Oropharyngeal Area Research Articles

Characterizing best practices for tonsil-oral-scrubbing (TOSc) collection for PRRSV RNA detection in sows

BackgroundA Tonsil-Oral-Scrubbing (TOSc) method was developed to sample the sow’s oropharyngeal and tonsillar area without snaring and has shown comparable porcine reproductive and respiratory syndrome virus (PRRSV) RNA detection rates with tonsil scraping in infected sows. This study investigated the effect of specific TOSc collection factors on the PRRSV RT-rtPCR results (detection rates and Ct values). Those factors include whether the sow was snared or not snared at TOSc collection (“snared” vs. “not snared”); whether the sow was laying down or standing at collection (“laying down” vs. “standing”); and type of collectors used for TOSc collection (“TOSc prototype” vs. “Spiral-headed AI catheter (SHAC)”). Volume of fluid was compared between “snared” and “not snared” groups, and collection time was compared between “laying down” and “standing” groups as well.ResultsThe effect for each factor was assessed in three independent studies following the same design: TOSc was collected twice from each studied sow, once with the baseline level for a factor (“not snared”, or “standing”, or “TOSc prototype”), and another time followed by the other level of the paired factor (“snared”, “laying down”, or “SHAC”, correspondingly). Results showed that “not snared” TOSc had numerically higher PRRSV RNA detection rate (60.7% vs. 52.5%, p = 0.11), significantly lower median Ct values (31.9 vs. 32.3, p < 0.01), and significantly higher volume of fluid than “snared” samples (1.8 mL vs. 1.2 mL, p < 0.01); “laying down” TOSc samples did not differ statistically (60.7% vs. 60.7%) in the PRRSV RNA detection rate, obtained numerically lower median Ct values (30.9 vs. 31.3, p = 0.19), but took 40% less collection time compared to “standing” TOSc samples; samples collected using the “TOSc prototype” had numerically higher PRRSV RNA detection rate (91.7% vs. 88.3%, p = 0.27) and significantly lower median Ct values (32.8 vs. 34.5, p < 0.01) than that from “SHAC”.ConclusionsUnder the conditions of this study best practices for TOSc collection aiming higher detection rate of PRRSV RNA while minimizing time for collection were suggested to be sampling TOSc without snaring, when sows are laying down, and using a prototype TOSc collector.

Evaluation of the Effects of Orthopedic Treatment on the Dentofacial Structure and Upper Airway of Subjects with Skeletal Class III Malocclusion.

The present study aimed to evaluate the effect of rapid maxillary expansion (RME) and face mask treatment on the upper airway in patients with maxillary retrusion in two dimensions using digital cephalograms and volumetric evaluation using acoustic rhinometric measurements. A total of 22 individuals with a concave profile and skeletal and dental Class III malocclusion during growth and development with a mean age of 9.9±1.38 years were included in the study. A bonded RME appliance and a petit face mask were adapted for the patients. Before treatment (T0) and after maxillary protraction (T1), lateral cephalometric films and acoustic rhinometric recordings were obtained. The dependent sample t-test was used for statistical evaluation. Cephalometric analysis revealed forward movement of the maxilla and backward downward rotation of the mandible. A significant increase was observed in the nasopharyngeal and oropharyngeal regions of the upper airway. Three-dimensional evaluation of the upper airway by acoustic rhinometry revealed only an increase in the volumes of the left nasal cavity after decongestant administration. A statistically significant increase in acoustic rhinometric measurements in nasal valves. When the correlation of the cephalometric findings of the nasopharyngeal region with the acoustic rhinometry findings was examined, no statistically significant relationship was found. As a result of this study, we observed an increase in the cephalometric measurements of the nasopharyngeal and oropharyngeal areas. A significant increase was observed in the minimal cross-sectional area measured by acoustic rhinometry.

Significance of p16 in Site-Specific Human Papillomavirus-Positive and Negative Head and Neck Squamous Cell Carcinoma (HNSCC).

Head and neck squamous cell carcinoma (HNSCC) represents a group of cancers characterized by diverse origins and changing epidemiological patterns. The significance of high-risk human papillomavirus (HPV) infection in certain HNSCC cases has gained attention for its impact on the disease's behavior. Our current research focused on exploring the importance of using p16 as an HNSCC biomarker, particularly in the context of HPV infection, assessing its value in prognosis, and examining its variation across different tumor locations. A retrospective analysis was carried out on 100 HNSCC patients from a tertiary care center, with particular attention paid to p16 expression, HPV status, clinic-pathological characteristics, and prognosis. HPV was detected using polymerase chain reaction (PCR) techniques, and p16 expression was evaluated by immunohistochemistry. According to the ethical guidelines outlined in the Declaration of Helsinki, multivariate analysis assessed the prognostic value of p16. Our analysis demonstrated a significant correlation between HPV status and p16 expression in HNSCC cases. A vast majority of 58 (96.7%) HPV-+cases exhibited p16 overexpression, contrasting sharply with only two (5%) in the HPV--group. Patients with tumors that were both p16+and HPV+exhibited more favorable overall survival rates. In contrast, those with p16-and HPV-tumors experienced the poorest survival outcomes. Notably, having a p16--status in HPV+cases emerged as an independent factor for reduced survival. Additionally, the study revealed distinct variations in p16 expression based on tumor location, particularly within the oropharyngeal area. The study established that p16 is a dependable indication for the existence of HPV in HNSCC and highlights its significant role as a prognostic factor, particularly in cases that are p16--yet HPV-+. These findings underscore the importance of adopting site-specific treatment approaches in HNSCC management and contribute to a deeper understanding of p16's role in the disease, thereby aiding in more effective risk assessment and treatment planning.

