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Measurement of Upper Airway Volume in Children with Craniofacial Abnormalities. Laryngoscope 2024; 134:2915-2921. [PMID: 38014817 DOI: 10.1002/lary.31203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/22/2023] [Accepted: 11/03/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE(S) Previous literature has established a high prevalence of upper airway obstruction in children with craniofacial abnormalities. This study aims to perform quantitative airway volume measurements in patients with craniofacial abnormalities and compare them to age and sex-matched controls. METHODS We performed a retrospective review of the records of all children with craniofacial abnormalities who underwent head-and-neck computed tomography (CT) imaging at a single tertiary-care center between 1/1/13 and 12/31/20 using the ICD-10 codes Q75.1, Q75.4, and Q87.0. These patients were then matched by age and sex to patients with isolated craniosynostosis (Q75.0). CT scans were imported into Dolphin Imaging software, and airway volumes were measured for the nasal cavity, nasopharynx, oropharynx, and hypopharynx. The primary outcome was the total airway volume, defined as the sum of these measurements. RESULTS Thirty subjects with craniofacial syndromes were matched to 30 patients with isolated craniosynostosis (controls). In both groups, 18 subjects (60%) were male (p = 0.99). The average ages for syndromic patients and controls were 12.1 and 12.9 months, respectively (p = 0.84). On average, the total airway volumes of syndromic patients were 25% lower than those of controls (p = 0.02). Syndromic patients had 39% smaller nasal cavity volumes (p < 0.001) and 32% smaller nasopharyngeal volumes (p < 0.01). Significant volume differences were not observed for the oropharynx or hypopharynx. CONCLUSION We present a unique technique to measure airway volumes in patients with craniofacial abnormalities. These findings will help practitioners to further understand the anatomy and pathophysiology of disturbed breathing in children with craniofacial syndromes. LEVEL OF EVIDENCE III Laryngoscope, 134:2915-2921, 2024.
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Fetal epignathus: texture analysis beyond surface of tissue using three-dimensional reconstruction models from ultrasound and magnetic resonance imaging data. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 58:789-791. [PMID: 33650724 DOI: 10.1002/uog.23624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/04/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
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Maternal Folic Acid Deficiency Is Associated to Developing Nasal and Palate Malformations in Mice. Nutrients 2021; 13:251. [PMID: 33467180 PMCID: PMC7830789 DOI: 10.3390/nu13010251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/25/2020] [Accepted: 01/14/2021] [Indexed: 11/25/2022] Open
Abstract
Craniofacial development requires extremely fine-tuned developmental coordination of multiple specialized tissues. It has been evidenced that a folate deficiency (vitamin B9), or its synthetic form, folic acid (FA), in maternal diet could trigger multiple craniofacial malformations as oral clefts, tongue, or mandible abnormalities. In this study, a folic acid-deficient (FAD) diet was administered to eight-week-old C57/BL/6J female mouse for 2-16 weeks. The head symmetry, palate and nasal region were studied in 24 control and 260 experimental fetuses. Our results showed a significant reduction in the mean number of fetuses per litter according to maternal weeks on FAD diet (p < 0.01). Fetuses were affected by cleft palate (3.8%) as well as other severe congenital abnormalities, for the first time related to maternal FAD diet, as head asymmetries (4.6%), high arched palate (3.5%), nasal septum malformed (7.3%), nasopharynx duct shape (15%), and cilia and epithelium abnormalities (11.2% and 5.8%). Dysmorphologies of the nasal region were the most frequent, appearing at just four weeks following a maternal FAD diet. This is the first time that nasal region development is experimentally related to this vitamin deficiency. In conclusion, our report offers novel discoveries about the importance of maternal folate intake on midface craniofacial development of the embryos. Moreover, the longer the deficit lasts, the more serious the consequent effects appear to be.
