Palatal Length Research Articles

Comparison of Dimensions of the Palate Between Individuals With and Without Nasal Septum Deviation on Cone-Beam Computed Tomography Images in an Iranian Population

Background: Nasal septum deviation might disrupt the integrity of nasal septum components, resulting in deformity. Such changes might affect the morphology of adjacent structures. The aim of the present study was to evaluate the dimensions of the palate in subjects with and without nasal septum deviation on cone-beam computed tomography (CBCT) images in an Iranian population. Methods: In the present cross-sectional study, the CBCT images of subjects with and without nasal septum deviation were evaluated in two groups (n=107) referred to the Department of Oral and Maxillofacial Radiology, Tabriz Faculty of Dentistry in 2017. The presence or absence of nasal septum deviation and its severity were evaluated in association with palatal dimensions. Data were analyzed by SPSS. Independent samples t test was used to compare the dimensions of the palate. Finally, the Mann-Whitney U test was employed to compare palatal arch depth (PAD)/palatal interalveolar length (PIL) ratios. Results: There were no significant differences between the two groups in terms of the palatal depth (P=0.967), palatal width (P=0.223), and palatal depth/palatal width ratio (P=0.644). However, the results demonstrated significant differences in palatal depth (P<0.001) and palatal width (P=0.05) between male and female subjects. Conclusions: Overall, no significant differences were observed in the dimensions of the palate (depth and width) and their ratios between subjects with and without nasal septum deviation, although greater palatal dimensions (depth and width) were detected in males compared to females.

Dermal Matrix Graft Effects on Facial Growth in a Veau-Wardill-Kilner Palatoplasty Model: An Experimental Study in Rats.

The primary goal of palatoplasty is the restoration of normal speech, that can be aimed by, among many procedures, lengthening the palate through the pushback technique; one of its complications is abnormal maxillary growth. The main factor affecting facial growth in CLP patients is believed by many to be the palatoplasty—due to the large scar retraction resulting from some surgical techniques. The non-crosslinked two-layer bioabsorbable collagen matrix Mucograft™ (Geistlich Pharma AG, Wolhusen, Switzerland) is a potential tool to aid in wound closure in a second-intention healing situation. The objective of this work was to test the use of an acellular dermal matrix (Mucograft®) in an experimental model of Veau–Wardill–Kilner palatoplasty, as a tool to reduce scar retraction of the denuded palatine mucosa. Twenty-four 3-week-old male Wistar rats were used. The animals were randomly divided into two groups. In the control group, an excision was made with bone exposure in the palate, simulating the defect left in the Veau–Wardill–Kilner palatoplasty. In the intervention group, the same procedure was performed, and the area of denuded palatine bone was treated with a bioabsorbable collagen matrix (Mucograft®). For data collection, 9 weeks after surgery (12 weeks of life), the animals were euthanized by excessive anesthetic dosage. Maxillary growth, macroscopic appearance of the scar, pain, and bleeding were evaluated. There were significant statistical differences between the groups for palate length growth (7.6 mm + −0.38 mm vs 5.5 mm + −0.36 mm, P = .009) and for palate width growth (1.47 mm + −0.8 mm vs −0.09 mm + −0.55 mm, P = .001), favoring dermal matrix group compared to controls. Whereas for pain and bleeding, there were no differences between the groups. The use of dermal matrix in rats with an area of bone denudation on the palate increases maxillary length and width growth patterns. Besides, it does not increase pain, bleeding, or post-operative complications.

