Pharyngeal wall and soft palate motion after two common speech surgeries

2021 ◽  
pp. 103351
Author(s):  
Tania Hassanzadeh ◽  
Nicole C. Mastacouris ◽  
Kathleen C.Y. Sie ◽  
Mark A. Vecchiotti ◽  
Andrew R. Scott
Keyword(s):  
Soft Palate ◽  
Pharyngeal Wall

Sites in the oropharynx reached by different methods of using mouthwash: clinical implication for oropharyngeal gonorrhoea prevention

2019 ◽  
Vol 96 (5) ◽  
pp. 358-360 ◽  
Author(s):  
Kate Maddaford ◽  
Christopher K Fairley ◽  
Sabrina Trumpour ◽  
Mark Chung ◽  
Eric P F Chow
Keyword(s):  
Soft Palate ◽  
Clinical Implication ◽  
Health Centre ◽  
Posterior Pharyngeal Wall ◽  
Pharyngeal Wall ◽  
Oral Rinse ◽  
Food Dye ◽  
The Mean ◽  
Application Methods ◽  
Sex With Men

ObjectivesOropharyngeal gonorrhoea is increasing among men who have sex with men and is commonly found in the tonsils and at the posterior pharyngeal wall. To address this rise, investigators are currently trialling mouthwash to prevent oropharyngeal gonorrhoea. We aimed to determine which parts of the oropharynx were reached by different methods of mouthwash use (oral rinse, oral gargle and oral spray).MethodsTwenty staff at Melbourne Sexual Health Centre participated in the study from March to May 2018. Participants were asked to use mouthwash mixed with food dye, by three application methods on three separate days: oral rinse (15 s and 60 s), oral gargle (15 s and 60 s) and oral spray (10 and 20 times). Photographs were taken after using each method. Three authors assessed the photographs of seven anatomical areas (tongue base, soft palate, uvula, anterior tonsillar pillar, posterior tonsillar pillar, tonsil, posterior pharyngeal wall) independently and scored the dye coverage from 0% to 100%. Scores were then averaged.ResultsThe mean coverage at the sites ranged from 2 to 100. At the posterior pharyngeal wall, spraying 10 times had the highest mean coverage (29%) and was higher than a 15 s rinse (2%, p=0.001) or a 15 s gargle (8%, p=0.016). At the tonsils, there was no difference in mean coverage between spray and gargle at any dosage, but spraying 20 times had a higher mean coverage than a 15 s rinse (42% vs 12%, p=0.012).ConclusionOverall, spray is more effective at reaching the tonsils and posterior pharyngeal wall compared with rinse and gargle. If mouthwash is effective in preventing oropharyngeal gonorrhoea, application methods that have greater coverage may be more efficacious.

ENDOSCOPIC IMAGE‐GUIDED TRANSORAL APPROACH TO THE CRANIOVERTEBRAL JUNCTION: AN ANATOMIC STUDY COMPARING SURGICAL EXPOSURE AND SURGICAL FREEDOM OBTAINED WITH THE ENDOSCOPE AND THE OPERATING MICROSCOPE

2009 ◽  
Vol 64 (suppl_5) ◽  
pp. ons437-ons444 ◽  
Author(s):  
Promod Pillai ◽  
Mirza N. Baig ◽  
Chris S. Karas ◽  
Mario Ammirati
Keyword(s):  
Soft Palate ◽  
Image Guidance ◽  
Odontoid Process ◽  
Posterior Pharyngeal Wall ◽  
Craniovertebral Junction ◽  
Craniocervical Junction ◽  
Transoral Approach ◽  
Operating Microscope ◽  
Microscopic Approach ◽  
Pharyngeal Wall