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Choanal atresia. Adv Otorhinolaryngol 2015; 23:65-72. [PMID: 622918 DOI: 10.1159/000400649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Velopharyngeal, speech and dental characteristics as diagnostic aids in 22q11.2 deletion syndrome. JOURNAL OF THE CALIFORNIA DENTAL ASSOCIATION 2011; 39:327-332. [PMID: 21721477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study examines velopharyngeal, speech, and dental parameters as possible diagnostic aids in 22q11.2 deletion syndrome. It is a retrospective study on 56 individuals. Twenty-one percent had a submucous cleft palate and 41 percent required palate surgery for speech. Common dental findings included poor oral hygiene, multiple carious lesions, congenitally missing teeth, class II malocclusion, and open bite.There are common findings that can aid the dental practitioner in recognizingthe syndrome and make appropriate referrals.
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Dynamic obstructions of the equine upper respiratory tract. Part 2: Comparison of endoscopic findings at rest and during high-speed treadmill exercise of 600 Thoroughbred racehorses. Equine Vet J 2010; 38:401-7. [PMID: 16986599 DOI: 10.2746/042516406778400619] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY The reliability of diagnoses of obstructive conditions of the upper respiratory tract (URT) based on examinations performed at rest vs. at exercise is controversial. OBJECTIVE To compare diagnosis of URT by endoscopy at rest with that achieved during high-speed treadmill exercise (HSTE). HYPOTHESIS Endoscopy of URT at rest, when performed in isolation from other simpler techniques is unreliable in the prediction of dynamic respiratory obstructions. METHODS Endoscopic findings of 600 Thoroughbred racehorses during quiet breathing were compared with findings during high-speed treadmill exercise. Other parameters were also assessed for their specificity in diagnosis. RESULTS Endoscopy of the resting horse showed low sensitivity (0.15) in the diagnosis of dorsal displacement of the soft palate (DDSP) and palatal instability (PI). When endoscopy and reported noises were taken together there was still a 35% misdiagnosis rate. Although there was significant association between resting laryngeal function score (LFS) and dynamic vocal cord and/or arytenoid cartilage collapse at exercise, 19% of horses with a grade 4/5 LFS were able to attain and maintain full abduction during exercise and 7% of those with 'normal' grades 1 or 2 LFS at rest showed dynamic laryngeal collapse when exerted. Sensitivity of the diagnostic model was greatly increased (80%) when a history of inspiratory noise and palpable intrinsic muscle atrophy were included. CONCLUSIONS AND POTENTIAL RELEVANCE Endoscopy of the upper respiratory tract of static horses is unreliable in the diagnosis of dynamic obstructions of the URT and should not be used in isolation in surgical decision-making or in the assessment of horses at the time of sale.
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Prevalence of pharyngeal and laryngeal abnormalities in Thoroughbreds racing in Australia, and their association with performance. Equine Vet J 2010; 37:397-401. [PMID: 16163940 DOI: 10.2746/042516405774480021] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Little information is available regarding the prevalence of abnormalities of the upper airway and their association with performance in the general population of Thoroughbred racehorses. OBJECTIVES To describe the prevalence of selected abnormalities of the upper airway and their association with performance in Thoroughbred racehorses in Australia. HYPOTHESIS That abnormalities of the upper airway of Thoroughbred racehorses are associated with poor race performance. METHODS Rhinolaryngoscopy was performed after racing and presence and characteristics of abnormalities of the larynx and pharynx were recorded in a prospective cross-sectional study of Thoroughbred horses racing in Victoria, Australia. RESULTS Rhinolaryngoscopy was performed once on each of 744 horses over 35 months. Fifty abnormalities of the upper airway were detected in 47 horses (6.3%, 95% confidence interval [CI] 4.7-83%). Epiglottic entrapment was detected in 7 horses (0.9%, 95% CI 0.4-1.9%) and was significantly (P = 0.015) associated with superior performance. Grade 2 asymmetry (4 grade scale) of the left arytenoid cartilage was detected in 9 horses (1.2%, 95% CI 0.5-2.4%) and was also associated with superior performance (P<0.001). Ulceration or erosion of the mucosa of the axial surface of one or both arytenoids was detected in 18 horses (2.4%, 95% CI 13-3.8%) and was not associated with alterations in exercise performance (P = 0.31). CONCLUSIONS Epiglottic entrapment, Grade 2 laryngeal asymmetry and mucosal erosions detected in Thoroughbred racehorses were not associated with impaired performance; therefore, surgical correction and concern over laryngeal function in horses with Grade 2 asymmetry may not be necessary in individuals performing to expectation.