Midline growth of the sphenoid bone in primates: A histological and microcomputed tomography study

AbstractObjectivesThe aim of the present study is to broaden our knowledge of the ontogeny of cranial base cartilaginous joints in primates.Materials and MethodsA cross‐sectional age sample of 66 specimens from four platyrrhine and three strepsirrhine genera were studied using microcomputed tomography, histology, and immunohistochemistry. Specimens were segmented, reconstructed, and measured using Amira software. Ontogenetic scaling of palatal, presphenoid, and basisphenoid length relative to cranial length was examined using standardized major axis regression. After histological sectioning, selected specimens were examined using immunohistochemistry of antibodies to proliferating cell nuclear antigen.ResultsOur results support the hypothesis that the presphenoid in platyrrhines grows more rapidly compared with strepsirrhines, but this study establishes that most or all of this growth discrepancy occurs prenatally, and mostly at the presphenoseptal synchondrosis (PSept). All species have prolonged patency (here meaning absence of any bony bridging across the synchondrosis) of the intrasphenoidal and spheno‐occipital synchondroses (ISS). However, immunohistochemical results suggest growth is only rapid throughout infancy, and mitotic activity is slowing during juvenile ages. The same is indicated for the PSept.DiscussionThese results demonstrate that platyrrhines and strepsirrhines do not follow the pattern of early fusion of ISS seen in humans. In addition, these primates have a more prolonged patency and growth at PSept compared with humans. Finally, results reveal that in bushbabies and tamarins, as in humans, synchondroses remain cartilaginous for a prolonged period after chondrocyte proliferation has slowed or ceased. In light of these results, it is time to reassess related processes, such as differences in timing of brain expansion.

Early Cleft Palate Repair by a Modified Technique Without Relaxing Incisions.

This study sought to evaluate a modified palatoplasty technique (MPT) concerning the postoperative outcomes and associated influencing factors. A retrospective cohort study. One hundred forty-three consecutive patients with non-syndromic cleft palate, who received MPT before one year of age within an oral and maxillofacial surgery department of a university-affiliated tertiary hospital between 2011-2017, were reviewed. The postoperative wound healing and velopharyngeal function (VPF) were the primary outcome measures. The sex, age at surgery, cleft type, cleft width, palatal width, soft palate length, pharyngeal cavity depth, and operation duration were preselected as influencing factors. Univariate and multivariate analyses were conducted. The mean age at surgery was 9 ± 1.31 months (5-11), and the average cleft width was 9.03 ± 2.41 mm (4-15). The rate of incomplete cleft palate was 84.6% while the complete cleft palate was 15.4%. Complete wound healing was reported in 96.5% while the others (3.5%) had persistent oronasal fistula. About 90.2% of cases have shown normal velopharyngeal function whereas the others (9.8%) had sustained velopharyngeal insufficiency. The wound healing appeared to be significantly impacted by cleft width and pharyngeal cavity depth (P = .015 and 0.049, respectively). However, none of the factors had a significant association with VPF. The present modified palatoplasty technique has obtained a low fistula rate and appropriate speech outcome. Therefore, this MPT could be promoted for early repairing cleft palate of different severities.

Evaluation of pharyngeal airway dimensions and cephalometric changes after premolar extraction and nonextraction orthodontic treatment in adolescent and adult patients

PurposeThe purpose of this study was to investigate the effects of premolar extraction and non-extraction for orthodontic treatment on the skeletal, dentoalveolar and pharyngeal airway. Material and MethodThe study was carried out with the radiographs of a total of 130 patients at the ages of 14 to 25, including 59 male and 71 female patients. The cases were divided into two groups as the “extraction” group(2 upper premolar teeth) (n = 66) and the “non extraction” group (n = 64). ResultsExtraction Group:In both age groups, there was a statistically significant increase in the mean interincisal angle (U1xL1) and lower anterior facial height (ANS-Me) values(p < 0.05). In the 14-18 age group, there was a significant increase in the mean upper airway thickness, inferior airway space, hyoid position, soft palate length(PNSP) and upper pharynx values(p < 0.05). In both sexes, while the mean U1xL1 and ANS-Me values significantly increased, the mean upper incisors inclination values decreased significantly(p < 0.05).Non Extraction Group:In both age groups, the mean ANS-Me values increased significantly from T0 to T1(p < 0.05). In the 14-18 age group, the increase in the mean upper adenoid thickness, tongue length,PNSP, softpalate thickness and vertical airway length values was significant(p < 0.05). In the male patients, the mean U1xL1 value decreased significantly(p < 0.05). ConclusionThe premolar teeth extraction performed in the patients receiving orthodontic treatment did not affect airway dimensions to a high extent.It was determined that the position of the hyoid bone and tongue length was not affected in the patients with premolar extraction and non extraction.