A Rare Case of Giant Epignathus (Teratoma) of Left Palatine Tonsil: A Case Report.

Teratomas are rare tumors that originate from all three primary germinal layers and can develop anywhere along the body's midline, most commonly in the sacrococcygeal area. Within the head-and-neck region, they are infrequent, especially in the oropharyngeal area, and predominantly occur in infants. This case report presents an unusual instance of a teratoma in the left palatine tonsil, also known as giant epignathus, of a 25-year-old female. The patient experienced a progressively enlarging mass over six to seven months without recurrent sore throat, fever, respiratory difficulties, or weight loss. Clinical and imaging assessments revealed a 2cm x 3cm irregular mass in the left palatine tonsil, which was surgically excised. Histopathology confirmed a mature teratoma. The patient was followed up for six months without evidence of recurrence. This case underlines the importance of considering teratomas in the differential diagnosis of tonsillar masses, even in adults, and highlights complete surgical excision as the treatment of choice to minimize recurrence risks and achieve optimal patient outcomes.

Results of the study of factors predicting the risk of the development of grade III radiation-induced mucositis during radiation or chemoradiation therapy in patients with oral cavity and oropharynx cancer.

Today, a number of methods and ways of prevention and treatment of radiation- -induced mucositis of the oral cavity and oropharynx have been developed, but the represented approaches are still not effective enough. Therefore, to increase the effectiveness of the prevention and treatment of radiation-induced mucositis, it is necessary to approach this problem comprehensively and individually, and to evaluate the factors affecting the development of mucositis. In this single-center prospective controlled non-randomized clinical trial, the results of clinical observation of the development of complications of radiation and chemoradiation therapy in 105 patients with a newly diagnosed squamous cell cancer of the oral cavity and oropharynx were analyzed. Factors affecting the risk of the development of grade III radiation-induced mucositis including the age, gender of the patients, their general condition before the treatment according to World Health Organisation scales, type of the treatment and its doses, additional use of immunotherapy with alpha/beta defensins, characteristic signs of the tumor process and all indices of the immune status of the patients before the treatment have been analyzed. The method of construction and analysis of one-factor logistic regression models, where 24 indices were analyzed as factorial features, showed that the reduction of the risk of the development of grade III radiation-induced mucositis is predicted by several factors: immunotherapy, gender, serum concentrations of IgG and IgA. A decrease (P &lt; 0.001) in the risk of the development of grade III radiation-induced mucositis was revealed if immunotherapy with alpha/beta defensins (with a total dose of 40 mg) was included into the treatment scheme (relative odds (RO) 0.05; 95% reference interval (RI) 0.02-0.18), in comparison with patients of the groups where it was not present or this immune agent was used in a total dose of 60 mg (P = 0.001, RO 0.06; 95% RI 0.01-0.30). The next factorial sign was gender, namely the risk of the development of grade III radiation-induced mucositis was lower for men (P = 0.003; RO 0.15; 95% RI 0.04-0.53) compared to women. An increase (P = 0.024) in the risk of the development of grade III radiation-induced mucositis with an increase in the initial level of IgG serum concentration was revealed, (RO 1.08; 95% RI 1.01-1.16) for each 1 mg/mL, as well as an increase (P = 0.044) in the possibility of the appearance of grade III radiation-induced mucositis with an increase in the serum concentration of IgA (RO 1.23; 95% RI 1.01-1.50) for every 1 mg/mL also before the beginning of the treatment. Multifactorial analysis has also confirmed that the risk of the development of grade III radiation-induced mucositis increases (P = 0.008) with a high serum IgG concentration before the treatment or with an increase in this index during therapy (RO 1.13; 95% RI 1.03-1.09) for every 1 mg/mL (when standardized by other risk factors). It was determined that when standardizing according to other factors (gender, IgG level), the risk of the development of grade III radiation-induced mucositis in the use of the immune agent alpha/beta defensins in a total dose of 40 mg per course decreases (P &lt; 0.001; RO 0.08; 95% RI 0.02-0.27) compared to patients with oral cavity and oropharynx cancer who were not treated with immunotherapy. The risk of the development of grade III radiation-induced mucositis also decreases (P = 0.001) in the use of immunotherapy in a higher dose, i.e. 60 mg per course (RO 0.03; 95% RI 0.004-0.24 compared to patients whose treatment did not include immunotherapy (when standardized by other factors). As a result of this controlled clinical study, some factors were determined in addition to the radiation as those affecting the risk of the development of grade III radiation-induced mucositis in patients with oral cavity and oropharynx cancer during special treatment. These factors comprise the inclusion of immunotherapy with alpha/beta defensins into the specific treatment; gender, and baseline levels of serum IgG and IgA concentrations suggest a pattern in which the higher the serum IgG and IgA concentrations are before the start of the treatment, the greater is the likelihood of severe radiation-induced mucositis degree during special therapy. The results of the study of humoral state of the immune system in patients with oral cavity and oropharynx cancer before the beginning of chemoradiation therapy can be used as prognostic risk factors for the development of severe gamma-irradiation-induced mucositis of the oropharyngeal area, as well as an indication for the use of immunotherapeutic agents (in particular, alpha/beta defensins) that are able to polarize the immune response towards type 1 T-helpers through their immunomodulatory action.