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Oculoauriculovertebral complex with an atypical cause of obstructive sleep apnea. Int J Pediatr Otorhinolaryngol 2009; 73:481-5. [PMID: 19111916 DOI: 10.1016/j.ijporl.2008.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Revised: 11/13/2008] [Accepted: 11/16/2008] [Indexed: 11/17/2022]
Abstract
Oculoauriculovertebral spectrum (OAVS) is a birth defect of unknown etiology, often causing obstructive sleep apnea, due to unilateral retrognathia. We describe an adolescent sleep apnea patient, with usual and unusual signs of OAVS. Apart from mandibular hypoplasia, microtia, external auditory canal atresia and cervical vertebrae anomalies, skull base asymmetry was also noted, resulting in aberrant anatomy of the tympanic cavity, and nasopharyngeal obstruction, which was the main source of the patient's apneas. The extended craniofacial abnormalities manifested here, suggest a broader developmental impairment, exceeding the 1st and 2nd branchial arch malformation theory, which is the principal hypothesis for OAVS etiology.
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[Accessory auricle in the nasopharynx in a case]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2007; 42:706. [PMID: 18051579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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10
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Abstract
Congenital choanal atresia (CCA) is the developmental failure of the nasal cavity to communicate with the nasopharynx. The aim of this study was to investigate and analyse the CT findings in such cases. Seven patients with CCA were included in our study over a 3-year period (2001-2004). All had a CT scan of the nasal cavity and nasopharynx to establish the diagnosis and to define the extent and type of atresia. The choanal atresia was found to be more commonly bilateral and more of the mixed (membranous-osseous) type. Bilateral CCA in the neonate is a medical emergency that should be treated as early as possible. Computed tomography is a valuable and easily accessible diagnostic tool.
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What to do if the endotracheal tube will not pass through the nasal passage during fiberoptic nasotracheal intubation. Acta Anaesthesiol Scand 2007; 51:777-8. [PMID: 17567274 DOI: 10.1111/j.1399-6576.2007.01318.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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13
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Dynamic obstructions of the equine upper respiratory tract. Part 1: observations during high-speed treadmill endoscopy of 600 Thoroughbred racehorses. Equine Vet J 2006; 38:393-9. [PMID: 16986598 DOI: 10.2746/042516406778400583] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY AND OBJECTIVE To review the prevalence of single and complex forms of dynamic airway obstructions within a large group of Thoroughbred horses in training referred for investigation of poor performance. METHODS Video-endoscopic recordings of the upper respiratory tract made during a standardised treadmill exercise test of 600 Thoroughbred racehorses were reviewed and analysed in real time and slow motion to identify dynamic collapse by the tissues bordering onto the pharyngeal and laryngeal airways. RESULTS Dynamic collapse within the nasopharynx or larynx was confirmed in 471 of the 600 horses. Dorsal displacement of the soft palate (DDSP; 50%) and palatal instability (33%) were the disorders most frequently identified. It was concluded that deglutition is not a significant event in the triggering of DDSP. Complex forms of dynamic collapse were present in 30% of the horses with upper respiratory tract obstructions. A significant influence of age on the prevalence of DDSP and dynamic laryngeal collapse was identified. There was an increased risk of DDSP in younger horses, and of laryngeal collapse in older horses. No association with gender or format of racing was identified. CONCLUSIONS AND POTENTIAL RELEVANCE Palatal instability and DDSP comprised the most frequently encountered forms of dynamic collapse within the upper respiratory tract of the Thoroughbred racehorses in this study and are probably expressions of the same nasopharyngeal malfunction. Complex obstructions, i.e. where more than one structure collapses into the airway, occur frequently and therefore treatments that address solitary disorders may often be unsuccessful. Younger horses were found to be at greater risk of sustaining DDSP while older horses seemed more at risk to vocal cord collapse but not to collapse of the arytenoid cartilage itself.