Assessment of Velar Morphological Variants as Gender Determination Tool in Kanpur Population: A Digital Cephalometric Study

Background: The posterior fibromuscular part of the palate that attaches to the hard palate is what is often referred to as the soft palate. To distinguish between sexes, this research measured the velar for length, breadth, and morphological diversity. Materials and Methods: One hundred and fifty boys and girls, ages 15–25, had digital lateral cephalograms obtained. Using the taxonomy proposed by You et al., we categorized velar morphology into six different types and conducted an in-depth analysis of each. The resting length of the soft palate may be seen as a straight line stretching from the back of the nose to the tip of the uvula. It was also determined how wide the soft palate really is. IBM SPSS statistics 21 was used for the statistical analysis. The mean, the standard deviation, and the percentage distribution were used to describe the data. To ensure that the data were normally distributed, the Shapiro–Wilk test was run on them. Comparisons of clusters of discrete categories were made using the Chi-square test. To identify statistically significant differences between the sexes, we employed the independent Student's t-test. The mean length and width of different velar shapes of both genders were calculated using an analysis of variance test. Results: Type 2 was more common in males than in Types 1, 3, or 6. Form 6 was the rarest of the forms. Type 1 was more common among women than any of the other types, including Types 2, 3, and 6. The most frequent kind was Type 1. The veli of men are much longer and broader than those of females. Conclusion: In light of all the metric measurements from the current study, gender can be established from the length, width, and soft palate morphology.

A Study on Various Sizes and Volumes of the Palate among the Korean Population in Mixed Dentition

The purpose of this study was to compare the palatal dimensions (volume, width, length, and height) in different malocclusions (Class I, II, and III) in mixed dentition using a three-dimensional digital scanner. The study was performed on 30 selected casts from 1400 casts that were taken at the Department of Pediatric Dentistry at Dankook University. Casts consisted of Class I, II, and III malocclusion groups in Hellman’s dental age IIIA. The mean age was 8 years and 6 months ± 11 months. Each cast was scanned by three-dimensional digital scanner, Medit T710 (Medit, Seoul, Korea), and shaped into the three-dimensional image and calculated palatal dimensions using the Plan T program (SMD solution, Seoul, Korea). The values were statistically compared and evaluated by Kruskal-Wallis followed by the Mann-Whitney test. According to our results, subjects with Class II malocclusion showed lower palatal width and longer palatal length compared to those with Class I and Class III. For palatal height, Class III malocclusion subjects in mixed dentition exhibited a larger number than Class II and Class I. Lastly, for palatal volume, compared to other malocclusions, Class III showed higher results; however, there were no significant differences. The form of the palate differs in types of malocclusions and understanding of these differences is important in clinical significance. Based on this study, the understanding of the relationship between the shape of the palate and the skeletal pattern provides useful information about orthodontic treatment plans, early diagnosis of malocclusion, and morphological integration mechanisms. Orthopedic treatment in the maxilla should be performed during early and intermediate mixed dentition to enhance treatment efficiency.

Cleft Palate in Apert Syndrome.

Apert syndrome is a rare genetic disorder characterized by craniosynostosis, midface retrusion, and limb anomalies. Cleft palate occurs in a subset of Apert syndrome patients. Although the genetic causes underlying Apert syndrome have been identified, the downstream signaling pathways and cellular mechanisms responsible for cleft palate are still elusive. To find clues for the pathogenic mechanisms of palatal defects in Apert syndrome, we review the clinical characteristics of the palate in cases of Apert syndrome, the palatal phenotypes in mouse models, and the potential signaling mechanisms involved in palatal defects. In Apert syndrome patients, cleft of the soft palate is more frequent than of the hard palate. The length of the hard palate is decreased. Cleft palate is associated most commonly with the S252W variant of FGFR2. In addition to cleft palate, high-arched palate, lateral palatal swelling, or bifid uvula are common in Apert syndrome patients. Mouse models of Apert syndrome display palatal defects, providing valuable tools to understand the underlying mechanisms. The mutations in FGFR2 causing Apert syndrome may change a signaling network in epithelial–mesenchymal interactions during palatogenesis. Understanding the pathogenic mechanisms of palatal defects in Apert syndrome may shed light on potential novel therapeutic solutions.

