Cleft of the secondary palate without cleft lip diagnosed with three-dimensional ultrasound and magnetic resonance imaging in a fetus with Fryns' syndrome.
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We present a case of Fryns' syndrome diagnosed prenatally using three-dimensional (3D) ultrasonography and magnetic resonance imaging (MRI). A cleft of the soft palate was diagnosed using 3D thick-slice ultrasonography. Other sonographic findings included a right diaphragmatic hernia, enlarged echogenic kidneys and severe polyhydramnios. The detection of the cleft palate was instrumental in suggesting the diagnosis of Fryns' syndrome in a fetus which also had a diaphragmatic hernia. These findings were also demonstrated with prenatal MRI. The technique of imaging the soft palate en face using a thick-slice technique is presented. (+info)
Successful engraftment of cultured autologous mesenchymal stem cells in a surgically repaired soft palate defect in an adult horse.
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The objective of this study was to graft autologous mesenchymal stem cells (MSCs) at the site of surgical repair of a soft palate defect in an adult horse in an attempt to improve wound healing and to investigate whether the transplanted MSCs would integrate into the soft palate structure and participate in regeneration. Bone marrow was collected from an adult horse with a full-thickness soft palate defect. The MSCs were isolated, cultured in monolayers, and labeled with 5-bromo-2-desoxymidine (BrdU) and chloromethylbenzamido-DiI-derived (cm-DiI) before transplantation. The soft palate defect was repaired by mandibular symphysiotomy, and the labeled MSCs were injected into the repaired soft palate. Postmortem examination revealed that 90% of the soft palate defect had been sutured. Staining by BrdU and cm-DiI was intense in the soft palate tissue. Labeled MSCs were detected in tissue slices from the injection sites. The cells were organized in a manner similar to that in native soft palate tissue, indicating successful engraftment. (+info)
Pharyngeal airway changes following mandibular setback surgery.
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Treatment of dentofacial deformities with jaw osteotomies has an effect on airway anatomy and therefore mandibular setback surgery has the potential to diminish airway size. The purpose of this study was to evaluate the effect of mandibular setback surgery on airway size. 8 consecutive patients were examined prospectively. All patients underwent mandibular setback surgery. Cephalometric analysis was performed preoperatively and 3 months post operatively with particular attention to pharyngeal airway changes. Pharyngeal airway size decreased considerably in all, patients thus predisposing to development of obstructive sleep apnea. Therefore, large anteroposterior discrepancies should be corrected by combined maxillary and mandibular osteotomies. (+info)
Neuronavigation-assisted transoral-transpharyngeal approach for basilar invagination--two case reports.
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Two patients presented with congenital basilar invagination manifesting as progressive myelopathy. Both patients underwent surgery using a neuronavigation-assisted transoral-transpharyngeal approach. The Brain-LAB Vector Vision navigation system was used for image guidance. The registration accuracies were 0.9 and 1.3 mm. After decompression, posterior stabilization was performed. Both patients had an uneventful postoperative course. The transoral-transpharyngeal approach with the neuronavigation system provides safe exposure and decompression for basilar invagination. (+info)
Immunohistochemical evaluation of metallothionein in palatal mucosal cells of mice treated with 4NQO.
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OBJECTIVE: Metallothionein (MT) may play a preventive role in various carcinogenic process. 4NQO is an alkaline compound and potent mutagen that causes the formation of DNA adducts. The purpose of this study was to evaluate the immunoexpression of MT in palatal cells of mice submitted to the carcinogen 4NQO. STUDY DESIGN: C57BL/6 mice received applications of 4NQO to palate for periods of 8, 16, 20 and 24 weeks (experimental group). A control group received only applications of propylene glycol for the same periods. Subsequently animals of experimental and control groups were sacrificed and the palate was histologically analysed and MT immunohistochemistry performed. RESULTS: Although morphological atypical features were scant, the expression of MT was higher in the experimental group in comparison to controls. There was an amplified induction of MT expression in oral epithelium of mice treated by 4NQO. CONCLUSION: These results suggest that MT may act as an endogenous defensive factor against 4NQO in early phases of oral carcinogenesis. (+info)
Velopharyngeal anatomy in 22q11.2 deletion syndrome: a three-dimensional cephalometric analysis.
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OBJECTIVE: 22q11.2 deletion syndrome is the most common genetic cause of velopharyngeal dysfunction (VPD). Magnetic resonance imaging (MRI) is a promising method for noninvasive, three-dimensional (3D) assessment of velopharyngeal (VP) anatomy. The purpose of this study was to assess VP structure in patients with 22q11.2 deletion syndrome by using 3D MRI analysis. DESIGN: This was a retrospective analysis of magnetic resonance images obtained in patients with VPD associated with a 22q11.2 deletion compared with a normal control group. SETTING: This study was conducted at The Children's Hospital of Philadelphia, a pediatric tertiary care center. PATIENTS, PARTICIPANTS: The study group consisted of 5 children between the ages of 2.9 and 7.9 years, with 22q11.2 deletion syndrome confirmed by fluorescence in situ hybridization analysis. All had VPD confirmed by nasendoscopy or videofluoroscopy. The control population consisted of 123 unaffected patients who underwent MRI for reasons other than VP assessment. INTERVENTIONS: Axial and sagittal T1- and T2-weighted magnetic resonance images with 3-mm slice thickness were obtained from the orbit to the larynx in all patients by using a 1.5T Siemens Visions system. OUTCOME MEASURES: Linear, angular, and volumetric measurements of VP structures were obtained from the magnetic resonance images with VIDA image-processing software. RESULTS: The study group demonstrated greater anterior and posterior cranial base and atlanto-dental angles. They also demonstrated greater pharyngeal cavity volume and width and lesser tonsillar and adenoid volumes. CONCLUSION: Patients with a 22q11.2 deletion demonstrate significant alterations in VP anatomy that may contribute to VPD. (+info)
Septic epiglottic chondritis with abscessation in 2 young Thoroughbred racehorses.
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Septic epiglottic chondritis with abscessation diagnosed in 2 Thoroughbred racehorses. Infected cartilage removed videoendoscopically followed by systemic antibiotics. The infectious process was successfully controlled, but permanent dorsal displacement of the soft palate (DDSP) with a shortened, deformed epiglottic cartilage developed. Surgery for the DDSP using bilateral partial sternothyroidectomy or laryngeal tie-forward failed. (+info)
Preliminary radiographic observations of the tongue-repositioning manoeuvre.
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The tongue-repositioning manoeuvre (TRM) is a method to place the tongue in direct contact with the hard palate. The TRM makes use of voluntary generation of negative interocclusal pressure controlled by an intra-extraoral pressure indicator device in combination with an oral shield. The aim of the study was to investigate whether the TRM influences vertical tongue position and/or tongue-velum contact. Ninety consecutive patients (75 males, aged 26-76 years, and 15 females, aged 36-70 years) who presented with snoring and/or obstructive sleep apnoea (OSA) were examined at the University of Gottingen. Two cephalograms, with and without the TRM, were taken and traced. The data were analysed using Wilcoxon matched-pairs signed-rank test. Evaluation of the TRM demonstrated a significant increase (P < 0.01) of the mean tongue-velum contact from 6.3 to 24.5 mm and a significant decrease (P < 0.01) of the mean tongue-palate distance (12.3-3.1 mm) measured perpendicular to the nasal line. This was compatible with an intensification of posterior mouth closure and a contact position of the tongue with the palate. (+info)