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[Paroxysmal inspiratory dyspnea as first sign in a patient with nasopharyngeal meningocele]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2006; 44:595. [PMID: 17083788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Unusual extension of the first branchial cleft anomaly. Eur Arch Otorhinolaryngol 2005; 263:263-6. [PMID: 16267682 DOI: 10.1007/s00405-005-0985-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2004] [Accepted: 04/19/2005] [Indexed: 01/11/2023]
Abstract
First branchial cleft is the only branchial structure that persists as the external ear canal, while all other clefts are resorbed. Incomplete obliteration and the degree of closure cause the varied types of first branchial cleft anomalies. They were classified based on the anatomical and histological features. We present an unusual type of first branchial cleft anomaly involving the external auditory canal, the middle ear and the nasopharynx through the eustachian tube.
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Arteriovenous malformation of the nasopharynx: a case report. Int J Pediatr Otorhinolaryngol 2005; 69:1287-90. [PMID: 15979733 DOI: 10.1016/j.ijporl.2005.03.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2005] [Accepted: 03/23/2005] [Indexed: 11/27/2022]
Abstract
Arteriovenous malformation (AVM) of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent itself truly as a lethal benign disease. We present here an unusual case of an AVM with the size of 1.5 cm x 0.8 cm at the adenoid tissue found in an 8-year-old boy, which is not previously reported in the literature where we treated the patient with surgery alone. Although bleeding is a common presentation with vascular malformations, we have not seen any bleeding in our case. After the surgery, paranasal sinus and neck CT were undertaken. They showed no other AVM.
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Complications in paediatric airway management. Int J Pediatr Otorhinolaryngol 2004; 68:1507-12. [PMID: 15533562 DOI: 10.1016/j.ijporl.2004.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2004] [Revised: 06/15/2004] [Accepted: 06/25/2004] [Indexed: 11/22/2022]
Abstract
Management of the paediatric airway can be difficult. This management in turn can be associated with complications which can be life threatening. We present three cases in which such complications occurred and then go on to discuss the different ways in which these can be prevented.
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Second branchial cleft anomaly presenting as a rudimentary pinna in the nasopharynx of a newborn. EAR, NOSE & THROAT JOURNAL 2004; 83:637-8. [PMID: 15529651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
We describe the case of a 4-day-old girl who presented with an epiglottic cyst that was later identified as a rudimentary pinna attached to the soft palate.
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Abstract
Congenital pharyngolaryngeal band (PLB) is an extremely rare congenital abnormality, characterized by a fibrous web extending from the nasopharynx to the epiglottis. We report a case of unilateral pharyngolaryngeal band in a new-born who presented severe airway obstruction and feeding difficulties. The band extended from the right postero-inferior part of the nasopharynx to the right lateral margin of the larynx. Faucial pillars and tonsil were absent on this side. Endoscopic and radiological assessments excluded associated cervicofacial abnormality. Two endoscopic laser resection procedures were necessary to liberate the larynx from PLB. Clinical and radiological assessment advocated a second pharyngeal pouch development failure as the origin to PLB.
