RESUMO
La hiperplasia de la úvula es una entidad poco frecuente. Puede tener diversas causas, tales como: surgir a partir de un proceso infeccioso; por reacciones alérgicas; angioedema hereditario (HANE) (14,16); inhalación de sustancias psicoactivas (7); traumatismos ocasionados por procedimientos como intubación o extubación endotraqueal, así como durante la aspiración de los líquidos de la cavidad oral en procedimientos quirúrgicos. (7,14,16) El alargamiento de la úvula, en algunos casos, se manifiesta asintomático. Este trabajo tiene como objetivo la descripción de esta entidad, la presentación de un caso clínico, y su manejo clínico-quirúrgico (AU)
The hyperplasia of the uvula is a rare entity, it can have diverse causes, such as: of an infectious process, allergic reactions, hereditary angioedema (HANE), (14 16) inhalation of psychoactive substances (7) traumatisms caused by procedures such as, intubation or endotracheal extubation, as well as during the aspiration of liquids from the oral cavity in surgical procedures (7,14,16). The lengthening of the uvula, in some cases, is asymptomatic. The aim of this work is the description of this entity, the presentation of a clinical case, and the clinical and surgical management (AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Úvula/cirurgia , Úvula/patologia , Procedimentos Cirúrgicos Bucais/métodos , Hiperplasia , Argentina , Cirurgia Plástica , Unidade Hospitalar de Odontologia , Angioedemas Hereditários , Intubação Intratraqueal/efeitos adversosRESUMO
The aim of the present study was to evaluate the dimensions of the pharyngeal airway space (PAS) in awake, upright children with different anteroposterior skeletal patterns using cone beam computed tomography (CBCT). The volume, area, minimum axial area and seven linear measurements of PAS were obtained from the CBCT images of 50 children (mean age 9.16 years). The patients were divided in two groups according to the ANB angle (group I 2° ≤ ANB ≤ 5°; group II ANB > 5°). Means and standard deviations of each variable were compared and correlated using independent t-test and Pearson's correlation test. There were statistically significant differences in the following parameters: angle formed by the intersection between NA and NB lines (p<0.001), angle formed by the intersection between SN and NB lines (p<0.05), Minimal pharyngeal airway space between the uvula and the posterior pharyngeal wall (p<0.05), airway volume (p<0.01), airway area (p<0.01) and minimum axial area (p<0.05). The anteroposterior cephalometric variable SNB had positive correlation with the variables PAS-UP (p<0.01), Minimal pharyngeal airway space between the uvula tip and the posterior pharyngeal wall (p<0.05), Pharyngeal airway space on mandibular line (p<0.05), Minimal pharyngeal airway space between the back of the tongue and the posterior pharyngeal wall (p<0.05), volume airway (p<0.05), airway area (p<0.05) and minimum axial area (p<0.05). The vertical cephalometric variables angle formed by the intersection between SN and GoGn lines (p<0.05) and angle formed by the intersection between FH and mandible plane (p<0.05) showed negative correlation with PAS-UT. These results showed that PAS was statistically larger in group I than group II, indicating that the dimensions of the PAS are affected by different anteroposterior skeletal patterns.
Assuntos
Má Oclusão/classificação , Faringe/patologia , Pontos de Referência Anatômicos/patologia , Cefalometria/métodos , Criança , Tomografia Computadorizada de Feixe Cônico/métodos , Epiglote/patologia , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Má Oclusão/diagnóstico por imagem , Má Oclusão/patologia , Mandíbula/patologia , Maxila/patologia , Nariz/patologia , Palato Duro/patologia , Faringe/diagnóstico por imagem , Sela Túrcica/patologia , Língua/patologia , Úvula/patologiaRESUMO
The files of 585 patients who had had pharyngeal flap surgery for the correction of velopharyngeal insufficiency were reviewed. Eighteen patients, ranging in age from 6 to 16 years, showed clinical symptoms of obstructive sleep apnea syndrome. All of these cases had a polysomnographic evaluation and videonasopharyngoscopy. Fifteen cases met the criteria for the diagnosis of obstructive sleep apnea syndrome and eventually underwent surgical treatment. A modified uvulopalatopharyngoplasty was done in 14 of the 15 cases. One patient had a prominent uvula flipping into the port of a Jackson's type pharyngoplasty, so a partial resection of the uvula was performed. Surgical treatment was successful in 14 of 15 cases, including the case with the partial uvular resection. In one case, severe sleep apnea persisted after surgery and a complete section of the flap was performed to correct the obstruction. Sizeable tonsils were found in 13 out of 15 cases, whereas flap width appeared unrelated to obstruction. Preoperative assessment of tonsillar tissue is of vital importance before pharyngeal flap surgery.
Assuntos
Faringe/cirurgia , Síndromes da Apneia do Sono/etiologia , Retalhos Cirúrgicos/efeitos adversos , Insuficiência Velofaríngea/cirurgia , Adolescente , Criança , Pré-Escolar , Endoscopia , Feminino , Humanos , Masculino , Nasofaringe/patologia , Palato/patologia , Faringe/patologia , Polissonografia , Retalhos Cirúrgicos/patologia , Úvula/patologia , Gravação em VídeoRESUMO
The files of 108 patients with submucous cleft palate were reviewed. Special attention was focused on the findings of videonasoendoscopy, videofluoroscopy, and audiometry. Velopharyngeal insufficiency was found in 53 percent of the cases. Since surgical correction is indicated only in the presence of insufficiency, waiting until speech has developed is recommended before considering treatment. A relationship between coronal pattern of velopharyngeal closure and velopharyngeal insufficiency was found. This relationship appears to be caused by the malformation of the musculus uvulae in the submucous clefts. Conductive hearing loss was significantly associated with velopharyngeal insufficiency. This suggests that a velar muscle malformation, which is frequently responsible for the insufficiency in these patients, may also cause Eustachian tube malfunction, resulting in serous otitis with conductive hearing loss.
Assuntos
Fissura Palatina/diagnóstico , Audiometria , Cinerradiografia , Fissura Palatina/cirurgia , Estudos Transversais , Endoscopia , Fluoroscopia , Perda Auditiva/etiologia , Humanos , Filmes Cinematográficos , Nasofaringe/fisiopatologia , Estudos Retrospectivos , Úvula/patologia , Insuficiência Velofaríngea/etiologiaRESUMO
Neste trabalho, fazem-se comentários acerca das principais deformidades da úvula palatina e mencionam-se meios de diagnóstico diferencial e tratamento dos alongamentos da úvula