Oropharyngeal Area Research Articles

RELATIONSHIP BETWEEN THE POSITION OF HEADS OF TEMPOROMANDIBULAR JOINT AND UPPER RESPIRATORY TRACT IN MALOCCLUSION CLASS I AND II

The respiratory organs and the maxillofacial apparatus are quite closely related to each other. Reducing the size of the upper respiratory tract is a factor that contributes to the development and formation of bite pathology and even dysfunction of the temporomandibular joint (TMJ). In recent years, there has been an increase in the prevalence of maxillofacial anomalies among children. The aim of the study Is to determine and to compare the position of the TMJ heads and the anatomical dimensions (anterior-posterior dimensions) of the upper respiratory tract in patients with malocclusion class I and II bite based on cone beam computed tomography findings. The analysis of 39 cone-beam computer tomograms of patients was carried out. According to the ANB angle, all patients were divided into two groups based on the type of malocclusion: group I included patients with malocclusion class I, and group II included patients with malocclusion class II. Measurement and interpretation of cone-beam computer tomography was carried out according to the method of N.A. Rabukhina and the McNamara’s method. The dimensions of the joint space of the temporomandibular joint in three sections (front, top and back both on the right and on the left) had no statistically significant differences. The average value of the joint space on the left and right in the patients of the first group in the front section was 2.5±0.27mm, in the patients of the second group – 3.01±0.35. In the upper part these indicators in patients of the first group were 2.76±0.37 mm, in the second group - 2.65±0.32 mm. In the posterior part the average value of the joint’s gap was 3.06±0.01 mm in patients of the first group and 2.28±0.27 mm in the second group. Measurements of the oropharyngeal area on cone-beam computed tomography were (according to the McNamara’s method): the width of the upper part of the pharynx in the first group - 17.41±0.44 mm, and in the second group averaged 15.82±0.61 mm with statistical significance (р˂0.05). In patients with bite pathology of both classed, according to the McNamara’s method, the lower part of the pharynx is narrowed compared to the norm. The study demonstrated the patients of the II group have a statistically significant difference in the reduction of the pharyngeal upper part width compared to I group and the displacement of the TMJ heads upwards and backwards.

Differential Oral Microbial Input Determines Two Microbiota Pneumo-Types Associated with Health Status.

The oral and upper respiratory tracts are closely linked anatomically and physiologically with the lower respiratory tract and lungs, and the influence of oral and upper respiratory microbes on the lung microbiota is increasingly being recognized. However, the ecological process and individual heterogeneity of the oral and upper respiratory tract microbes shaping the lung microbiota remain unclear owing to the lack of controlled analyses with sufficient sample sizes. Here, the microbiomes of saliva, nasal cavity, oropharyngeal area, and bronchoalveolar lavage samples are profiled and the shaping process of multisource microbes on the lung microbiota is measured. It is found that oral and nasal microbial inputs jointly shape the lung microbiota by occupying different ecological niches. It is also observed that the spread of oral microbes to the lungs is heterogeneous, with more oral microbes entering the lungs being associated with decreased lung function and increased lung proinflammatory cytokines. These results depict the external shaping process of lung microbiota and indicate the great value of oral samples, such as saliva, in monitoring and assessing lung microbiota status in clinical settings.

ATTITUDE TOWARDS COVID-19 IN DENTAL COLLEGE POPULATION: A CROSS SECTIONAL STUDY.