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Transsphenoidal (large craniopharyngeal) canal associated with a normally functioning pituitary gland and nasopharyngeal extension, hyperprolactinemia, and hypothalamic hamartoma. AJR Am J Roentgenol 2003; 180:76-7. [PMID: 12490480 DOI: 10.2214/ajr.180.1.1800076] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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21
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More extensive analysis is needed when assessing facial structure in SIDS. BMJ (CLINICAL RESEARCH ED.) 1999; 318:396-7. [PMID: 9933217 PMCID: PMC1114856 DOI: 10.1136/bmj.318.7180.396a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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22
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[A rare case of tumor-like mass in the nasopharynx]. Vestn Otorinolaringol 1998:54-5. [PMID: 9662985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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23
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[Recurrent meningitis in cleft lip-palate. Sphenopharyngeal meningocele]. HNO 1998; 46:346-7. [PMID: 9606649 DOI: 10.1007/s001060050250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Abstract
Here we report on a boy with both a partial deletion of chromosome 18p and a partial duplication of chromosome 18q, caused by a paternal pericentric inversion (46,XY,rec(18),dup q,inv(18)(p11.2q21.1)pat). The findings in the patient are compared to those in the literature. The symptoms in the described patient can be explained for the major part by the 18p- and 18q+ syndromes separately. A specific 18p-/18q+ syndrome cannot be clearly delineated yet. Inspiratory stridor is a symptom that has not been described before in either 18p- or 18q+, but has been found twice before in patients with the combined 18p-/18q+ syndrome.
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26
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[Intracranial complications after endonasal surgery]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 1996; 43:225-7. [PMID: 8756242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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27
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Apert's syndrome: cephalometric evaluation and considerations on pathogenesis. J Craniofac Surg 1996; 7:23-31. [PMID: 9086898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Apert's syndrome is a malformation characterized by abnormalities in the cranial vault, midfacial malformations, and syndactylia. The present study analyzes the lateral and frontal projections of the teleradiograms from five patients. Data were taken on the skeletal features and an attempt was made to interpret them in terms of functional matrices. We have used cephalometry as a descriptive device although the intent was also to use it to provide a perspective on the pathogenetic data derived from the literature. The hypothesis analyzed is that from the outset of craniofacial pathogenesis there may be a primitive alteration of the cartilaginous template from which are derived endochondral bones. The progressive involvement of the synchondrosis of the cranial base is subsequently transmitted to the membranous structures of the vault and face through the coronal ring and lambdoid suture systems. Although the data gained do not actually confirm this hypothesis, they do provide further support for it.
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Imaging of nasopharyngeal atresia. AJNR Am J Neuroradiol 1995; 16:1936-8. [PMID: 8693998 PMCID: PMC8338210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
CT and MR revealed a case of nasopharyngeal atresia, a malformation in which the soft palate is not formed, and the hard palate extends posteriorly to fuse with the anterior surface of the clivus, resulting in complete isolation of the nasal and oral cavities and the absence of a nasopharynx. We believe this rare anomaly results from abnormal persistence of the embryologic bucconasal plate and/or anomalous migration of the nasoseptal elements.
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Nasopharyngeal teratoma with a difference. INDIAN J PATHOL MICR 1994; 37 Suppl:S15-6. [PMID: 8613155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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One-stage closure of isolated cleft palate with the Veau-Wardill-Kilner V-Y push-back method or the Cronin modification. Cephalometric comparison of nasopharynx. Int J Oral Maxillofac Surg 1993; 22:267-71. [PMID: 8245564 DOI: 10.1016/s0901-5027(05)80513-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The craniofacial structure of 116 consecutive patients with isolated cleft palate was studied by lateral cephalograms at 17-20 years of age. One-stage soft- and hard-palate closure had been done with the Veau-Wardill-Kilner or the Cronin mucoperiosteal palatal V-Y push-back method at the mean age of 1.8 years. The patients treated with the Veau-Wardill-Kilner method showed larger sagittal depths of the bony nasopharynx and nasopharyngeal airway but smaller thickness of the soft tissue on the posterior nasopharyngeal wall. The sagittal depth of the nasopharyngeal airway was larger in patients who had had secondary palatal operations. The effect of sex was significant, males having larger dimensions.
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Abstract
Dyskeratosis congenita is a multisystem disorder with an increased incidence of neoplasia and opportunistic infections. A case is reported as a cause of complete nasopharyngeal atresia.