Changes in Acoustic Pharyngometric Indices After Adenotonsillectomy in Children

Background and Objective This study aimed to assess the effectiveness of acoustic pharyngometry by examining the data before and after adenotonsillectomy in children with sleepdisordered breathing (SDB).Methods This prospective, observational study included 29 children (M/F = 17/12, age = 8.69 ± 2.52 years) with SDB who underwent acoustic pharyngometry before and after adenotonsillectomy. Pre- and postoperative acoustic pharyngometry data, such as the oropharyngeal junction area (OPJ), pharyngeal volume (Vp), glottic area (GL), maximal pharyngeal cross-sectional area (Apmax), minimal pharyngeal cross-sectional area (Apmin), and mean pharyngeal cross-sectional area (Apmean), were compared.Results Before surgery, Apmean was measured at 1.75 ± 0.81 cm&lt;sup&gt;2&lt;/sup&gt; and increased to 2.24 ± 0.89 cm&lt;sup&gt;2&lt;/sup&gt; after surgery (p &lt; 0.001); this difference was statistically significant. Moreover, OPJ demonstrated statistically significant changes from 1.03 ± 0.62 cm&lt;sup&gt;2&lt;/sup&gt; to 1.53 ± 0.77 cm&lt;sup&gt;2&lt;/sup&gt; (p &lt; 0.001); Apmin measured from 0.99 ± 0.51 cm&lt;sup&gt;2&lt;/sup&gt; to 1.38 ± 0.69 cm&lt;sup&gt;2&lt;/sup&gt; (p = 0.003); and Vp increased from 14.45 ± 7.05 cm&lt;sup&gt;3&lt;/sup&gt; to 18.89 ± 7.72 cm&lt;sup&gt;3&lt;/sup&gt; (p &lt; 0.001) after surgical treatment.Conclusions Acoustic pharyngometry, a non-invasive and reproducible method, effectively reflects upper airway changes before and after adenotonsillectomy in children with SDB and ATH. This underscores its potential as a valuable tool for objectively evaluating upper airway obstruction caused by ATH in children.

Neighborhood Deprivation and Symptoms, Psychological Distress, and Quality of Life Among Head and Neck Cancer Survivors

Socioeconomic deprivation is associated with increased risk of poor health and quality-of-life (QOL) outcomes in head and neck cancer (HNC) survivors. However, there are few data on how neighborhood deprivation affects patient-reported outcome measures (PROMs) in HNC survivors. To investigate whether neighborhood socioeconomic deprivation is associated with symptom burden, psychological distress, and QOL among HNC survivors. This cross-sectional study used prospectively collected data from patients seen in a university-affiliated multidisciplinary HNC survivorship clinic between September 2018 and September 2021 who received radiotherapy for squamous cell carcinoma of the oral cavity, oropharynx, and larynx or hypopharynx. Neighborhood socioeconomic deprivation, measured using the Area Deprivation Index (ADI). The PROMs pertaining to symptom burden and severity of psychological distress were measured using the Neck Disability Index, Insomnia Severity Index, the 10-item Eating Assessment Tool, the Generalized Anxiety Disorder 7-item scale, and the 8-item Patient Health Questionnaire. Physical and social-emotional QOL were obtained using the University of Washington QOL questionnaire. Multivariable linear regression analysis adjusting for individual-level sociodemographic, comorbidity, and treatment characteristics investigated the association between ADI and PROMs. A subgroup analysis was performed to compare the lowest (most affluent areas: ADI, 0%-20%) and highest (most deprived areas: ADI, 80%-100%) ADI quintiles. A total of 277 patients were included in the final analysis (mean [SD] age, 64.18 [9.60] years; 215 [77.6%] male). Cancer sites were the oral cavity (52 [18.8%]), oropharyngeal area (171 [61.7%]), and larynx or hypopharynx (54 [19.5%]). Multivariable analysis showed that for every 1-point increase in ADI, social-emotional QOL changed by -0.14 points (95% CI, -0.24 to -0.05 points), anxiety increased by 0.03 points (95% CI, 0.01-0.06 points), and neck disability worsened by 0.05 points (95% CI, 0.01-0.10 points). Compared with patients in the most affluent areas, those in the most deprived areas had significantly lower physical (-15.89 points; 95% CI, -25.96 to -2.31 points; Cohen d = -0.83) and social-emotional (-13.57 points; 95% CI, -22.79 to -3.49 points; Cohen d = -0.69) QOL and higher depression (2.60 points; 95% CI, 0.21-4.40 points; Cohen d = 0.52), anxiety (3.12 points; 95% CI, 1.56-4.66 points; Cohen d = 0.61), insomnia (3.55 points; 95% CI, 0.33-6.41 points; Cohen d = 0.54), and neck disability (5.65 points; 95% CI, 1.66-9.55 points; Cohen d = 0.66) scores. In this cross-sectional study, a higher ADI score was associated with higher risk of increased psychological distress, higher symptom burden, and decreased QOL after treatment among HNC survivors. These findings suggest that proactive, patient-centered interventions are needed to address these disparities.