Introduction: In this COVID -19 pandemic dentists are at high risk of cross-infection. The dental practice is a source of cross contamination in the absence of adequate preventive measures. As COVID -19 is highly contagious and use of air rotors adds to air born route for transmission and dentist's proximity to the oropharyngeal area of the patient, a dental professional is always at higher risk. Therefore all the dental students and professionals should be competent with knowledge and must be aware of precautionary methods, social distancing, sanitization and vaccination. Aim: The present study is aimed to assess the attitude towards COVID-19 in dental college population Materials & Methods: This study was conducted among 200 participants, the faculties and students in a dental college. A ten questions multiple choice questionnaire form was prepared on effect of COVID-19 on participant's life and distributed among the participants who were divided into two groups as faculty & students, in the dental college and their response was tabulated and analyzed. Results: The results of this study suggested that majority of participants of both the groups strictly followed precautionary measures, followed social distancing, taken both the doses of vaccination and showed positive attitude towards prevention of further spread of corona virus. Conclusion: The participants in this study seemed to be aware of the detrimental effects of COVID-19 and had good knowledge, attitude and selfcare practice, which are necessary in preventing the spread of COVID-19.

Candidiasis and Other Bacterial Infections among Patients Diagnosed with Burning Mouth Syndrome.

Background and Objectives: Burning mouth syndrome (BMS) is a state in which a patient experiences intraoral burning or a dysesthetic sensation without clinically evident causative lesions in the oropharyngeal area. The disorder is linked to a variety of conditions, including dry mouth, Candida, and bacterial infections. The aim of this study was to determine the incidence of oral Candida and/or bacterial infections among patients with BMS and whether they have an effect on pain/burning and salivary flow levels. Objectives: (1) Gather patient data regarding the presence of oral infections, dry mouth, and pain levels in the morning, afternoon, and evening periods; (2) data analysis and assessment to determine medians, means, frequencies, correlations, and statistically significant differences between patient groups. Materials and Methods: Overall, 173 patients (23 males and 150 females) with BMS and 13 controls (five males and eight females) took part in the study. We measured pain/burning levels, unstimulated and stimulated salivary flow, the percentage of patients infected with Candida species and/or bacterial species, and the said species growth in Petri dishes. Results: Candida albicans was the most commonly found infection among patients with BMS (n = 28, 16.2%). Overall, 21.4% patients with BMS were diagnosed with either C. albicans or another Candida species. Enterobacter had the richest growth among patients with BMS (7.5% out of the infected 10.4% BMS patients). No statistical significance could be noted between the existence of either Candida species or bacterial species infections and changes in pain/burning and salivary flow levels. Negative correlations were noted between age and unstimulated and stimulated salivary flow, and positive correlations were noted between age and Candida andspecific bacteria species’ growth levels. Conclusions: Although patients with present bacterial or Candida infections showed a marginal increase in pain/burning levels, no direct statistically significant associations could be made between the presence of Candida species or other bacteria and the symptoms among patients with BMS.

A new needle biopsy approach for dolphins with lesions in the pterygoid sinus

To the best of our knowledge, there are no previous studies on a surgical approach for lesions in the pterygoid sinus of dolphins as it lies deep in the oropharyngeal area and there is risk of bleeding. For such lesions, we undertook a surgical approach for dolphins under general anesthesia. The line of incision was located on the oral mucosa anterior to the palatine bone. A surgical approach with needle biopsy was used to reach the lesion in the pterygoid sinus from within the crest of the pterygoid. Subsequently, this approach was confirmed to be minimally invasive, simple, and safe for dolphins with lesions in the pterygoid sinus.

CBCT Based Comparison of Pharyngeal Airway Area and Volume in patients with Angle’s Class I and Class II Malocclusion: A Retrospective Study

Aim: To ascertain if there was any association between dental malocclusion and narrow/constricted pharyngeal airway. Methods: It was a retrospective study and cross-sectional in design. Oropharyngeal airway volume and regional area for 58 patients having either Class I or Class II Angles malocclusion were evaluated on the CBCT scans. Results: Oropharyngeal airway volume and area among Angles class I and Class II patients was found to have no statistical difference. There was however statistical difference in the oropharyngeal regional area of male and female patients (t=2.395, p=0.020) with male patients having greater oropharyngeal regional area than female patients. Conclusion: In summary, this research concludes that Angles Class I or Class II malocclusion does not influence oropharyngeal airway volume or area. Gender had no impact on the size of airway volume but had significant influence on the oropharyngeal regional area with male patients having greater oropharyngeal area than females. Keywords: Oropharyngeal airway, CBCT, Class I Malocclusion, Class II Malocclusion