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Abstract
Cleft lip and palate is known to be associated with a number of other skeletal anomalies. The purpose of this study was to investigate the prevalence of possible malformations of the cervical spine and their relationship to velopharyngeal incompetence. The lateral cephalometric radiographs of 30 patients aged between 14 and 27 years of age with cleft lip and palate were compared with these of a control group, who had been involved in cycle accidents. The radiographs were assessed for morphological anomalies of the first and second cervical vertebrate and, in addition, longitudinal and angular measurements performed. Speech was assessed by electromagnetic articulography. A greater number of cervical spine anomalies were found in patients with cleft lip and palate and these were also associated with significantly (P < 0.05) greater osseous-nasopharyngeal depth.
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The nasopharynx in oral and maxillofacial radiology. I. Benign lesions. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1991; 72:484-91. [PMID: 1656358 DOI: 10.1016/0030-4220(91)90565-t] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This is not a comprehensive review of all benign lesions that can be found in the nasopharynx, but merely a review of the relationship of the nasopharynx to its surroundings. It is also a reminder of the need for the oral and maxillofacial radiologist to be familiar with this area, because it often appears on radiographs made for other purposes, or to investigate problems that have extended to and from the nasopharynx and the oral and maxillofacial region.
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[Extrapulmonary respiratory sounds in newborns: classification and iconographic contribution]. LA PEDIATRIA MEDICA E CHIRURGICA 1989; 11:625-35. [PMID: 2699927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The extra-pulmonary stridors of the newborn represent a frequent and difficult diagnosis pathology for the radiologists and the neonatologist. After an introduction about the most important anatomical dates, A. reviews the reasons of the neonatologic stridor, and emphasizes the vascular congenital anomalies, most important for a early differential diagnosis. Concluding, are reported radiologic findings of this shifty pathology.
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Prometaphase chromosomes in the tricho-rhino-phalangeal syndrome type I. AMERICAN JOURNAL OF MEDICAL GENETICS 1989; 32:524-7. [PMID: 2773997 DOI: 10.1002/ajmg.1320320420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Prometaphase chromosome analysis was undertaken in a patient with familial tricho-rhino-phalangeal syndrome type I (TRPS-I). The patient had apparently normal chromosomes and produced counterevidence to part of Bühler's hypothesis. Thus, although some cases of typical TRPS-I may be derived from a deletion of 8q24.12, others might be caused by gene mutation or submicroscopic deletion involving the corresponding locus within the band 8q24.11----24.13.
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Abstract
Two cases of congenital bony stenosis of the nasal piriform aperture (anterior nares) are presented. Both patients experienced episodes of respiratory distress and clinical symptoms similar to those seen in patients with posterior choanal atresia. The underlying anatomic abnormalities in congenital bony inlet stenosis are quite different from those in choanal atresia and require different surgical approaches for correction. Computed tomography demonstrates in detail the underlying anatomic abnormality and allows differentiation of bony inlet stenosis from choanal atresia.
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Cornella de Lange syndrome or Amsterdam dwarfism. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 1986; 34:149-50. [PMID: 3711008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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38
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[Developing facial hyperdivergence in rhinopharyngeal insufficiency. Pathogenesis and therapeutic protocol]. ACTUALITES ODONTO-STOMATOLOGIQUES 1985; 39:529-56. [PMID: 3915851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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39
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Abstract
Computed tomography facilitates the diagnosis of children with choanal atresia. This modality defines the full anatomic abnormality of bony choanal atresia: medial bowing and thickening of the lateral wall of the nasal cavity, enlargement of the vomer, and fusion of these elements. Bony atresia patients can be clearly separated from those with membranous choanal atresia. In membranous atresia, the lateral wall of the nasal cavity is minimally affected and the vomer is normal. This precise anatomic evaluation aids in determining the surgical approach.
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40
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Abstract
Anatomic and congenital abnormalities of the nasal pharynx may make nasotracheal intubation difficult. We present a case of a patient who was comatose from a drug overdose and who required endotracheal intubation. Blind nasotracheal intubation was attempted and was initially unsuccessful due to the presence of a congenital pharyngeal bursa. After the cause of the obstruction was recognized, guided nasotracheal intubation was accomplished without complications. The patient made an uneventful recovery.
