RESUMO
A new palatopharyngoplasty which allows good muscular reorientation as well as elongation of the soft palate with minimal morbidity and scarring has been developed, and 66 selected patients underwent the procedure during the period September 1989 to March 1993. The most important findings were reduced operative bleeding, good length and mobility of the soft palate, and minimal scarring. A total of seven fistulas (11%) developed. Twenty-three patients (mean age 6 years and 2 months at the time of operation) underwent nasopharyngoscopy and multiview videofluoroscopy; velopharyngeal insufficiency was evident in only four (17%). Dental casts were obtained in 14 patients (mean age at the time of the operation 1 year, 3 months) who were followed up for a maximum period of two years. No postoperative orthodontic treatment was required and the width and harmony of the dental arch were maintained in all cases.
Assuntos
Fissura Palatina/cirurgia , Cirurgia Plástica/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
There is a certain global awareness to unify the reports of the findings with the Fiber Optic Endoscopy and The Fluoroscopy in the Velopharyngeal Sphincter. The evaluation must be made by specialists. Nasopharyngoscopy: The required equipment is the nasopharyngoscope with a source of light. A videotape is desirable although not necessary. The report must be descriptive and should arrive at precise conclusions. The following are described: 1) nasal phosae, 2) meatus, 3) the exit orifice of the Eustachian Tube, 4) oropharyx, 5) velopharyngeal sphincter (posterior and lateral pharyngeal walls, and the palatal velum), 6) the closing pattern (form, separate structure, at rest, and in phonation), and 7) larynx. Fluoroscopy: It is useful to evaluate the lateral pharyngeal walls as well as the level at which the velopharyngela sphincter closes. The fluoroscopy is not required in every combination instance. Nevertheless, when it is used, it must be in complement with the nasopharyngoscopy. The videotape is not indispensable. Frontal, lateral, and basal incidences must always be performed.
Assuntos
Palato Mole/fisiologia , Faringe/fisiologia , Endoscopia , Fluoroscopia , Humanos , Valores de ReferênciaRESUMO
Congenital facial palsy is a devastating deformity. At present time there are no reports of the early treatment of this disorder. The treatment may be to supply contralateral auto reinnervation to the affected muscles through a sural-facial nerve graft enhanced by electric field stimulation. The purpose of this paper is to report 5 cases of congenital facial palsy treated by a crossed sural-facial nerve graft, enhanced by electric field stimulation. One year after surgery, clinical and electrodiagnostic examinations indicate appropriate reinnervation activity in all the patients.
Assuntos
Terapia por Estimulação Elétrica , Nervo Facial/cirurgia , Paralisia Facial/terapia , Nervo Sural/transplante , Terapia Combinada , Eletromiografia , Nervo Facial/fisiologia , Paralisia Facial/congênito , Seguimentos , Humanos , LactenteRESUMO
Thirty-one patients with surgically repaired cleft palate who had velopharyngeal deficiency and compensatory articulatory defects in comparison to hyperrhinophony were studied. All patients were submitted to a videonasopharyngescopic and videofluoroscopic study of multiple incidence before and after speech therapy in order to correct the compensatory articulation. The movement proportions of the pharyngeal velum structures increased significantly after the correction of the compensatory articulation. Even moreso, the size of the pharyngeal velum defect decreased significantly. The results of this study support the postulate which recommends that the articulatory abnormalities associated to hyperrhinophony should be corrected before surgery for pharyngeal velum insufficiency secondary to the closure of the cleft palate.