Anatomical Study of Domain Rescue of Palatal Length in Patients With a Wide Cleft Palate: Buccal Flap Reconstruction in Primary Palatoplasty.

This study characterizes the potential loss of velar length in patients with a wide cleft and rescue of this loss of domain by local flap reconstruction, providing anatomic evidence in support of primary lengthening of the soft palate during palatoplasty. A retrospective review was conducted of all patients with a cleft palate at least 10mm in width, who underwent primary palatoplasty with a buccal flap prior to 18 months of age over a 2-year period. All patients underwent primary palatoplasty with horizontal transection of the nasal mucosa, which was performed after nasal mucosa repair, but prior to muscular reconstruction. The resulting palatal lengthening was measured and the mucosal defect was reconstructed with a buccal flap. Of the 22 patients included, 3 (13.6%) had a history of Pierre Robin sequence, and 5 (22.7%) had an associated syndrome. No patients had a Veau I cleft, 7 (31.8%) had a Veau II, 12 (54.5%) had a Veau III, and 3 had (13.6%) a Veau IV cleft. All patients had a right buccal flap during primary palatoplasty. The mean cleft width at the posterior nasal spine was 10.6 ± 2.82mm, and mean lengthening of the velum after horizontal transection of the nasal mucosa closure was 10.5 ± 2.23mm. There were 2 (9.1%) fistulas, 1 (4.5%) wound dehiscence, 1 (4.5%) 30-day readmission, and no bleeding complications. Patients with a wide cleft palate have a potential loss of 1cm velar length. The buccal flap can rescue the loss of domain in palatal length, and potentially improve palatal excursion.

Learning curve in performing palatoplasty

Objectives: The aim of the study was to assess the influence of the experience of the surgeon on the occurrence of fistulas and breakdowns following palatoplasty. Materials and Methods: A retrospective review on the outcomes of palatoplasty done by a young surgeon in his initial 3 years of operating cleft palate was done. Cleft palate repair was performed using the Pinto's modification of Wardill–Kilner palatoplasty, Veau-Wardill-Kilner V-Y Pushback in both the techniques radical levator muscle dissection was carried out. Data were collected for age, sex, date of birth, syndrome, cleft palate type, type of repair, cleft width, length of soft palate, quality and quantity of muscle, fistula occurrence, and location of fistula. Results: Retrospective analysis was done on the outcomes of palatoplasty performed by a young surgeon in his initial 3 years at Charles pinto center for cleft lip palate and craniofacial on 220 cleft palate children which included all variants and dimensions of cleft palates. Postoperatively, the incidence of palatal fistulas occurred in 12 patients, three patients had bifid uvula, however, out of 12 patients who had fistulas only four needed fistula closure and one required a uvula re-repair; the rest healed well. Conclusion: We believe there is a learning curve in performing cleft palate repair. Our technique and principles followed in palatoplasty appear to have a low or zero fistula rate even in the initial period of learning. Furthermore, effective mentorship and guidance help in reducing errors and providing a better outcome.

