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PubMed1985

Hemispheric control of speech expression in aphasia. A mouth asymmetry study.

Clinical observation of aphasic patients often shows a dissociation between impaired propositional speech and preserved automatic speech. The question of differing hemispheric control between these speech tasks was examined by measuring asymmetry in facial muscle activity. In spite of right-sided facial palsy, greater opening of the right side of the mouth was seen for spontaneous speech, repetition, and word list generation, suggesting that the damaged left hemisphere still controlled motor output in these propositional tasks. However, greater opening of the left side of the mouth for serial speech and singing indicated at least a relatively greater role of the right hemisphere in these "automatic" tasks.

Adult↗
PubMed2002

Neonatal dermoid cyst of the floor of the mouth extending to the midline neck.

We describe a male neonate who presented at birth with a compressible dermoid cyst that extended from the floor of the mouth to the midline of the neck. Ultrasonography revealed a fluid-filled sublingual mass. Magnetic resonance imaging performed when the patient was 1 week old demonstrated a 2-cm, cystic, left-sided, sublingual mass that crossed the midline without extension inferior to the mylohyoid muscle. At 3 months of age, the patient developed a 1-cm, solid, submental mass. At the time of surgery, the lesion had a fibromembranous tract that extended through the myolohyoid muscle to a 1-cm cyst in the submental region. Histologic sections depicted 2 dermoid cysts and a connecting fistula. This case represents the first report (to our knowledge) of a dermoid cyst presenting in a neonate as a mass in the floor of the mouth with extension to the midline of the neck.

Dermoid Cyst↗
PubMed2004

Effectiveness of gabapentin for treatment of burning mouth syndrome.

Burning mouth syndrome is a debilitating disorder involving oral pain that may have at least 4 underlying causes. Although several treatments have been proposed, none seems to be universally effective. We report the case of a 67-year-old woman with unremitting oral burning that is increased with the application of anesthetic agents. Initial treatments with nortriptyline hydrochloride and sertraline hydrochloride were contraindicated because of adverse effects, but the administration of gabapentin significantly reduced oral burning. The present case illustrates the effectiveness of gabapentin as a treatment of burning mouth syndrome.

Acetates↗
PubMed1997

Photodynamic therapy for early squamous cell carcinomas of the esophagus, bronchi, and mouth with m-tetra (hydroxyphenyl) chlorin.

OBJECTIVE: To clinically evaluate a new photosensitizer, m-tetra(hydroxyphenyl) chlorin (m-THPC), for the photodynamic therapy of early squamous cell carcinomas of the upper aerodigestive tract. DESIGN: Phase 1 included evaluation of the innocuousness of the compound after intravenous injection (control of vital parameters and blood analysis before and after injection) and evaluation of the duration of skin photosensitization. Phase 2 included assessment of optimal conditions for treatment (injected dose, drug-light interval, light dose, wavelength, etc), on 33 early squamous cell carcinomas of the mouth, esophagus, and bronchi, with a mean follow-up of 14 months; irradiation tests on healthy and neoplastic mucosae to determine the irradiation conditions that lead to tumor eradication with minimal damage to the surrounding normal mucosa and muscle layers; and localization of the dye in various tissue compartments and cells at different time intervals after the injection of the photosensitizer, by using a fluorescence microscope to analyze 46 biopsy specimens taken during the treatment sessions and 8 resected specimens of early cancers, excised with the carbon dioxide laser. SETTING: Endoscopic medical center of an otolaryngology-head and neck surgery department. PATIENTS: Twenty-five patients treated previously for a head and neck cancer with a synchronous or metachronous early second primary cancer. Patients with porphyria were excluded from the trial. RESULTS: The best results in the bronchi and mouth were obtained with an injected dose of 0.15 mg of m-THPC per kilogram of body weight 4 days before irradiation. The fluence was 7 to 16 J/cm2, and the fluence rate was between 100 and 150 mW/cm2 using red light at 652 nm. In the esophagus, green light at 514 nm is preferred to the red light to avoid fistulas. Optimal irradiation conditions at this wavelength, which was also used in the trachea, were found at a fluence of 75 to 100 J/cm2 and a fluence rate between 70 and 100 mW/cm2. Of 33 lesions treated thus far by photodynamic therapy with m-THPC, 28 show no recurrence with a mean follow-up of 14 months. Photosensitivity to sunlight does not exceed 6 weeks. CONCLUSIONS: m-Tetra(hydroxyphenyl) chlorin is a second-generation photosensitizer that has several significant advantages as compared with the first-generation porphyrin mixtures hematoporphyrin derivative and porfimer sodium (Photofrin II). It is a pure compound that is 100 times more phototoxic at 652 nm and 10 times more photoxic at 514 nm, has better selectivity for early carcinomas, and a shorter duration of skin photosensitivity. The therapeutic results indicate a recurrence rate that is similar to that obtained with Photofrin II, ie, about 15%.

