
BACKGROUND: The state of the art for correcting velopharyngeal insufficiency (VPI) is a surgical procedure which is customized according to findings on imaging procedures: multiplanar videofluoroscopy (MPVF) and flexible videonasopharyngoscopy (FVNP). Recently, the use of MPVF has been challenged because of the potential risk of using ionizing radiation, especially in children. OBJECTIVE: To study whether using a protocol for performing MPVF can effectively decrease radiation dose in patients with VPI while providing useful information for planning surgical correction of VPI in combination with FVNP...
October 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27617133/a-case-of-concurrent-miller-dieker-syndrome-17p13-3-deletion-and-22q11-2-deletion-syndrome
#20
Paldeep S Atwal, C Macmurdo
Features of Miller-Dieker syndrome (MDS, 17p13.3 deletion syndrome, LIS1-associated lissencephaly) include classic lissencephaly, microcephaly, cardiac malformations, growth restriction, and characteristic facial changes. Individuals with 22q11.2 deletion syndrome (DiGeorge syndrome or velocardiofacial syndrome) are known to have congenital cardiac malformations (in particular conotruncal defects), palatal abnormalities (especially velopharyngeal insufficiency), hypocalcemia, immune deficiency, learning disabilities, and characteristic facial features...
December 2015: Journal of Pediatric Genetics
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