Prospective open pilot study on the use of cam oleum ointment for feline calicivirus disease in cats in Baghdad City

Feline calicivirus (FCV) is a highly contagious virus that causes a mild to severe respiratory infection and oral disease in cats. It is especially common in shelters and breeding colonies, and often infects young cats, this study contained 50 different cats and samples were collected from September 2020 to January 2021. Samples taken by swabs from oropharyngeal and conjunctival area depending on the lesion of FCV infection to investigate viral nucleic acid from collected swabs, then extracting RNA from the swabs and converting it to a cDNA molecule, and last detecting the open reading template gene 2 using specific primer, these samples isolated from veterinary clinics, and shelters, all samples were collected from Baghdad city .Rapid test AG kit and Real time PCR were done to confirm the detection and the results gave us 28 positive results on rapid AG kit and RT-PCR results gave us 32 positive samples and the other 18 samples gave us negative results by detection with nanodrop device before sending all samples for molecular investigation by polymerase chain reaction. Most cats recover completely after a calicivirus infection when we treated with Camoleum ointmentprepared in veterinary medicine college lab.

Changes in Cone-Beam Computed Tomography Pediatric Airway Measurements After Adenotonsillectomy in Patients With OSA

Early intervention using cone-beam computed tomography (CBCT) and adenotonsillectomy for children with obstructive sleep apnea (OSA) may prevent impaired growth, adverse cardiovascular consequences, learning deficits, and poor quality of life. To assess changes in CBCT airway measurements and polysomnography (PSG) parameters that occur after adenotonsillectomy in children with OSA and to determine whether CBCT changes are correlated with apnea-hypopnea index (AHI) reduction. This prospective cohort study was conducted at a tertiary medical center from 2013 to 2016. Children aged 7 to 13 years with PSG-confirmed OSA (ie, AHI ≥1) were recruited. Data analysis was performed from March to July 2021. All participants underwent CBCT and PSG before and after adenotonsillectomy. Changes in PSG and CBCT parameters after adenotonsillectomy were analyzed. A total of 49 children (mean [SD] age, 9.5 [1.8] years; 34 boys [69.4%]) were recruited. Eighteen participants (36.7%) had obesity. After adenotonsillectomy, AHI significantly decreased from 11.4 to 1.2 events per hour (mean difference, -10.24 events per hour; 95% CI, -13.84 to -6.64 events per hour). The following CBCT parameters significantly increased: total airway volume (from 11 265 to 15 161 mm3; mean difference, 3896.6 mm3; 95% CI, 2788.0 to 5005.2 mm3), nasopharyngeal volume (from 2366 to 3826 mm3; mean difference, 1459.7 mm3; 95% CI, 1122.9 to 1796.5 mm3), minimal nasopharyngeal airway area (from 128 to 191 mm2; mean difference, 63.1 mm2; 95% CI, 47.4 to 78.8 mm2), mean nasopharyngeal airway area (from 144 to 231 mm2; mean difference, 86.8 mm2; 95% CI, 67.0 to 106.5 mm2), oropharyngeal volume (from 8898 to 11 335 mm3; mean difference, 2436.9 mm3; 95% CI, 1477.0 to 3396.8 mm3), minimal oropharyngeal airway area (from 82 to 158 mm2; mean difference, 76.2 mm2; 95% CI, 57.0 to 95.4 mm2), and mean oropharyngeal airway area (from 182 to 234 mm2; mean difference, 52.5 mm2; 95% CI, 33.6 to 71.4 mm2). Among all parameters, only body mass index percentile showed large effect size between the group with residual OSA (postoperative AHI ≥1) and the group with resolved disease, with the residual OSA group having a higher body mass index percentile (87.8 vs 61.4; mean difference, 26.33; 95% CI, 10.00 to 42.66). A quantile regression model revealed that total airway volume and minimal oropharyngeal airway area were significantly correlated with reductions in AHI. These findings suggest that in children undergoing adenotonsillectomy, improvements in total airway volume and oropharyngeal minimal airway area were correlated with reduction of AHI. Future studies are needed to assess whether CBCT has a role in the evaluation of children with OSA who are being considered for adenotonsillectomy.