Antineoplastic Agents↗
PubMed1999

Diagnosis of dermoid cyst of the floor of the mouth by fine-needle aspiration cytology: a case report.

A case of a dermoid cyst in the floor of the mouth in a 17-yr-old male is described. The diagnosis was made by fine-needle aspiration cytology and supported by histologic examination of the subsequently excised tissue. Dermoid cysts are benign lesions that can occur in the floor of the mouth. This case is presented to increase awareness of this entity and its occurrence in this location, and to demonstrate the feasibility of diagnosis by fine-needle aspiration. The cytologic and histologic features of dermoid cysts are described and discussed.

Adolescent↗
PubMed1992

Hand-rolled cigarette smoking and risk of cancer of the mouth, pharynx, and larynx.

A case-control study, involving 205 patients with cancer of the mouth, pharynx, and larynx and 273 control subjects with conditions considered not related to tobacco or alcohol consumption, was performed in Montevideo, Uruguay, between January 1988 and December 1990. Smokers of hand-rolled cigarettes showed an increased risk of cancer of the mouth and pharynx (odds ratio [OR] = 2.5; 95% confidence limit = 1.2-5.2) when compared with smokers of manufactured cigarettes. Also, the risk of laryngeal cancer was greater among smokers of hand-rolled cigarettes (OR = 2.7; 95% confidence limit = 1.3-5.7) as compared with smokers of commercial cigarettes.

Adult↗
PubMedDate not supplied

Distribution of surviving tumor cells after chemoradiotherapy in tongue and floor of mouth carcinomas.

BACKGROUND: Conservative surgery according to the clinical response to induction therapy is applied in breast carcinomas but not yet in head and neck carcinomas. The possibility of conservative surgery after induction therapy for preservation of function was examined. METHODS: Forty-three tongue and 15 floor of mouth carcinomas that had received induction therapy and tumor resection were submitted for a comparative investigation on the clinical effect of induction therapy and cancer cell degeneration, which was examined in semiserial specimens from the bread-loaf sections of the excised materials, and a classification of the surviving tumor cell distribution in the tissue was proposed. The distribution was divided into four patterns according to the dispersion and volume of the remaining tumor cells (pattern I, no surviving tumor cells; pattern IIA, viable tumor cells in the central superficial region of the original tumor tissue; pattern IIB, viable cells in the superficial portion, but distributed widely; pattern III, massive tumor cell nests in the deep portion, but centrally localized; pattern IVA, sporadical viable cell islands, but not in the periphery; and pattern IVB, diffuse viable cells scattered throughout the original tumor tissue). RESULTS: The original tumor size did not affect the remaining viable tumor cell distribution pattern, but sporadic distribution patterns (patterns IVA and IVB) were observed in most of the T4 cases. In many cases, especially in tumors of the nondiffuse invasion type (invasion of grade 1 and 2), the tumor remission rate was inversely correlated with the dispersion of the viable tumor cells. However, some cases of grade 3 and 4 invasion exhibited sporadical surviving tumor cells even though a high tumor remission rate was obtained. These tumors, especially those located on the floor of the mouth, recurred with high frequency. CONCLUSIONS: Conservative surgery can be applied to nondiffuse invasion cases, according to the tumor remission rate. In T3 and T4 cases exhibiting grade 3 or 4 invasion, conservative surgery is ill-advised, even if more than 90% tumor remission is obtained.

Carcinoma↗
PubMedDate not supplied

The role of irradiation in the management of squamous-cell carcinomas of the mouth and throat.