Clinical efficacy and mechanism study of mid-frequency anti-snoring device in treating moderate obstructive sleep apnea-hypopnea syndrome.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is primarily caused by airway obstruction due to narrowing and blockage in the nasal and nasopharyngeal, oropharyngeal, soft palate, and tongue base areas. The mid-frequency anti-snoring device is a new technology based on sublingual nerve stimulation. Its principle is to improve the degree of oropharyngeal airway stenosis in OSAHS patients under mid-frequency wave stimulation. Nevertheless, there is a lack of clinical application and imaging evidence. To investigate the clinical efficacy and mechanisms of a mid-frequency anti-snoring device in treating moderate OSAHS. We selected 50 patients diagnosed with moderate OSAHS in our hospital between July 2022 and August 2023. They underwent a 4-wk treatment regimen involving the mid-frequency anti-snoring device during nighttime sleep. Following the treatment, we monitored and assessed the sleep apnea quality of life index and Epworth Sleepiness Scale scores. Additionally, we performed computed tomography scans of the oropharynx in the awake state, during snoring, and while using the mid-frequency anti-snoring device. Cross-sectional area measurements in different states were taken at the narrowest airway point in the soft palate posterior and retrolingual areas. Compared to pretreatment measurements, patients exhibited a significant reduction in the apnea-hypopnea index, the percentage of time with oxygen saturation below 90%, snoring frequency, and the duration of the most prolonged apnea event. The lowest oxygen saturation showed a notable increase, and both sleep apnea quality of life index and Epworth Sleepiness Scale scores improved. Oropharyngeal computed tomography scans revealed that in OSAHS patients cross-sectional areas of the oropharyngeal airway in the soft palate posterior area and retrolingual area decreased during snoring compared to the awake state. Conversely, during mid-frequency anti-snoring device treatment, these areas increased compared to snoring. The mid-frequency anti-snoring device demonstrates the potential to enhance various sleep parameters in patients with moderate OSAHS, thereby improving their quality of life and reducing daytime sleepiness. These therapeutic effects are attributed to the device's ability to ameliorate the narrowing of the oropharynx in OSAHS patients.

Cephalometric changes in pharyngeal airway dimensions after functional treatment with twin block versus myobrace appliances in developing skeletal class II patients: a randomized clinical trial

BackgroundSeveral appliances have been used for correction of developing skeletal Class II, including different myofunctional appliances as Twin block (TB)as well as the new pre-fabricated Myobrace (MB) appliance. However, the effects of these devices on the pharyngeal airways have not been compared in the literature. Thus, the aim of this study was to compare the effects of two Class II correction appliances; TB and MB on the sagittal pharyngeal airway dimension (SPAD), including the nasopharyngeal airway area (NPAA), the oropharyngeal airway area (OPAA), and the laryngopharyngeal airway area (LPAA).MethodsThis is a two parallel arms randomized comparative clinical trial. Twenty-six children of 9–12 years with Skeletal Class II malocclusion due to mandibular deficiency and normal maxillary growth as confirmed by lateral cephalometric X-ray readings (ANB angle > 4° and SNB angle < 78) and Cervical vertebral maturational index (CVMI) 1 or 2 were randomly assigned into two equal groups. Group I: TB, Group II: MB (prefabricated functional appliance, Myofunctional Research Co., Australia). Lateral cephalograms were taken for all patients in both groups before treatment (T1) and after treatment (6 months later) (T2). The primary aim was to assess pre and post treatment changes in the SPAD in each group, and compare between the two study groups. The secondary aim was to evaluate the sagittal skeletal measurements such as the SNA, SNB, ANB, Wits appraisal, as well as vertical skeletal measurements represented by the Frankfurt-mandibular plane angle (FMA) measured pre- and post-treatment. The independent samples t-test was used to compare the two study groups, and the mean difference and 95% confidence intervals (CI) were computed. The paired samples t-test was used to compare various parameters between T1 and T2 within each group. The cutoff for significance was p-value < 0.05. Data were analyzed using IBM SPSS for Windows (Version 26.0).ResultsBy Comparing changes in airway measurements within each group, it was found that NPAA, OPAA, and LPAA increased significantly after treatment within each group of MB and TB. TB group showed significantly higher mean difference (T2-T1) in both NPAA and OPAA than MB group with 28.39 (± 56.75) and 40.46 (± 52.16) respectively. The increase in LPAA values was not statistically significant at (T2-T1) between both groups. Regarding skeletal changes, there was a significant increase in the SNB values between T1 and T2 within each group with 2.82 (± 3.32) for MB group and 3.79 (± 3.06) for TB group Moreover, there was a significant decrease in the ANB values between T1 and T2 within each group by 2.42 (± 2.70) for MB group and 3.06 (± 1.14) for TB group. Similarly, there was a significant decrease in the ANB values between T1 and T2 within each group by -2.13 (± 0.62) for MB group and − 2.46 (± 0.72) for TB group. No significant differences were found between both groups in SNA, SNB, ANB and Wits appraisal at p = 0.06, p = 0.45, p = 0.43 and p = 0.22 respectively. FMA did not show significant difference between T1 and T2 within each group, nor showed a significant mean difference between both groups at T2-T1.ConclusionsTB was more effective than MB in improving the upper (NPAA) and middle (OPAA) airways, while no difference was found regarding the lower airway (LPAA). Both TB and MB reduced the severity of developing skeletal class II due to mandibular retrognathism by forward posturing of the mandible. Thus, patients with airway problems would benefit more from TB than MB.