High incidence of cleft palate and vomer deformities in patients with Eustachian tube dysfunction

Although the cleft palate is regarded as a contraindication for Eustachian tube ballooning, the presence of submucosal cleft palate may be overlooked while diagnosing Eustachian tube dysfunction. Therefore, we aimed to determine the incidence of the presence of a hard palate bony notch and vomer defect, which indicate the presence of submucosal cleft palate in patients with Eustachian tube dysfunction. In the Eustachian tube dysfunction group (n = 28), 4 patients (14.3%) exhibited a hard palate bony notch and a concurrent vomer defect. Three of them exhibited the presence of occult submucosal cleft palate, which had not been diagnosed previously. None of the control group (n = 39) showed any of these findings. The hard palate length of patients in the Eustachian tube dysfunction group was significantly lesser than that of those in the control group (34.2 ± 5.6 mm vs. 37.2 ± 2.1 mm, P = 0.016). Patients with Eustachian tube dysfunction have a high incidence of submucosal cleft palate and its occult variant, which are challenging to diagnose without any preexisting suspicion. Clinicians should evaluate the hard palate and vomer to exclude the presence of occult submucosal cleft palate while diagnosing Eustachian tube dysfunction.

Effect of Twin-block Appliance on Pharyngeal Airway, Sleep Patterns, and Lung Volume in Children with Class II Malocclusion

In this study, we sought to evaluate the effect of the twin-block appliance on pharyngeal airway dimensions, sleep patterns, and lung volumes in growing children with class II malocclusion with a retrognathic mandible. Twenty children aged 9-12 years with class II malocclusion with a retrognathic mandible participated in the study. A validated sleep questionnaire assessed the sleep patterns and the sleep problems of the children. The pre-treatment cephalometric variables and the pharyngeal airway passage (PAP) dimensions were analyzed. Spirometry tests were performed to evaluate lung volumes. A custom-made twin-block appliance was fabricated, and children were instructed to wear it for a minimum of 10 months. All variables including sleep problems, cephalometric variables, and pharyngeal airway measurements were evaluated post-treatment. Spirometry tests were re-evaluated at the end of the twin-block treatment. All data were statistically analyzed. Post-twin-block appliance treatment, there was a definite decrease in snoring, noisy breathing, and sleeping with mouth open. The sella-nasion to B point angle (SNB), mandibular length, the depths of oropharynx, nasopharynx, and hypopharynx as well as the height of nasopharynx (HNP) were significantly increased post-treatment (p <0.001). The length and thickness of soft palate (SPI) increased significantly (p <0.001), while its inclination decreased significantly (p <0.001). We found improvements in forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1); however, the changes were statistically not significant (p = 0.88 and p = 0.78). Twin-block appliance significantly increased the pharyngeal airway dimensions and improved the length and thickness of the soft palate in children with class II malocclusion. Post-twin-block treatment showed a considerable reduction in the sleep problems of the children. The lung volume measurements showed improvement; however, it was not statistically significant. Twin block may be used not only to correct the facial disharmony of children with a retrognathic mandible but also to improve the airway dimensions and lung volume as well as to reduce the sleep-disordered symptoms.

Comparative craniometric measurements of two Canid species in Egypt: the Egyptian red fox and the Egyptian Baladi dog

The Egyptian red fox (Vulpes vulpes aegyptiaca) and Egyptian Baladi dog (Canis familiaris) are two members of the Family Canidae that are widely distributed in Egypt. The skulls of different Canid species vary greatly in their size and shape; therefore, they can be used as a tool to study the evolution and evolutionary history of these animals. The craniometric measurements are crucial for species identification and determination of the specific sites for nerve blocks. The present study compared the craniometric measurements of the red fox and Baladi dog skulls by measuring 47 parameters on each skull and calculation of 8 indices. The red fox skull had significantly lower values of 41 craniometric measurements (approximately 87% of the measurements done), including skull length, width, and height, cranial length and width, palatal and mandibular length, and dental measurements. In contrast, the red fox had significantly higher values of only 3 measurements (approximately 6% of the measurements done) including the tympanic bulla measurement. While only three skull measurements did not differ significantly between the red fox and dog. Statistics revealed that domestic dog had significantly higher values of foramen magnum and palatine indices, and significantly lower value of nasal index than those of red fox. The present work reported variations in the gross and craniometric measurements of skull between the red fox and dog. The measured cranial parameters of both adult animals provide valuable information that can be used in ecological studies, comparative anatomy, and clinical veterinary sciences.