Fundamental precepts of radiation biology are presented to provide a basis for the comprehension of radiotherapy. These precepts include cell viability, randomness of cell killing by radiation, the influence of molecular oxygen on radiosensitivity, phases of the cell cycle, and repopulation. The combined-treatment concept is developed, and preoperative and postoperative irradiation options, as well as the optimal extent of the surgical procedure, are discussed. These principles of combined treatment are first applied to the management of neck disease, which is a common denominator to all sites. The anatomic sites of the mouth and throat are then discussed. The capabilities of radiotherapy have greatly altered treatment planning for carcinomas of the mouth and throat; one must now develop an initial overall plan that varies with the extent and anatomic site of the primary lesion, the extent of neck disease, and the probability of spread to clinically uninvolved lymphatic areas.

Adult↗
PubMedDate not supplied

Surgery versus combined therapies for cancer of the anterior floor of the mouth.

We report the results of treatment in a consecutive series of 75 patients operated on at the Istituto Nazionale Tumori of Milan, from January 1965 to December 1979, for cancer of the anterior floor of the mouth. Most of the tumors were advanced: 39 were treated with simple resection, and 36 underwent combined treatment, consisting of surgery associated with either chemotherapy or surgery. Three- and five-year observed survival rates of the whole series were good (41% and 25%, respectively), considering the tumor stage of these patients, but the determined survival rates were particularly high (56% and 46%, respectively). No real advantage was found in the use of multiple planned sequential therapies over surgery alone, and deaths from intercurrent diseases seemed to be more frequent in the patients who underwent combined therapies. We conclude that for patients in poor general condition, such as those with carcinomas of the anterior floor of the mouth, aggressive and complex treatments should be considered with caution in controlled clinical trials.

Carcinoma↗
PubMed2002

New characters in the Gnathostomulid mouth parts revealed by scanning electron microscopy.

An analysis with SEM of the mouth parts of 16 species belonging to 10 genera of Gnathostomulida resulted in the following new characters and conclusions: 1) At least in the genus Haplognathia, jaw teeth that are visible by conventional light microscopy are composed of the same aggregated needle-like denticles that are found, often in large numbers, on the basal plates of many filospermoid species. 2) Other new ultrastructural tooth features include the tricuspid basal plate teeth in Problognathia minima, tripartite teeth in Austrognathia and Austrognatharia, and the clear separation, in the Gnathostomula basal plate, of a mediodorsal set of teeth from a more extensive rostroventral set. 3) Three rows of teeth, as typical for Gnathostomulidae and Austrognathiidae, are also present in the filospermoid Haplognathia filum. 4) The wide range of geographic variation in Haplognathia ruberrima is confirmed by significant differences in jaw teeth between specimens from Belize and Bermuda. 5) A compartmentalized involucrum is present in Labidgonathia longicollis. 6) A pair of lamellae addentales, until now only known from Valvognathia pogonostoma, was found in Tenuignathia rikerae, Problognathia minima, and probably also Labidognathia rikerae. 7) In all gnathostomulids, the lamella symphysis is composed of identical rods that are considered homologous with those in the mouth parts of Rotifera and Micrognathozoa.

Animals↗
PubMed1979

The fine structure of the hypostome and mouth of hydra. II. Transmission electron microscopy.

The normal morphology of the hypostome and mouth of hydra were examined by transmission electron microscopy with conventional thin sections and freeze-fracture replicas. Myonemes of the hypostome are small in diameter, have gap and intermediate-type cell junctions within each epithelial layer and are associated with the opposite epithelial layer by transmesogleal processes and gap junctions. Nematocysts and sensory cells are aggregated in the circumoral region. The fine structure of adherent flagella arising from gastrodermal gland cells, and the transition region at the mouth between epidermis and gastrodermis are described in detail for the first time. The possible functional significance of the findings is discussed.

Animals↗
PubMed1995

Laryngeal mask airway with mouth opening less than 20 mm.