Anaesthesiologic and intensive care particularities in cervical surgery

Abstract BACKGROUND. Endotracheal intubation is frequently used to maintain airways proper functioning during elective surgical operations, in intensive care and in emergency rooms. The pathology of the oropharyngeal and laryngeal area or that of the cervical area induces, in most cases, changes in the airways, especially in the sense of their narrowing or deviation. The presence of tumors on the oro-pharyngo-laryngeal axis, some bleeding easily spontaneously or upon touch, can make the anaesthetic procedure difficult. MATERIAL AND METHODS. We conducted a prospective, observational study on 50 patients with cervical pathology who required general anaesthesia during 2019-2021. The criteria and parameters analysed for predicting difficult intubation were the duration of orotracheal or nasotracheal intubation, difficult face mask ventilation, Cormack-Lehane and Mallampati scores, anthropometric determinations of various cervical landmarks, including the thyromental distance, the distance between the arytenoid cartilages and the distance from the plane of the arytenoid cartilages to the skin, both of the latter determined ultrasonographically. RESULTS. The following statistically significant differences emerge from the study: the duration of orotracheal intubation (p&lt;0.001), the difficulty of face mask ventilation (p&lt;0.001), the intercondylar distance (p=0.042), the intermastoid distance (p=0.023), the Cormack-Lehane score (p=0.013), the Mallampati score (p=0.004), the distance between the arytenoid cartilages (p=0.007), the distance between the plane of the arytenoid cartilages and the skin (p&lt;0.001). All were increased in patients with tumoral pathology. CONCLUSION. The study demonstrates the variation of new criteria and parameters that can be analysed for the prediction of a difficult airway, identifies the efficiency of using ultrasound whenever possible in the preanesthetic evaluation of the airway, and quantifies the risk of difficulty in airway management based on anthropometric data, particularly through the occurrence of asymmetry at the cervical or facial level.

Maxillary Protraction: A Bibliometric Analysis

ObjectivesThe aim of this analysis was to investigate the historical development, current status, and research hot spots related to maxillary protraction in the treatment of maxillary hypoplasia. MethodsThe term “TS = maxillary protraction” was used to search for articles in the Web of Science Core Collection at the library of Capital Medical University. The results were analysed using CiteSpace6.2.R1 software, including the examination of annual publication trends and analysis of author, country, institution, and keywords. ResultsA total of 483 papers were included in this study. The annual publications showed an overall increasing trend. The top 5 authors with the most published papers were Lorenzo Franchi, Tiziano Baccetti, Seung-Hak Baek, Paola Cozza, and U Hagg. The top 5 countries with the highest publication counts were the US, Turkey, South Korea, Italy, and China. The top 5 institutions in terms of the number of published papers were the University of Florence, the University of Michigan, Kyung Hee University, Seoul National University, and Gazi University. The top 3 journals with the most citations were the American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, and the European Journal of Orthodontics. Furthermore, “Maxillary protraction,” “Class III malocclusion,” and “Maxillary expansion” were the most common keywords. ConclusionsThe effective age range for maxillary protraction has been expanded with the introduction of skeletal anchorage and the combination of maxillary expansion and protraction. Skeletal anchorage offers significant advantages over dental anchorage, but there is a need for further research to further substantiate its stability and safety. In recent years, the positive effects of maxillary protraction on the nasopharyngeal area have been well established, but its impact on the oropharyngeal area remains a topic of debate. Therefore, it is crucial to conduct further investigations into the effects of maxillary protraction on the oropharyngeal area and explore the factors that influence different outcomes.

Computational investigation of flow characteristics and particle deposition patterns in a realistic human airway model under different breathing conditions

Airborne particle pollution causes a range of respiratory and cardiovascular disorders by entering the human respiratory system through the breathing process. The administration of pharmaceutical particles by inhalation is another effective way to treat pulmonary illnesses. Studying particle deposition in the respiratory system during human breathing is crucial to maintaining human health. This necessity served as the impetus for this work, which aims to investigate how the airflow and particles' deposition are influenced by constant inhalation and circulatory breathing, particle diameter, and changes in airflow rate. The focus of this paper is to compare the particle deposition results of circulatory respiration with constant respiration. Based on computed tomography (CT) scan pictures, a precise human airway model from the mouth cavity to the fifth-generation bronchi was created. Flow fields and particle deposition inside the respiratory tract were examined at varied breathing rates (30, 60, and 90 L/min of constant and circulatory breathing) and varying haled particle sizes (5 and 10 µm). The results showed that the oropharyngeal area is often where the majority of particles are deposited. The particle distribution fraction is more significant in the bronchial area than the oropharyngeal region due to lower inhalation velocities and smaller particle sizes. For particles with a diameter of 5 µm, constant respiration and circulatory respiration have virtually identical particle distribution fractions in each region. For particles with a diameter of 10 µm, the particle distribution fraction for circulatory respiration is slightly higher than for constant respiration in the bronchial region as the flow rate increases. For both constant and circulatory respiration, particles are deposited more in the right lung and less in the left. These results contribute to further research on respiratory diseases caused by inhaled particles and guide inhalation therapy for better treatment outcomes.