Geometric morphometric analysis of the pharyngeal airway during treatment of Class III malocclusion

The pharyngeal airway is important during diagnosis and treatment planning in orthodontics. This study aimed to compare the changes in the shape of the pharyngeal airway in patients with Class III malocclusion treated with a facemask (FM) with a removable maxillary appliance and modified tandem traction bow appliance (MTTBA). This study consisted of pretreatment and posttreatment lateral cephalograms of 35 subjects with skeletal and dental Class III malocclusion. In the first group, 20 patients (12 males, 8 females; mean age, 10.2 years) were treated with MTTBA. The mean treatment time was 12 months. In the second group, 15 patients (10 males, 5 females; mean age, 10.3 years) were treated with FM. The mean treatment time was 11.7 months. Nineteen pharyngeal landmarks were considered from the image corresponding to the midsagittal plane and marked using tpsDig software (version 2.04; Stony Brook, NY). Pharyngeal airway shape difference between the groups was assessed by performing a Generalized Procrustes analysis. The shape deformation of the pharyngeal airway from the pre- to posttreatment periods was evaluated using the thin-plate spline method. There were no differences between MTTBA and FM groups according to airway shape for pretreatment and posttreatment periods. However, there were some deformities using the enlargement of the nasopharyngeal area in the FM group and oropharyngeal area in the MTTBA group according to pretreatment periods. There were no differences between the groups according to the mean pharyngeal airway shapes when the posttreatment periods of the FM and MTTBA groups were examined.

Association of Human Papillomavirus and Epstein-Barr Virus Infection with Tonsil Cancer in Northeastern Thailand.

Background:Human papillomavirus (HPV) and Epstein-Barr virus (EBV) are associated with head and neck cancer, including tonsil cancer (TC) in the oropharyngeal area. Increasing incidence of HPV and EBV infection in different cancer tissues of oropharynx in both epithelial and lymphoid tissues, have been reported. However, little is known about association of these tumor viruses with TC in the Thai population. Here, we investigated the prevalence of HPV and EBV infection in different histology of TC and their association with TC from Thai patients. Methods:Eighty-three exfoliated tonsil cells from non-cancer controls (NCC) and 65 formalin-fixed paraffin-embedded TC tissues (TC) that were histologically classified as tonsillar squamous-cell carcinoma (TSCC) or diffuse large B-cell lymphoma (DLBCL) were studied. Prevalence of HPV and EBV infection was determined by real-time PCR. HPV genotyping was performed by reverse line blot hybridization and HPV genome status was investigated by multiplex qPCR. Localization of EBV infection was determined by EBER in situ hybridization. Results:Infection of HPV and EBV in TC cases was 16.9% and 30.8%, whereas in exfoliated tonsil cells was 1.2% and 66.3% respectively. HPV infection was significantly higher in TSCC (30.6%) than DLBCL samples (13.8%). HPV58 was commonly detected and presented as an integrated form in TSCC, whereas only episomal form was found in DLBCL. EBV infection was significantly higher in DLBCL (44.8%) than TSCC samples (19.4%), and detected in both lower than among exfoliated tonsil cell samples (66.3%). By EBER in situ hybridization in TSCC, EBV infection localized both in epithelial cells and infiltrating lymphocytes. The co-occurrence of HPV and EBV infection was 11.11% and 13.79% of TSCC and DLBCL, respectively, was associated with well-differentiated TSCC. Conclusion:HPV and EBV infection was significantly involved in a specific TC tissue, and associated with a good clinical outcome in TSCC.

