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At least 73 records · Page 4Linked to original sources
PubMed1996

Relationship between velopharyngeal dimensions and palatal EMG during progressive hypercapnia.

To examine the contribution of specific palatal muscles to velopharyngeal dimensions, we recorded electromyographic (EMG) activity in the levator veli palatini, the tensor veli palatini, and the palatoglossus while examining the velopharynx (VP) with videoendoscopy in eight awake normal adults. Simultaneous display of VP images and airflow provided precise timing of events. Video images and EMG signals were recorded during progressive hypercapnia. Every tenth breath was analyzed. For each selected breath, VP area, anteroposterior and lateral diameters, and EMG activity were determined at five points: beginning, middle, and end of inspiration and middle and end of expiration. VP measurements changed significantly during the respiratory cycle. Although maximum area was measured at end inspiration or middle expiration and minimum area at the beginning or end of the breath, respiratory-related changes in VP measurements and EMG activity were characterized by substantial inter- and intrasubject variability. This variability is similar to velopharyngeal behavior during nonrespiratory tasks and suggests that upper airway patency is determined by multiple factors.

Adult↗
PubMed1998

Congenital fistula of the palate.

Four cases of congenital fistula of the palate are presented. All four patients had a fistula which was situated in the vault with a bifid uvula, submucous separation of the palatal muscles, deformities of the palatal plates and unilateral cleft lip. Velopharyngeal incompetence appeared in primarily treated children. The aetiology and surgical treatment of the congenital defect are discussed.

Adolescent↗
PubMed1990

Effects of percentage Brahman and Angus breeding, age-season of feeding and slaughter end point on meat palatability and muscle characteristics.

Steers (n = 125) of known percentage Angus (A) and Brahman (B) breeding (A = 31, 3/4A:1/4B = 32, 1/2A:1/2B = 31, 1/4A:3/4B = 31) were slaughtered after being fed as calves during the cool period of the year or fed as yearlings during the warm period of the year. Steers were slaughtered at equivalent outside fat thickness as monitored visually and with real-time ultrasound. Warner-Bratzler shear (WBS) force increased and sensory panel tenderness decreased as percentage Brahman increased. Loin muscle characteristics indicated that differences in tenderness between breed groups were not attributed to cold shortening effects or differences in amount or integrity of connective tissue. Fragmentation values suggested that breed group tenderness differences probably resulted from differences in the muscle fiber component. A 10-d postmortem aging study revealed a differential breed group response to postmortem aging, suggesting that breed groups differed in amount and(or) activity of naturally occurring proteolytic enzymes in muscle tissue.

Age Factors↗
PubMed1992

[A case of progressive supranuclear palsy presenting mouth opening difficulty with tonic contraction of the orbicularis oris muscle].

A 72-year-old man developed supranuclear ophthalmoplegia, bradykinesia, rigidity, unsteady gait, dementia, dysphagia, retrocollis, grasp reflex and apraxia of eyelid opening. These findings were compatible with progressive supranuclear palsy (PSP). At the age of 66, he presented a peculiar phenomenon characterized by simultaneous tonic contraction of the orbicularis oris muscle (OOM) and the palatal muscles elicited by pronouncing "pa", which resulted in difficulty of voluntary opening of the mouth and the rhinopharynx. Therefore, the respiration air reciprocated between the lung and the closed mouth. The expiratory pressure puffed out the cheeks, while the lips remained tightly closed. While the respiratory movements and the pressure increased by degree, the OOM contracted more strongly in proportion to the pressure. Sixty to ninety seconds after the elicitation, the pressure overcame the contraction of the OOM and the course of the phenomenon was completed. The electromyograms showed that the OOM activity was prolonged after initial voluntary contraction, remaining thus after a tracheostomy for pneumonia at the age of 72, and that it increased in response to the pressure. Apraxia of eyelid opening, one of the other symptoms, resembled this phenomenon in terms of the aspect of difficulty of voluntary mouth opening. The "holding" phase of grasp reflex, yet another symptom, resembled it in the recruitment of the OOM activity. The phenomenon is not common in patients with PSP. However, we concluded that it may be included among the symptoms of PSP because it has similar characteristics to apraxia of eyelid opening and grasp reflex, which are not uncommon in patients with PSP.

Aged↗
PubMed1998

Mechanical properties of the upper airway.