How to Make a Vampire: Part II. Getting Ready to Feed

The mammalian feeding system is made up of multiple components that influence facial variation, including the masticatory muscles, bony jaw apparatus, and teeth. However, it is not fully understood how the development of these components are coordinated and are impacted by life history and diet.Bats are the only mammals that continue to nurse until they are almost adult size, and often after they become volant. Common vampire bats (Desmodus rotundus) have a relatively prolonged juvenile period among bats, can nurse up to nine months, and later solely subsist off of blood. Feeding system maturity may therefore be delayed in bats, and particularly delayed in Desmodus, as a result of their lengthy juvenile period and liquid diet. In this study, we examine the developmental maturity of the cranium and feeding apparatus in the late fetus of a common vampire bat (Desmodus rotundus) relative to an adult (its mother).The heads of each specimen were microCT scanned twice. Conventional microCT was used to image mineralized tissues. Diffusible iodine‐based contrast‐enhanced CT (diceCT) imaging was used to image soft tissues. Cranial length and palate length measurements were acquired from unstained scans to evaluate size and jaw apparatus development. Masticatory muscles (e.g., medial pterygoid, zygomaticomandibularis) and permanent tooth crypt volumes were acquired from stained tissue scans to evaluate masticatory muscle and tooth development. Developmental maturity of these structures was assessed by calculating a percentage of the growth completed (i.e., [fetal muscle volume/adult muscle volume]*100).In the fetus, permanent tooth crypt volume is already comparable to the adult condition despite cranial length and palate length being &lt;75% of adult size. Masticatory muscle volume maturity is highest in the lateral pterygoid muscle (~35%), whereas other masticatory muscles are far less developed (e.g., medial pterygoid volume maturity, ~20%; temporalis profundus volume maturity, ~20%; temporalis medius volume maturity, ~6%).These results reveal highly precocious permanent tooth development in Desmodus. Although this may facilitate transition to hematophagy, Desmodus do not fly until eight to ten weeks, so the precocious incisors may primarily aid the infant to grip its mother’s skin. Differential development of the masticatory muscles may also be influenced by the need for young bats to use their mouths to help anchor themselves to their mother early in life. This may explain the advanced maturity of the lateral pterygoid muscle, which would protrude the jaw and help to facilitate a more secure grip.

Nasopharyngeal morphology contributes to understanding the "muddle in the middle" of the Pleistocene hominin fossil record.

The late archeologist Glynn Isaac first applied the term "muddle in the middle" to a poorly understood period in the Middle Pleistocene human fossil record. This study uses the nasopharyngeal boundaries as a source of traits that may inform this unclear period of human evolution. The nasopharynx lies at the nexus of several vital physiological systems, yet relatively little is known about its importance in human evolution. We analyzed a geographically diverse contemporary Homo sapiens growth series (n= 180 adults, 237 nonadults), Homo neanderthalensis (La Chapelle aux Saints 1, La Ferrassie 1, Forbes Quarry 1, Monte Circeo 1, and Saccopastore 1), mid-Pleistocene Homo (Atapuerca 5, Kabwe 1, Petralona 1, and Steinheim 1), and two Homo erectus sensu lato (KNM-ER 3733 and Sangiran 17). Methods include traditional (Analysis 1) and 3D geometric morphometric analysis (Analysis 2). H. erectus exhibited tall, narrow nasopharyngeal shape, a robust, ancestral morphology. Kabwe 1 and Petralona 1 plotted among H. sapiens in Analysis 2, exhibiting relatively shorter and vertical cartilaginous Eustachian tubes and vertical medial pterygoid plates. Atapuerca 5 and Steinheim 1 exhibited horizontal vomeral orientation similar to H. neanderthalensis, indicating greater relative soft palate length and anteroposterior nasopharynx expansion. They may exhibit synapomorphies with H. neanderthalensis, supporting the accretionary hypothesis. Species-level differences were found among H. sapiens and H. neanderthalensis, including relatively longer dilator tubae muscles and extreme facial airorhynchy among Neanderthals. Furthermore, H. neanderthalensis were autapomorphic in exhibiting horizontal pterygoid plate orientation similar to human infants, suggesting that they may have had inferiorly low placement of the torus tubarius and Eustachian tube orifice on the lateral nasopharyngeal wall in life. This study supports use of osseous nasopharyngeal boundaries both for morphological characters and understanding evolution of otitis media susceptibility in living humans.