The relationship between mandibular advancement, tongue movement, and treatment outcome in obstructive sleep apnea.

To characterize how mandibular advancement enlarges the upper airway via posterior tongue advancement in people with obstructive sleep apnea (OSA) and whether this is associated with mandibular advancement splint (MAS) treatment outcome. One-hundred and one untreated people with OSA underwent a 3T magnetic resonance (MRI) scan. Dynamic mid-sagittal posterior tongue and mandible movements during passive jaw advancement were measured with tagged MRI. Upper airway cross-sectional areas were measured with the mandible in a neutral position and advanced to 70% of maximum advancement. Treatment outcome was determined after a minimum of 9 weeks of therapy. Seventy-one participants completed the study: 33 were responders (AHI<5 or AHI≤10 events/hr with >50% AHI reduction), 11 were partial responders (>50% AHI reduction but AHI>10 events/hr), and 27 nonresponders (AHI reduction<50% and AHI≥10 events/hr). Responders had the greatest naso- and oropharyngeal tongue anterior movement (0.40 ± 0.08 and 0.47 ± 0.13 mm, respectively) and oropharyngeal cross-sectional area enlargement (6.41 ± 2.12%) per millimeter of mandibular advancement. A multivariate model that included tongue movement and percentage of airway enlargement per millimeter of mandibular advancement along with baseline AHI correctly classified 69.2% (5-fold cross-validated 62.5%, n = 39) of participants in response categories when the jaw was advanced in the range that would usually be regarded as sufficient for clinical efficacy (> 4 mm). In comparison, a model using only baseline AHI correctly classified 50.0% of patients (5-fold cross-validated 52.5%, n = 40). Tongue advancement and upper airway enlargement with mandibular advancement in conjunction with baseline AHI improve treatment response categorization to a satisfactory level (69.2%, 5-fold cross-validated 62.5%).

Sensory representation and detection mechanisms of gut osmolality change.

Ingested food and water stimulate sensory systems in the oropharyngeal and gastrointestinal areas before absorption1,2. These sensory signals modulate brain appetite circuits in a feed-forward manner3-5. Emerging evidence suggests that osmolality sensing in the gut rapidly inhibits thirst neurons upon water intake. Nevertheless, it remains unclear how peripheral sensory neurons detect visceral osmolality changes, and how they modulate thirst. Here we use optical and electrical recording combined with genetic approaches to visualize osmolality responses from sensory ganglion neurons. Gut hypotonic stimuli activate a dedicated vagal population distinct from mechanical-, hypertonic- or nutrient-sensitive neurons. We demonstrate that hypotonic responses are mediated by vagal afferents innervating the hepatic portal area (HPA), through which most water and nutrients are absorbed. Eliminating sensory inputs from this area selectively abolished hypotonic but not mechanical responses in vagal neurons. Recording from forebrain thirst neurons and behavioural analyses show that HPA-derived osmolality signals are required for feed-forward thirst satiation and drinking termination. Notably, HPA-innervating vagal afferents do not sense osmolality itself. Instead, these responses are mediated partly by vasoactive intestinal peptide secreted after water ingestion. Together, our results reveal visceral hypoosmolality as an important vagal sensory modality, and that intestinal osmolality change is translated into hormonal signals to regulate thirst circuit activity through the HPA pathway.

A Case of Pharyngeal-Cervical-Brachial Variant of Guillain-Barré associated with Campilobacter Jejuni Infection

The pharyngeal-cervical-brachial variant of Guillain-Barré syndrome is a rare but well documented in the adult population, characterized by rapidly progressive weakness of oropharyngeal and cervicobrachial areas with areflexia in the upper limbs. We describe a 19-year-old young man with predominantly pharyngeal-cervical-brachial weakness and pronounced bulbar symptoms. Atypical Guillain-Barré variants can be challenging in early disease stage and should be considered in the differential diagnosis of a young adult presenting with bulbar palsy.