Abstract OBJECTIVE The transoral approach is the most direct and commonly used method to access the ventral craniocervical junction. Recently, an endonasal, endoscopic approach to the craniovertebral junction was proposed. We reasoned that the coupling of the endoscope with the direct transoral approach and image guidance could result in a minimally invasive, simple approach to the ventral craniovertebral junction. We investigated the potential usefulness of such an approach in a cadaver model. METHODS A direct transoral approach to the craniovertebral junction was performed using computed tomography-based image guidance in 9 fresh adult head specimens. Endoscopic odontoidectomy was performed in 5 specimens. In the remaining 4 specimens, the surgical working area and surgical freedom associated with an endoscopic and a microscopic approach to the ventral craniovertebral junction were evaluated and compared. In these 4 specimens, we also measured and compared the exposure of the clivus provided by the endoscope and by the operating microscope without splitting the soft palate. RESULTS With variously angled endoscopic assistance and image guidance, it was possible to tailor the excision of the anterior arch of the atlas and to precisely identify the odontoid process and its related ligaments intraoperatively, resulting in a complete and controlled odontoidectomy. The surgical area exposed over the posterior pharyngeal wall was significantly improved using the endoscope (606.5 ± 127.4 mm3) compared with the operating microscope (425.7 ± 100.8 mm3), without any compromise of surgical freedom (P < 0.05). The extent of the clivus exposed with the endoscope (9.5 ± 0.7 mm) without splitting the soft palate was significantly improved compared with that associated with microscopic approach (2.0 ± 0.4 mm) (P < 0.05). CONCLUSION With the aid of the endoscope and image guidance, it is possible to approach the ventral craniovertebral junction transorally with minimal tissue dissection, no palatal splitting, and no compromise of surgical freedom. In addition, the use of an angled-lens endoscope can significantly improve the exposure of the clivus without splitting the soft palate. An endoscope-assisted transoral approach is a direct and powerful tool for the treatment of surgical pathology at the craniovertebral junction.

Double-opposing Z-Plasty Extended with a Pedicled Buccal Fat Pad Flap for Correcting Velopharyngeal Insufficiency after Primary Palatoplasty

2021 ◽  
pp. 105566562110471
Author(s):  
Hojin Park ◽  
Jin Mi Choi ◽  
Tae Suk Oh
Keyword(s):  
Soft Palate ◽  
Surgical Outcomes ◽  
Velopharyngeal Insufficiency ◽  
Moderate Degree ◽  
Fat Pad ◽  
Buccal Fat Pad ◽  
Pharyngeal Wall ◽  
Mucosal Flap ◽  
Velopharyngeal Closure ◽  
Submucous Cleft Palate

Introduction Furlow double-opposing Z-plasty (DOZ) lengthens the soft palate; however, this lengthening is achieved at the expense of increased mucosal flap tension. Thus, its use is limited in patients with severe tension applied on mucosal flap after DOZ. In this study, DOZ was combined with a buccal fat pad (BFP) flap to maximize palatal lengthening and muscle repositioning. Methods This study included patients who underwent surgical correction for velopharyngeal insufficiency between December 2016 and February 2019. Patients with more than moderate degree hypernasality following primary palatoplasty were included in the study. Patients younger than 4 years of age, those with a submucous cleft palate, or syndromic patients were excluded. Speech outcomes were investigated for those who underwent DOZ only (DOZ group, n = 17) and those in whom a BFP was used (BFP group, n = 15) pre- and postoperatively. The velopharyngeal gaps between the uvula and pharyngeal wall were measured before and immediately after surgery to estimate the palatal length. Results Most patients who received a BFP showed improvement in hypernasality. However, the hypernasality of the DOZ group was more severe than that of the BFP group (p = 0.023). The extent of palatal lengthening was 4.4 ± 1.7 mm and 7.5 ± 2.1 mm in the DOZ and BFP groups, respectively (p = 0.001). Conclusions BFPs reduced the tension of the DOZ mucosal flap and maximized palatal lengthening and muscle repositioning. They promoted velopharyngeal closure in patients with moderate and moderate-to-severe velopharyngeal insufficiency. Hence, our method improves the surgical outcomes of patients with velopharyngeal insufficiency after primary palatoplasty.