THE POSITION OF THE TONGUE AND VOLUME OF THE UPPER RESPIRATORY TRACT IN PATIENTS WITH MALOCCLUSION

This study is a fragment of the planned research work "Features of rehabilitation of orthodontic patients in various ages" state registration No. 022U201229.&#x0D; Malocclusion and functional disorders that accompany them are not only a health problem, but also a rather important aspect in the process of personality formation and adaptation in society. To increase the effectiveness at the beginning of orthodontic treatment and stability in the retention period, it is important to take into account the etiological factor that led to the occurrence of malocclusion.&#x0D; In order to study and evaluate the position of the tongue in patients with malocclusion, to identify the influence and relationship on the patency of the upper respiratory tract, the volume of the oropharyngeal area was measured according to the McNamara’s method, the size and position of the tongue on cone-beam computer tomograms of orthodontic patients on the Donders’s residual space.&#x0D; The average indicators of the volume of the upper respiratory tract in patients with class I are 10.103±1.27 cm3, in patients with class II by 0.8 cm3 less 9.3±0.706 cm3.&#x0D; In patients with class I, the average parameters of the space of Donders are 4.4379±0.8077 mm. In patients with class II, the average values were lower 2.6667±0.3609 mm (р˂0.5). The distribution of patients by gender shows that in men the position of the tongue (space of Donders) had average indicators of 2.411±0.318 mm, in women the average indicators were almost 2 times higher and amounted to 4.603±0.754 mm, which is typical for the displacement of the tongue to the bottom, i.e. lower position of the tongue (р˂0.01). That is, the volume of the respiratory tract depends on the skeletal structure of the pathology, in other words, the morphology of the thoracic duct in the sagittal plane.&#x0D; Cephalometric analysis of the interaction of the airways and the tongue in orthodontic patients on TRG is quite limited compared to the CBCT image, as the CBCT enables a three-dimensional study of the shape and volume of the upper respiratory tract, the position of the tongue at rest.&#x0D; The position of the tongue has a rather insignificant effect on the type of malocclusion in the sagittal plane, but it has a rather large effect on the formation of the pathology in the vertical plane, which is the subject of research in future works.

Human Papillomaviruses in Adolescents: Knowledge, Attitudes, and Practices of Pharmacists Regarding Virus and Vaccination in France

Human papillomaviruses (HPVs) are responsible for one of the most common sexually transmitted diseases in the world, and their oncogenic role has been well demonstrated in genital, anal, and oropharyngeal areas. However, a certain distrust and a lack of knowledge about this vaccine are perceptible among French adolescents and their parents. Thus, health professionals and, more particularly, pharmacists appear to be key persons to promote HPV vaccination and restore confidence in the target population. The present study aims to assess the knowledge, attitudes, and practices regarding HPV vaccination among pharmacists, particularly in boys, following the 2019 recommendation to vaccinate them. The present study was designed as a cross-sectional, quantitative, and descriptive survey that was conducted from March to September 2021 among pharmacists in France. 215 complete questionnaires were collected. Gaps in knowledge were found, only 21.4% and 8.4% obtained a high level of knowledge related to, respectively, HPV and vaccination. Pharmacists were confident in the HPV vaccine (94.4%), found it safe and useful, and felt that the promotion of the vaccine was part of their role (94.0%). However, only a few have already advised it, which they justify due to a lack of opportunity and forgetfulness. Faced with this, training, computerized reminders, or supportive materials could be implemented to improve the advice and thus the vaccination coverage. Finally, 64.2% were in favor of a pharmacy-based vaccination program. In conclusion, pharmacists are interested in this vaccination and the role of promoter. However, they need the means to facilitate this mission: training, computer alerts, supportive materials such as flyers, and the implementation of vaccination in pharmacies.