Abnormalities of upper airway mechanical properties are a well-recognized and important feature of the pathophysiology of the obstructive sleep apnea hypopnea syndrome (OSAHS). Recently, investigations enhanced our understanding of the factors that promote upper airway obstruction. In patients with OSAHS, anatomic narrowing of the pharyngeal airway, particularly in the lateral dimension with thickening of the lateral pharyngeal walls, is present. In addition, the passive upper airway (absent muscle activity) demonstrates increased collapsibility, which is modulated by caudal tracheal traction, mucosal surface forces, route of breathing, and the balance of intraluminal airway and extraluminal tissue pressures. In patients with OSAHS, pharyngeal dilator muscles (including the genioglossus and soft palate muscles) demonstrate a coordinated pattern of increased muscle activity while awake compared with normals. This is thought to represent a neuromuscular compensatory mechanism for the anatomically narrow, more collapsible upper airway. With the onset of sleep, the reflexes that drive this muscular compensation are diminished, leading to reduced muscle activity and predisposing the OSAHS patient to pharyngeal collapse. Better understanding of the mechanical properties of the upper airway in normals and patients with OSAHS should help in the development of new therapeutic strategies.

Airway Obstruction↗
PubMed1983

Palatopharyngeal anatomy and physiology.

Current literature concludes that the levator veli palatini and the musculus uvulae are the muscles primarily responsible for palatopharyngeal closure during speech in the normal individual. As a compensatory mechanism in approximately one third of patients with palatopharyngeal insufficiency, the superior constrictor muscle may be active in the form of Passavant's ridge. This ridge occurs infrequently in normal speakers. There is some evidence that this conclusion is too simplistic. There may be more individual variation involved than admitted or understood at present.

Humans↗
PubMed1992

[Experience with Furlow's palatoplasty and its preliminary result].

The palatal muscle reconstruction has become an essential part of cleft palate repair. Sixty-one cases of various cleft palate and velopharyngeal incompetence after palatoplasty repair using the Furlow's double Z-plasty technique have been reported. A description of our surgical procedure along with the follow-up of 40 cases 1/2 to 1 year after operation demonstrate the advantages of the Furlow's palatoplasty. Our preliminary follow-up results show that the palatal competence rates are 90.5% in 21 cases of nasopharyngoscopic examination and 83.7% in 37 cases of still lateral X-ray radiograph. For maintaining adequate muscle reposition and soft palate pushback, the unilateral or bilateral mucoperiosteal flaps from hard palate are recommended in wider cleft palate. The design and some key points in the Furlow's palatoplasty are also discussed.

Adolescent↗
PubMed1982

Relationships between muscle activity and velar position.

Five normal subjects were used to study the relations between muscle activity and velar position. The speech sample consisted of the sustained sounds /i/, /u/, /s/, nonnasal /a/, and nasalized /a/. Velar position was determined using lateral-view x-rays. Electromyographic activity was measured from hooked-wire electrodes intended to record from the levator veli palatini, palatoglossus, palatopharyngeus, and the superior pharyngeal constrictor muscles. A transnasal approach was used to insert electrodes intended for superior constrictor. It was found that 1) the level of levator activity was not directly related to velar position, 2) for a given velar position the level of levator activity was related to palatoglossus and/or palatopharyngeus activity in most cases, and 3) superior constrictor was active during all speech samples studied, but the level of activity was inconsistent both within and between subjects.

Adult↗
PubMed2006

Histological analysis of palatopharyngeal muscle from children with snoring and obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome (OSAS) is an upper airway obstruction that occurs during the sleep. One of the suggested mechanisms involved in this process is a neuromuscular abnormality of the palatal muscles. Whether children with OSAS develop into OSAS adults, or children and adult OSAS are two distinct disorders occurring at different ages are questions to be answered. Here, we made the histological analysis of palatophryngeal muscle in 34 oral-breathing children of both genders, aged 5-12 years old, with hypertrophic tonsils and adenoids. According to the polysomnographic study the participants were divided into children without sleeping disorders (group I) and children with primary snoring (group II) or apnea (group III). The main histological findings were fiber size variability in 70% cases from groups II and III and in 71% from group I; perimysial connective tissue infiltration in 48% children from groups II and III and in 71% from group I; intracytoplasmatic mitochondrial proliferation in 63% cases from groups II and III and in 57% cases from group I. Muscle necrosis was only observed in one case, in association with subglandular inflammation. Others findings observed in all groups included fibers with internal architecture alteration, such as moth-eaten and lobulated fibers, type 2 fiber predominance, and small areas of fiber type grouping. The presence of similar histological findings in the palatopharyngeal muscle in children with primary snoring or apnea but also in children without sleeping disorders indicate that such changes could be a normal histological feature of this muscle rather than a neurogenic or myopathic pathology.