Soft palate and oronasal breathing in humans

1984 ◽  
Vol 57 (3) ◽  
pp. 651-657 ◽  
Author(s):  
D. O. Rodenstein ◽  
D. C. Stanescu
Keyword(s):  
Healthy Volunteers ◽  
Soft Palate ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Posterior Pharyngeal Wall ◽  
Nasal Breathing ◽  
Quiet Breathing ◽  
Pharyngeal Wall ◽  
Respiratory Impairment ◽  
Open Mouth

In 20 naive patients without respiratory impairment, we investigated the ability of the soft palate to direct airflow during breathing. Patients were connected to a spirometer, without noseclip. No instructions were given on the breathing route. During quiet respiration, 15 patients breathed solely through the nose, despite an open mouth. During forced vital capacity (FVC) maneuvers, 19 patients expired exclusively through the mouth. When specifically asked to breathe quietly through the mouth, pure nasal breathing was no longer observed. Tidal volume (VT) or FVC were comparable when patients were asked to breathe through the mouth, with or without noseclip: 0.67 +/- 0.46 vs. 0.60 +/- 0.21 liter for VT (mean +/- SD); 4.05 +/- 0.65 vs. 4.18 +/- 0.70 liters for FVC. In eight separate healthy volunteers, the soft palate was shown by fluoroscopy to close the oropharyngeal isthmus during quiet breathing (resulting in pure nasal breathing) and to close the nasopharynx during FVC efforts (resulting in mouth breathing). During oronasal breathing, the soft palate lay in between the tongue and the posterior pharyngeal wall. These data suggest that when both mouth and nose are open, the soft palate is responsible for the partitioning of oronasal flow.

The demography of human papillomavirus (HPV) infections in oropharyngeal cancer patients from 2011-2016: A single Veteran Administration institution.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17532-e17532
Author(s):  
George Anthony Dawson ◽  
Yue Hua Zhang ◽  
Angela Laurio ◽  
Patricia Smith ◽  
Michael Dellatto ◽  
...  
Keyword(s):  
Marital Status ◽  
Head And Neck ◽  
Soft Palate ◽  
Veteran Administration ◽  
Neck Region ◽  
Unknown Primary ◽  
Tobacco Exposure ◽  
Pharyngeal Wall ◽  
Nccn Guidelines ◽  
Hpv Status

e17532 Background: Human papilloma virus (HPV) is a known biologic (viral) carcinogen and has a predilection for tissue in head and neck sites- HPV types 16/18. Current NCCN guidelines recommend HPV testing on newly diagnosed cancers - Head and Neck region - specifically the oropharynx. Methods: After IRB approval, data from our center ranging from 01/01/2011 to 12/31/2016 were collected by using international classification codes (ICD-9) 142, 143, and 146. We enrolled 81 patients for review from of these anatomic sites: Base of tongue, Tonsils, Posterior hypo-pharyngeal wall, soft palate and unknown primary + neck nodes. Data collected: HPV status / age / stage at diagnosis. Risk factors collected were marital status, ethnicity, age, alcohol and tobacco use, and other co-factors. Results: A total of 73 of 81 cases met our criteria for inclusion into review: excluded - 5 with Non-Hodgkin’s lymphoma; 1 with plasma cell neoplasm; 2 excluded - p16 testing only. All enrollees were male. Age range 45 - 91. Mean age: HPV + 64.11 / HPV – 66.76yrs. Anatomic site:BOT-35(48%) /Tonsil-25 (34%) /unknown primacy- 6(8%) /Soft palate– 4(0.05%) /Hypo-pharnyx-3(0.04%). Ethnicity: Non-Hispanic White– 32(44%) /Black-19(26%) /Hispanic – 20 (27%) /American Indian – 1(0.01%) /Unknown – 0. Seventy-three tested for HPV: 36 pos (49%) /37 neg (51% ). Whites were of 49% HPV+. HPV16/18+ in 34 of 36 (94%) tumors. Tobacco exposure ever:32/37(75%) HPV + and 26/36 (75%) HPV - groups. Alcohol use ever: HPV+ 75%; HPV – 67%. Location:BOT/Tonsils were 32/36 (80%) HPV+ cases and 27/37(73%) of HPV – cases. HPV + Marital status: Married 9 (26%) / Never mar 9/Divced 15/Sep 2/Wid 1 - 74% not married. HPV – 37: Married 12 (32%) /Never mar 9 /Divced 9/Sep 5/Wid 2 – 68% not married. Conclusions: HPV +16/18 (34 of 36) infections in our patients (73) were 49% of the overall group. BOT and Tonsil cancers most were the common sites in both groups (+/-). Compared to non-VA patients, our HPV + group used more alcohol and smoked more, and were older - though both groups (+/-) had high usage rates. We noted more divorcees, and lower marriage rate in the HPV+ group. Whites were 44% overall but 49% of HPV + group.

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