The Effect of Laser Diode 940 nm on Decreasing Oropharyngeal Pain After Bimaxillary Orthognathic Surgery: A Double-Blind Randomized Trial Study

Background: Due to its invasiveness and length, bimaxillary orthognathic surgery causes highly excruciating pain in the oropharyngeal area for the patient. There are several ways to reduce this pain, including prescribing painkillers and anti-inflammatory drugs. The aim of this study was to evaluate the effect of photobiomodulation by a 940-nm laser on reducing pain in the oropharyngeal area after bimaxillary orthognathic surgery. Methods: This randomized clinical trial study was performed on 40 patients aged 17-40 years who were candidates for bimaxillary orthognathic surgery referred to the Department of Oral and Maxillofacial Surgery of Besat hospital in 2021. All patients in the intervention group underwent the photobiomodulation of the oropharyngeal area with a 940-nm diode laser immediately after the end of bimaxillary orthognathic surgery. Sore throat, jaw pain, pain when swallowing, and stridor were recorded in the first to fifth days after surgery. Finally, changes in the mean score of indices were compared within and between the two groups using repeated measure analysis of variance. Results: The mean age of patients in the intervention and control groups was 22.4±4.38 and 25.15±5.48 years, respectively (P=0.09). The pain score in the four areas studied in both intervention and control groups had a decreasing trend over time, which was statistically significant (P&lt;0.001). In addition, the difference in the trend between the two groups was statistically significant so that in the intervention group, the decreasing trend was more severe (P&lt;0.05). Eventually, a significant interaction was observed between the type of intervention and time in all four areas (P&lt;0.05). Conclusions: The results showed that the use of a 940-nm diode laser led to a significant reduction in all four areas of sore throat, pain when swallowing, and stridor after bimaxillary orthognathic surgery.

Prevalence and clinical features of pollen-food allergy syndrome in adults with seasonal allergic rhinitis.

Pollen-food allergy syndrome (PFAS) is an IgE-mediated allergic reaction to certain foods due to prior sensitization to pollen allergens. The data about the prevalence of PFAS in adults in Turkey is not sufficiently reported. Our objective was to investigate the frequency and clinical features of PFAS in adult patients with seasonal allergic rhinitis (SAR). A total of 222 patients with SAR were enrolled in our outpatient allergy clinic at Hacettepe University, during a ten-month period. A questionnaire was used to evaluate patients and to categorize those who experienced obvious allergy symptoms consistent with PFAS. Atopy was assessed by a standard skin prick test panel including common aeroallergen extracts. Among 222 patients with a diagnosis of SAR, 31 had patient reported PFAS (31/222, 14%). Among them, 23 (74.2%) were females, and their mean age was 32.29±9.24 years. The most common symptoms were isolated oropharyngeal symptoms (58.1%), followed by urticaria (51.6%) after culprit food ingestion. The most frequent culprit foods were eggplant, walnut, kiwi, peach, and melon. The predominant sensitizing aeroallergen was grass pollen. PFAS can be frequently observed in adults who are followed up for SAR. The most frequently involved foods are eggplant, walnut, kiwi, peach, and melon in Ankara Province. The symptoms of PFAS are usually localized in the oropharyngeal area and are self-limited.

Geometria orofaríngea e parâmetros acústicos vocais de indivíduos hígidos e com doença de Parkinson

ABSTRACT Purpose to verify whether there are differences in acoustic measures and oropharyngeal geometry between healthy individuals and people with Parkinson's disease, according to age and sex, and to investigate whether there are correlations between oropharyngeal geometry measures in this population. Methods 40 individuals participated, 20 with a diagnosis of Parkinson's disease and 20 healthy individuals, matched by age, sex, and body mass index. Acoustic variables included fundamental frequency, jitter, shimmer, glottal-to-noise excitation ratio, noise, and mean intensity. Oropharyngeal geometry variables were measured with acoustic pharyngometry. Results geometry variables were smaller in the group with Parkinson's disease, and older adults with Parkinson's disease had a smaller oropharyngeal junction area than healthy older adults. Regarding acoustic parameters of voice, fundamental frequency values were lower in males with Parkinson's disease, and jitter values were higher in the non-elderly subjects with Parkinson's disease. There was a moderate positive correlation between oral cavity length and volume, pharyngeal cavity length and vocal tract length, and pharyngeal cavity volume and vocal tract volume. Conclusion individuals with Parkinson's disease had smaller glottal areas and oropharyngeal junction areas than healthy individuals. When distributed into sex and age groups, the fundamental frequency was lower in males with Parkinson's disease. There was a moderate positive correlation between oropharyngeal length and volume measures in the study sample.

Oropharyngeal geometry and acoustic parameters of voice in healthy and Parkinson's disease subjects

to verify whether there are differences in acoustic measures and oropharyngeal geometry between healthy individuals and people with Parkinson's disease, according to age and sex, and to investigate whether there are correlations between oropharyngeal geometry measures in this population. 40 individuals participated, 20 with a diagnosis of Parkinson's disease and 20 healthy individuals, matched by age, sex, and body mass index. Acoustic variables included fundamental frequency, jitter, shimmer, glottal-to-noise excitation ratio, noise, and mean intensity. Oropharyngeal geometry variables were measured with acoustic pharyngometry. geometry variables were smaller in the group with Parkinson's disease, and older adults with Parkinson's disease had a smaller oropharyngeal junction area than healthy older adults. Regarding acoustic parameters of voice, fundamental frequency values were lower in males with Parkinson's disease, and jitter values ​​were higher in the non-elderly subjects with Parkinson's disease. There was a moderate positive correlation between oral cavity length and volume, pharyngeal cavity length and vocal tract length, and pharyngeal cavity volume and vocal tract volume. individuals with Parkinson's disease had smaller glottal areas and oropharyngeal junction areas than healthy individuals. When distributed into sex and age groups, the fundamental frequency was lower in males with Parkinson's disease. There was a moderate positive correlation between oropharyngeal length and volume measures in the study sample.