Randomised, multicentre, prospective interventional study to evaluate the efficacy of immediate diet in addition to standard mouth rinsing in reducing local adverse events of inhaled corticosteroid among asthmatic patients: a pilot study

AbstractBackgroundInhaled corticosteroid (ICS) is recommended as first‐line therapy for all asthmatic patients. However, regular use of ICS is always associated with occurrence of local adverse events (LAEs) in the oropharyngeal area that may compromise asthma control. This study introduced a new intervention, namely immediate diet in addition to standard mouth rinsing (ID‐SMR), for better preventing LAEs.AimTo investigate the efficacy of the new intervention, in terms of reducing occurrence of ICS‐induced LAEs, as compared to standard mouth rinsing. To compare the level of asthma control between standard mouth rinsing method and the new intervention in the participants.MethodsTwo public health clinics and two public hospitals in the Kedah area participated in this study. Participants were randomised into a control arm (standard mouth rinsing) and interventional arm (new intervention) to complete four visits with one‐month intervals. In each visit, participants were interviewed on incidences of LAEs and asthma control levels were assessed. This study (NMRR‐18‐3113‐44829‐IIR) was approved by the Medical Research and Ethics Committee, Malaysia.ResultsTwelve participants per arm completed this study. Participants with one or more LAEs in the control group were significantly higher (p &lt; 0.05) than in the interventional group at last visit. Incidence of each LAE showed a declining trend in the interventional group but remained almost the same in the control group. A similar increment was observed in participants with good asthma control from baseline visit to last visit with non‐significant difference between the two groups.ConclusionsImmediate diet in addition to mouth rinsing method can effectively minimise the occurrence of LAEs, but is not better in improving asthma control.

RELATIONSHIP BETWEEN CLASS I-II MALOCCLUSIONS AND UPPER RESPIRATORY TRACT DISEASES

In recent years, there has been an increase in the prevalence of dental anomalies among children, and sagittal occlusion anomalies range from 33 to 67% of them. Quite high prevalence of distal occlusion causes morphological changes in the structure of the dentition that lead not only to functional impairment in the dentofacial system, but also in the entire oropharyngeal area. This forces scientists to search for new methods for the diagnosis and differential diagnosis of the conditions. The purpose of this study is to determine and compare anatomical dimensions (anteroposterior size and volume) of the upper respiratory tract in patients with occlusion pathology class I and II on the basis of cone-beam computed tomography. We measured the width of the upper, lower part of the pharynx according to the McNamara method, and the volume on 46 tomograms of patients with dentoalveolar anomalies aged from 8 to 29 years, who were divided into two groups according to the ANB angle into classes I and II. The patients of the group I had the average volume of 10.1 ± 1.27 cm3. According to the McNamara method, the width of the upper pharynx was 17.41 ± 0.44 mm, and width of the lower pharynx was 10.1 ± 0.73 mm. The patients of group 2 showed that the average value of the airpassageways volume was 9.3 ± 0.71 cm3. There was a statistically significant difference in the reduction of the width of the upper pharynx (р˂0, 05). Decrease in the width of the lower respiratory tract in the 1st and 2nd groups in the patients aged 15-29 years may be associated with changes in the cervical spine, resulting from postural disorders of the locomotive apparatus, which increases with age and affects the severity of the dental anomaly and the narrowing of the airways in the lower part.

Rare Report Case of Oral Verruca Vulgaris on Torus Palatinus.

Verruca vulgaris, also known as common warts, is most often seen on the skin of hands and feet. Human papilloma virus (HPV) plays an aetiological role in the development of this lesion. Oral verruca vulgaris (OVV) may occur on the palate, buccal mucosa, and tongue. Although asymptomatic and benign, HPV has been linked to squamous cell carcinoma in the oral cavity and oropharyngeal areas. Therefore, prompt surgical removal of OVV is warranted. We report a case of a OVV in a 48-year-old male patient on palate. The lesion was a white nonscrapable lesion in the middle of a torus palatinus. Excisional biopsy was done together with surgical removal of torus palatinus. Histopathological analysis confirmed the diagnosis of OVV.