P76. SINGLE Z-PLASTY VERSUS DOUBLE-OPPOSING Z-PLASTY: A COMPARISON OF SUCCESS WITH PALATAL LENGTHENING

PURPOSE: Palate length is associated with improved speech outcomes in cleft palate repair. The Furlow double-opposing Z-plasty (2ZP) utilizes two Z-plasties to reorient palatal musculature and lengthen the velum. An overlapping intravelar veloplasty with a single oral Z-plasty (1ZP) has been described previously. The authors hypothesize that these 2 closure techniques will result in similar palatal lengthening. METHODS: A retrospective comparative study of patients with a cleft palate was conducted. All included patients underwent either 2ZP or 1ZP. Pre- and post-operative measurements of the palate were recorded along various dimensions. The primary outcome of interest was anterior-posterior (AP) palatal length, defined as a straight line measurement from the teeth to the uvula. Analysis was conducted to detect statistical differences using the Mann-Whitney-Wilcoxon test for significance. RESULTS: 80 patients met inclusion criteria (2ZP = 14, 1ZP = 66). Patients who underwent 2ZP exhibited an average increase in palatal length of 7.93mm, and 1ZP was 7.23mm. Both techniques led to a statistically significant increase in palate length. There was no statistically significant difference observed in the change of the AP palatal length by technique (2ZP 16.2% vs 1ZP 15.7%; p = 0.53). CONCLUSION: A single oral Z-plasty results in statistically significant palatal lengthening in patients. There was no difference seen in the AP dimension of palate length comparing 2ZP and 1ZP techniques. production.

Soft Palate Mucosal Adhesion with Muscle Release: An Option in "Wide" Cleft Palates in a Cohort in Southern Africa.

Comparison of speech outcomes in 2 similar groups of "wide" cleft palate. One received a Furlow double-opposing Z- plasty (FZP) versus a group (non-FZP) that received only a muscle release at the second stage after both received a soft palate mucosal adhesion (SPA) at the first stage. Retrospective review. Thirty-three patients (non-FZP) versus 29 patients (FZP) between 2010 and 2016. Both groups had SPA at approximately 6 months of age. After 12 months, an FZP with hard palate closure was performed in the FZP group. in the non-FZP group, only the muscle was released from the posterior palatal shelves with hard palate closure. Speech and velopharyngeal insufficiency (VPi) were determined clinically and by videofluoroscopy. The FZP group (15 M: 14 F) with Veau (III = 14; IV = 5; II = 10) had a mean palate length (MPL) of 20.5 mm and mean palate width (MPW) of 11.2 mm at 8.3 months. MPW decreased to 7 mm after 20.7 months. 21% (n = 6) had fistulae. 14% (n = 4) (all males) had VPI. Their MPL was 16.3 mm. The mean follow-up was 5.5 years. In the non-FZP group, (18 M: 15 F) with Veau (III = 22; IV = 7; II = 4), the MPL was 20.5 mm and MPW was 11 mm at 8.4 months. MPW decreased to 6.5 mm after 12.5 months (P = 0.006). The fistula rate was 18% (n = 6). 24% (n = 8) predominantly male (87%) had VPI (P = 0.432). Their MPL was 17 mm; the mean follow-up was 4.7 years. SPA as a first stage performed in "wide" cleft palate narrows the subsequent hard palate repair and with a muscle release, may be adequate in some patients.

Split staphylectomy to address soft palate thickness in brachycephalic dogs: 75 cases (2016-2018).