Biopsy↗
PubMed2006

Floating the uvula: an intraoperative method for detecting bifidity.

A bifid uvula, midline diastasis of the palatal muscles, and notching of the posterior hard palate have classically formed a triad diagnosing submucosal clefts. The uvula has thus served as a tool for clinicians to detect the earliest signs of clefting. In this case report, we discuss how mucosal lining may be held together by mucous viscosity, making it difficult to detect notching or a grossly bifid uvula. We demonstrate a simple intraoperative technique to easily overcome this force. This paper involves a case report of an 8-year-old female undergoing an adenotonsillectomy. A previously undetected bifid uvula was found only after floating the uvula in normal saline solution. This changed our surgical approach from a complete to a partial adenoidectomy. A bifid uvula may be considered the earliest form of a cleft palate, and more importantly, it has been shown in the literature to be associated with other anomalies as submucosal cleft, hyoplastic eustachian tube orifice, and absence of the salpingopharyngeal folds. The intraoperative technique of floating the uvula helps to overcome mucous viscosity and identify an otherwise missed bifid uvula.

Adenoidectomy↗
PubMed2002

Abnormal palatopharyngeal muscle morphology in sleep-disordered breathing.

The aim of the present study was to investigate whether histopathological changes can be detected in two soft palate muscles, the palatopharyngeus and the uvula, in 11 patients with long duration of sleep-disordered breathing (SDB). Muscle samples were collected from patients undergoing uvulo-palatopharyngoplasty (UPPP). Reference samples from the corresponding areas were obtained at autopsy from five previously healthy subjects. Muscle morphology, fibre type and myosin heavy chain (MyHC) compositions were analysed with enzyme-histochemical, immunohistochemical and biochemical techniques. The muscle samples from the patients, and especially those from the palatopharyngeus, showed several morphological abnormalities. The most striking findings were (i) increased amount of connective tissue, (ii) abnormal variability in fibre size, (iii) increased proportion of small-sized fibres, (iv) alterations in fibre type and MyHC compositions, (v) increased frequency of fibres containing developmental MyHC isoforms. Our findings point towards a pathological process of denervation and degeneration in the patient samples. Conclusively, the morphological abnormalities suggest a neuromuscular disorder of the soft palate in SDB patients.

Adult↗
PubMed1996

Coordination between palatal and laryngeal muscle activities in response to rebreathing and lung inflation.

The soft palate and larynx play an important role in respiration and phonation, regulating the airflow in the upper airway. The levator veli palatini muscle (LVP) is the principal muscle responsible for generating palatal movements. The lateral cricoarytenoid muscle (LCA) is a laryngeal adductor muscle, and the posterior cricoarytenoid muscle (PCA) is a laryngeal abductor muscle. This study was designed to define, by electromyographic techniques, the coordination between palatal and laryngeal muscle activities in response to rebreathing and lung inflation. We performed tracheotomies on 12 mongrel dogs anesthetized with sodium pentobarbital and compared the effects of rebreathing and lung inflation on LVP activities with those on LCA and PCA activities. During rebreathing, expiratory LVP and inspiratory PCA activities were progressively augmented, but expiratory LCA activity was inhibited. On the other hand, lung inflation caused augmentation of LVP and LCA activities. In contrast, lung inflation inhibited PCA activity. We thus concluded that LVP activity coordinates with PCA activity in response to alternation of Paco2 and Pao2 levels, while it coordinates with LCA activity in response to lung inflation.

Animals↗
PubMed1993

The use of clostridium botulinum toxin in palatal myoclonus. A preliminary report.

Palatal myoclonus is a rare syndrome characterized by involuntary rhythmical movements of the soft palate giving rise to clicking objective tinnitus. The intrusive nature of the tinnitus prompts patients to seek medical advice but to date no single treatment modality has been shown to be consistently effective. We present three cases in whom various management regimens were unsuccessful and in whom botulinum toxin injection to the palatal muscles was undertaken. All three cases were rendered free of their tinnitus with complete abolition of the myoclonus. The questions of optimum dosage as well as frequency of injection will be answered as greater numbers are treated by this method.

Adult↗