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41
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Abstract
A transnasal approach was employed in 28 neonates (26 blacks and 2 whites) with bilateral choanal atresia. In each patient the atresia was perforated microsurgically with the drill, followed by insertion of a Portex endotracheal tube for a period of three months. By this method a satisfactory nasal respiration was established immediately. Removal of the posterior part of the vomer is crucial to the successful result. During the follow-up, one death was recorded in a microcephalic neonate, unrelated to the operation and another four patients required repositioning of the tube under general anesthesia. We feel that the above technique is simple and definitive with negligible complications.
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Anatomic abnormalities of the pediatric airway. EAR, NOSE & THROAT JOURNAL 1985; 64:47-60. [PMID: 3882393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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43
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Abstract
Taking cognizance of the embryology and newer diagnostic techniques, the transpalatal route is strongly recommended as the optimal surgical procedure for the management of choanal atresia. It should be performed as soon as general anesthesia can be safely administered. In selected instances, but particularly when a patient is at increased surgical risk, necessitating surgical brevity, the endonasal puncture technique should be considered as the initial procedure. Parents must be appraised of the potential for subsequent growth deficiencies, mental retardation, and crossbite.
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44
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Abstract
Posterior choanal atresia has a significant incidence of associated defects. Recently a constellation of defects, bearing the acronym of CHARGE, has been described. Its entities are (ocular) Coloboma, Heart defects, Atresia choanae, Retarded growth and development, Genital hypoplasia and Ear anomalies or hearing loss. Some of these have been previously noted. There are 26 patients in this series, none having the entire CHARGE association, but 7 had several; 3 of the 7 had bilateral choanal atresia. One other patient had a chromosomal defect with an associated heart defect. Two patients had cardiac and other visceral defects. Seven had base of skull abnormalities, 3 of whom had elements of CHARGE, and 9 had congenital hearing loss. Five were normal. CT scan suggests a growth disturbance of the basicranium in some of the patients.
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45
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Abstract
Six patients with both choanal atresia (ChA) and additional malformations are described and another 110 cases with this combination reviewed from the literature. Our study of these cases supports the existence of the CHARGE-association (Coloboma, Heart Disease, Atresia of choanae, Retarded mental development and growth, Genital hypoplasia, Ear anomalies and deafness). Our findings suggest the inclusion of orofacial clefts and oesophageal atresia among the main symptoms of this association. A certain degree of facial dysmorphism (low set, dysplastic ears, retrogenia, antimongoloid slant of palpebral fissures and anteverted nares) was observed in each of our cases. Infants with the bilateral type of ChA plus cardiac defects and those with ChA plus renal malformations have a high mortality rate. The aetiology of the association is not clear. The recurrence risk may be low.
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Abstract
The physician who is called upon to evaluate stridor in the infant or child must be familiar with common congenital lesions of the airway, the symptoms they produce, and methods for their diagnosis and treatment. The authors discuss some of the more common anomalies and review the guidelines for their diagnosis and treatment.
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Choanal atresia: a report of 3 cases. Indian J Pediatr 1984; 51:493-5. [PMID: 6526457 DOI: 10.1007/bf02776439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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49
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[Surgical treatment of congenital choanal atresia in adults]. CESKOSLOVENSKA OTOLARYNGOLOGIE 1984; 33:159-162. [PMID: 6498999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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50
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[Treatment of choanal atresia]. LARYNGOLOGIE, RHINOLOGIE, OTOLOGIE 1984; 63:181-183. [PMID: 6727498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
17 unilateral and 6 bilateral choanal atresias in children were observed in the ENT-Dept. of the University Hospital Erlangen during 1975-1982. Bilateral choanal atresia requires immediate trepanation by using the CO2 or Argon laser technique. The surgical procedure in unilateral choanal atresia is postponed until the age of 4 years. Transnasal microsurgical approach is preferred in these cases because it involves minimal damage to the developing structures. The satisfying results are reported.
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