Describe the split staphylectomy procedure to address soft palate thickness and assess the complications and long-term outcome of this procedure as a part of multi-level surgery for brachycephalic obstructive airway syndrome. To consider whether same-day discharge following this surgery can be recommended. Medical records of dogs treated for brachycephalic obstructive airway syndrome using the split staphylectomy were reviewed. Owners were contacted to complete a questionnaire assessing initial postoperative concerns, the long-term outcome and the effect of surgery on their dog's quality of life. Seventy-five dogs underwent split staphylectomy during the study period. The overall complication rate was 8.3%, of which 2.7% were considered major. No life-threatening complications occurred, and no complications were related to the staphylectomy. The questionnaire was completed by 66.7% of owners (median follow-up 459 days), of which 88% felt that surgery had improved the quality of life for their dog. The majority (88%) of dogs were discharged from hospital on the day of surgery. Of the surveyed owners, 14% sought veterinary attention between their dog leaving the hospital and the scheduled postoperative reassessment 2 weeks after surgery. Four dogs were presented for veterinary intervention during this time period, but no intervention was related to the staphylectomy or for a life-threatening condition. The split staphylectomy offers a safe, straightforward method of addressing both excess thickness and length of soft palate in dogs with brachycephalic obstructive airway syndrome. Dogs can be discharged on the same day as brachycephalic obstructive airway syndrome surgery including split staphylectomy without an increased risk of complications.

Adaptive Changes in the Posterior Pharyngeal Wall Following Large Retraction of Incisors During Comprehensive Orthodontic Treatment.

To evaluate the effects of large retraction of incisors on the adaptive changes in the posterior pharyngeal wall and soft palate during comprehensive orthodontic treatment. Twenty-seven females with Class I mild crowding or spacing who required non-extraction treatment (group I) and 34 females with Class I bimaxillary dentoalveolar protrusion who required all first premolars extraction for the retraction of their incisors (group II) were included in the study. The effects of non-extraction and incisor retraction following all first premolars extraction orthodontic treatment on the sagittal dimensions of pharyngeal airway passage and posterior pharyngeal wall thickness were evaluated from pre- and post-treatment cephalograms. The dimensions of pharyngeal airway passage were comparable among the groups. The length of the soft palate increased (P < .01) and the thickness of the soft palate decreased (P < .01) following retraction of incisors, and the difference between the groups was significant (P < .05). The posterior pharyngeal wall thickness was reduced significantly at PPWT2 (P < .05), PPWT3 (P < .001), PPWT4 (P < .001), PPWT5 (P < .001), and PPWT6 (P < .01) regions following retraction of the incisors, and the difference between the groups was statistically highly significant. The large retraction of incisors during comprehensive orthodontic treatment in Class I bimaxillary dentoalveolar protrusion malocclusion subjects did not affect the sagittal dimensions of pharyngeal airway passage, but the thickness of the posterior pharyngeal wall reduced significantly as an adaptation to maintain the patency of the upper airway.

Cranial volume and palate length of cats, Felis spp., under domestication, hybridization and in wild populations.

Reduced brain size, compared with wild individuals, is argued to be a key characteristic of domesticated mammal species, and often cited as a key component of a putative ‘domestication syndrome’. However, brain size comparisons are often based on old, inaccessible literature and in some cases drew comparisons between domestic animals and wild species that are no longer thought to represent the true progenitor species of the domestic species in question. Here we replicate studies on cranial volumes in domestic cats that were published in the 1960s and 1970s, comparing wildcats, domestic cats and their hybrids. Our data indicate that domestic cats indeed, have smaller cranial volumes (implying smaller brains) relative to both European wildcats (Felis silvestris) and the wild ancestors of domestic cats, the African wildcats (Felis lybica), verifying older results. We further found that hybrids of domestic cats and European wildcats have cranial volumes that cluster between those of the two parent species. Apart from replicating these studies, we also present new data on palate length in Felis cat skulls, showing that domestic cat palates are shorter than those of European wildcats but longer than those of African wildcats. Our data are relevant to current discussions of the causes and consequences of the ‘domestication syndrome’ in domesticated mammals.