Genome of Helicobacter pylori and Serotype of HPV Detected in Oropharyngeal and Laryngeal Cancer and Chronic Inflammation Patients.

Objective: Oropharyngeal/laryngeal carcinoma are common cancers of the upper aerodigestive system. Human papillomavirus (HPV) is described as the most frequent in the cancer of unknown primary. The presence of Helicobacter pylori (HP) in the oral cavity is discussed in some papers. The aim of study: To analyze the incidence of HPV and HP in oropharyngeal/laryngeal cancer persons versus persons with chronic tonsillar inflammation and healthy persons. Methods: The samples were taken in three groups: (1) tissue of oropharynx/larynx cancer (103 specimens); (2) tissue of palatine tonsils (85 specimens); and (3) healthy control group (50 specimens). We analyzed the presence of HP (PCR) and HPV genomic DNA (Sacace HPV High-Risk Screen Real-TM Quant) in the samples. Results: HP was detected in 86 samples (83.5%) and high-risk HPV in 62 samples (60.2%). We found a very high incidence of HP. In the cancer group, HP was detected in 82.5% cases and HPV positivity in 57.8%. In total, 7.2% of the cancer patients were negative for HP and HPV together. In turn, 53.6% of the cancer patients were positive for HP and HPV together. Four cases (4.2%) were positive for HPV only. VacA positivity was detected in 82 (79.6%) of the cancer cases and VacA negativity in 21 (20.4%) if the cancer cases. The incidence of HP in chronic inflammation (n = 85) was 65 cases (76.5%) and the incidence of HPV was 38 cases (44.7%). VacA positivity was detected in 59 (69.4%) of the chronic inflammation cases and VacA negativity was found in 26 (30.6%) of the chronic inflammation cases. Regarding the control group, we found HP positivity in 5 cases (11.1%) and HPV positivity in 19 cases (42.2%). There was VacA positivity in 6 cases (50.0%) of the control group. Statistically significantly lower prevalence of HP (p < 0.001) and HPV (p = 0.006) was found in the control group. Conclusions: We suggest that the palatine tonsils are colonized by HP. In our study, HP was present in oropharyngeal cancer in more cases in comparison with HPV infection. The presence of VacA from HP can have an influence on the human epithelial and immune cells’ regulation ways. Our results do not support idea that the CagA-positive HP is a primary carcinogen in oropharyngeal area.

Pharyngeal airway space changes and stability following an extended LeFort-I osteotomy advancement in cleft lip and palate and non-cleft lip and palate patients: A long term comparison study

PurposeThe aim of this study was to evaluate effects of extended maxillary advancement osteotomy on pharyngeal airway space (PAS) in mid-facial deficient cleft lip and palate (CLP) patients and mid-facial deficient non-CLP patients. MethodsPharyngeal airway space (PAS) of 10 CLP and 10 non-CLP patients with the mean age of 19 years 10 months was measured on digitized lateral cephalograms taken shortly before maxillary advancement operation with Quadrangular Le Fort I osteotomy (QLF-I) (T0), early post-operative, (T1) and long term post-operative (T2). Two way repeated analysis of variance, independent samples t-test and correlations tests were used for statistical analysis of airway and skeletal changes. ResultsTotal PAS depth and area was significantly increased after the advancement and was stable in long term post-operative period for CLP and non-CLP patients. Nasopharyngeal and velopharyngeal airway space depth and area was statistically increased at T1 and T2 for both groups. Oropharyngeal airway depth and area showed no significant statistical difference at any of the time points. The effect of QLF-I osteotomy on (PAS) was similar in both CLP and non-CLP patients. ConclusionsNasopharyngeal, velopharyngeal, and total pharyngeal airway space depth and area increased after maxillary advancement with the QLF-I osteotomy; this increase was stable in long term follow up. Maxillary advancement with the QLF-I technique had no significant effect on oropharyngeal airway space depth and area in both CLP and non-cleft patients.