Oral microbiota in patients with oropharyngeal cancer with an emphasis on &lt;i&gt;Candida&lt;/i&gt; spp.

Introduction. Interactions between the 2 microbiota components – bacteria and fungi – are of interest as diagnostic and prognostic markers in selection of treatment tactics for oncological patients.Aim. To study microbiota of the oral cavity in patients with primary squamous cell carcinoma of the oropharyngeal area before and after surgical intervention to find biomarkers for rational selection of antifungal drugs.Materials and methods. At the Surgical Department of Head and Neck Tumors of the N. N. Blokhin National Research Center of Oncology, three-component study was performed: investigations of spectrum of Candida spp. isolates, Candida spp. strains’ resistance to antifungals, and oral washes in primary patients before and after surgery. mALDI-Tof microflex LT (Biotyper, Bruker Daltonics, germany) was used for strain identification; Sensititre Yeast ONE, YO10 (Trek Diagnostic System, united kingdom) plates were used for determination of minimal inhibiting concentrations of anti fungals. values of minimal inhibiting concentrations were evaluated based on the European Committee on Antimicrobial Susceptibility Testing (EuCAST) criteria (version 10.0).Results. four-year observation of patients at the surgical department of head and neck tumors of the N. N. Blokhin National Research Center of Oncology showed that the most common species of Candida is C. albicans (73.5 % of cases). Candida spp. resistance to antifungals was detected only for fluconazole (9.3 % of cases) and micafungin (8.0 % of cases), mostly among C. albicans strains. In 31.8 % of primary patients, oral washes prior to surgery showed growth of Candida spp. (probably, tissue colonization). After surgical intervention, Candida spp. growth was detected in 36.4 % of cases, only 1 of which was diagnosed as invasive mycosis. In 54.5 % of cases before and in 72.7 % of cases after surgery, gram-negative rods were detected. After surgical intervention, percentage of enterobacteria and non-fermenters significantly increased: 59.1 % versus 27.3 % (p &lt;0.05) and 63.6 % versus 27.3 % (p &lt;0.02), respectively. prior to surgery, non-fermenting gram-negative bacteria were represented only by P. aeruginosa; after surgery, the spectrum of non-fermenting gram-negative bacteria became wider but percentage of P. aeruginosa remained high: 71.4 %. ERG11 gene was identified only in 1 strain: C. albicans. FKS1 gene also was identified only in 1 strain: C. inconspicua. virulence factor genes were detected in 57.1 % of strains.Conclusion. Surgical intervention is associated with changes in bacterial microbiota but not fugal microbiota. presence of virulence factor genes and resistance genes in Candida spp. strains should be considered a biomarker allowing to differentiate between colonization and candida infection and can be used for rational selection of antifungal drugs in prevention and treatment of invasive candidiasis, especially in the absence of criteria for interpretation of measured minimal inhibiting concentrations of antifungals.

S2513 Not All That Appears Like Oral Thrush Is Candidiasis: A Case of Oral Actinomycosis

Introduction: Oral thrush is one of the most common infections that affect the oral cavity. The oral candidiasis lesions classically present as whitish confluent plaques on oral cavity examination of tongue, palate, and buccal mucosa. Oral thrush has long been associated with overgrowth of Candida albicans in the mouth in dialysis dependent patients, diabetics, immunocompromised, and who are on corticosteroid therapy. In this abstract we present a case of oral actinomycosis mimicking oral thrush upon presentation. Case Description/Methods: 51-year-old female a history of squamous cell esophageal cancer status post distal esophagectomy and gastric pull through operation 5 years ago. She with a presented with a chief complaint of odynophagia and recurrent episodes of dysphagia for solid foods that has been worsening since past few weeks. About 6 months ago the patient had an upper endoscopy, which was significant for acute gastritis and pyloric stenosis, which was dilated. No obvious thrush was identified during that visit. Patient was not on any immunosuppressive medication. A repeat upper endoscopy was performed at this visit which was revealing of thrush in the oropharyngeal area and chronic gastritis. Tongue brushings were obtained for cytopathological analysis, which were suggestive of actinomyces infection. The patient was started on amoxicillin therapy for 2 weeks, which resulted in resolution of thrush as well as her clinical symptoms. Other treatment alternatives for actinomycosis include doxycycline, clindamycin, ceftriaxone, and imipenem (Figure). Discussion: Actinomyces is a rare bacterium often found in the head and neck region. They are partially acid-fast, filamentous gram-positive microorganisms. They were originally classified with fungi organisms as they possess hyphae. Actinomyces is considered to cause chronic suppurative infection. However, actinomycosis infection of the tongue is rare, it usually presents as an abscess formation, draining sinus tracts, fistulae, and tissue fibrosis. The gold standard for the diagnosis of Actinomyces is histological examination. Identification of the underlying pathogen is crucial for management of these patients. Candida is treated with antifungals, however, for actinomyces the treatment is penicillin group of antibiotics. Therefore, it is important to have awareness for actinomyces in the setting of oral thrush for appropriate treatment.Figure 1.: Endoscopic Findings.