Study on the structural changes of pharyngeal cavity after bariatric surgery in obese patients with obstructive sleep apnea

Objective:To study whether and how bariatric surgery changes the structure of the pharyngeal cavity in obese patients with obstructive sleep apnea（OSA）. Methods:Forty-two patients who underwent laparoscopic sleeve gastrectomy were recruited. Morphological indicators（BMI, neck and waist circumference）, PSG and acoustic pharyngometry indicators were evaluated pre-operatively and 3, 6, and 12 months post-operatively. Results:All indicators including morphology, pharyngeal cavity structure and OSA severity changed significantly after surgery. Among them, BMI, neck circumference, waist circumference and AHI value were significantly reduced（P<0.001）, while pharyngeal cavity volume, pharynx volume, oropharyngeal junction area, glottis area and LSaO2 increased significantly（P<0.001）. The results of multiple comparisons showed that BMI, neck and waist circumference decreased significantly in the first 6 months, and no further decline occurred during 6 to 12 months postoperatively. The decrease in AHI and LSaO2 mainly occurred within the first 3 months postoperatively, while there was no statistically significant difference in these two indicatiors between 3 months vs. 6 months, 6 months vs. 12 months postoperatively. The area of the oropharyngeal junction increased significantly within 0 to 3 months after surgery, while the volume of the pharyngeal cavity and the area of the glottis increased at 6 months and 12 months after surgery. Conclusion:Bariatric surgery can significantly reduce body weight and reduce fat accumulation in the neck. It can also enlarge the volume and cross-sectional area of the pharyngeal cavity, and improve upper airway obstruction, therefore reduce the symptoms of sleep apnea in obese patients with OSA to a certain extent.

Importance in the Occurrence Distribution of Minimum Oropharyngeal Cross-Sectional Area in the Different Skeletal Patterns Using Cone-Beam Computed Tomography.

Purpose Obstructive sleep apnea is a condition involving repetitive partial or complete collapse of the pharyngeal airway, especially in patient with mandibular hypoplasia. The present study investigated the differences between the volume of the oropharyngeal airway and the minimum axial area in three skeletal patterns through the use of cone-beam computed tomography (CBCT). Materials and Methods CBCT scans of 147 patients were collected to measure the upper oropharyngeal airway volume (UOV), lower oropharyngeal airway volume (LOV), upper oropharyngeal airway area (UOA), minimum upper oropharyngeal airway area (MUOA), lower oropharyngeal airway area (LOA), minimum lower oropharyngeal airway area (MLOA), anatomical structures (orbitale, Or; porion, Po; pogonion, Pog; hyoid, H; second cervical vertebra, C2; fourth cervical vertebra, C4), and relevant angles. Statistical analysis was performed using analysis of variance and Pearson's test. Results Compared with patients in Class II, those in Class III and Class I exhibited a significantly anterior position of H and Pog. The vertical positions of H and Pog revealed no significant difference between the three skeletal patterns. Patients in skeletal Class III exhibited significantly larger oropharyngeal area (UOA, MUOA, LOA, MLOA) and oropharyngeal airway (UOV and LOV) than those in skeletal Class II did. The horizontal position of Pog had a moderately significant correlation with UOA (r = 0.471) and MUOA (r = 0.455). Conclusion Patients in skeletal Class II had significantly smaller oropharyngeal airway areas and volumes than those in Class III did. The minimum oropharyngeal cross-sectional area had a 67% probability of occurrence in the upper oropharyngeal airway among patients in Class I and Class II and a 50% probability of occurrence among patients in Class III.