We describe the use of a laryngeal mask airway in three adult patients whose mouth opening varied from 12 mm to 18 mm. The first patient's incisal opening was 12 mm. His airway was otherwise normal and the standard laryngeal mask was used as the definitive airway for the 90 min revision of facial scars and bone graft to mandible. The second patient, who had an incisal opening of 18 mm, was scheduled for posterior fossa craniotomy. She adamantly refused awake fibreoptic tracheal intubation. Following induction of general anaesthesia, a standard laryngeal mask was inserted and, through this, fibreoptic intubation was performed. The third patient, in addition to a mouth opening of only 18 mm, had limited neck movement from previous flap reconstruction following mandibulectomy, hemiglossectomy and radical neck dissection. For three more reconstructive head and neck procedures that ranged from 90 min to nine hours, the flexible reinforced laryngeal mask was inserted under topical anaesthesia and its correct position confirmed by fibreoptic laryngoscopy before induction of general anaesthesia. Maintenance of anaesthesia in all cases was uneventful and there were no postoperative complications.

Adult↗
PubMedDate not supplied

Stages III and IV squamous cell carcinoma of the mouth: three-year experience with superselective intraarterial chemotherapy using cisplatin prior to definitive treatment.

PURPOSE: This study was designed to assess the 3-year experience with superselective intraarterial chemotherapy prior to definitive treatment for stages III and IV squamous cell carcinomas of the mouth. METHODS: Twenty-two patients prospectively received superselective intraarterial chemotherapy using relatively low-dose cisplatin via a transfemoral approach. The locations of the tumors were the tongue (n = 12), gingiva (n = 5), buccal mucosa (n = 2), hard palate (n = 1), floor of the mouth (n = 1), and lip (n = 1). After intraarterial chemotherapy, 21 patients underwent surgery (n = 14), radiation therapy (n = 6), or both (n = 1). The survival rate of 25 patients who underwent surgery with/without radiation therapy until 1992 at Kumamoto University Hospital was also evaluated as a historical control. The survival curve was calculated with the Kaplan-Meier method, and the statistical difference between survival curves was determined with the generalized Wilcoxon test. RESULTS: The overall response rate was 95% [complete response (tumor completely resolved), 24%; partial response (tumor reduction > or = 50%), 71%]. Fifty-two intraarterial infusions were performed without any catheter-related complications. Mild and transient local toxicity such as edema or mucositis of the infused area was relatively common. One patient died of renal failure from cisplatin. After a median follow-up of 20 months (range 2-41 months), the estimated 3-year survival rate for patients who underwent intraarterial chemotherapy plus surgery was 91%. The survival of the patients who underwent intraarterial chemotherapy plus surgery tended to be longer than that of the historical control. CONCLUSIONS: Early tumor reduction without delay of subsequent treatments can be obtained by intraarterial chemotherapy while minimizing complications and possibly improving survival. Further investigations of long-term survival with larger series need to be performed.

Antineoplastic Agents↗
PubMed2004

Histogenesis of the oropharyngeal cavity taste buds and the relevant nerves and brain centers in substrate-brooding and mouth-brooding cichlid fish (Cichlidae, Teleostei).

This study follows the histogenesis of the oropharyngeal cavity taste buds, along with the development of the relevant neural centers and gustatory nerves, in two cichlid species: the substrate-brooding Cichlasoma cyanoguttatum and the mouth-brooding Astatotilapia flavijosephi, from fertilization to 20-day-old juveniles, grown at a temperature of 26 degrees C. Significant differences in pace of development were shown between the two social types: Substrate-brooders complete embryogenesis and hatch 48 h after fertilization (HAF) and begin to swim 120 HAF, with the yolk sac disappearing 160 HAF, whereas mouth-brooders hatch 84 HAF and begin to swim 196 HAF, with the yolk sac disappearing 360 HAF. Histogenesis of primordial taste buds occurs 75 HAF and 160 HAF in C. cyanoguttatum and A. flavijosephi, respectively. Accordingly, the related sensory ganglia and nerves (VII, IX, and X) develop much earlier in the substrate-brooded larvae and postlarvae. Nerve and brain development in juvenile A. flavijosephi of 13 mm total length (TL) closely resemble those of 8-mm-TL C. cyanoguttatum. These differences in development continue throughout the early stages of growth. Similar differences are observed in the ripening and increase in number of taste buds and dentition on the jaws and pharyngeal bones. The possible triggers and causes of such differences in development, as well as the inductors of taste bud development, are discussed.

Afferent Pathways↗
PubMed1999

Dummy use, thumb sucking, mouth breathing and cot death.

UNLABELLED: In the Netherlands a case control study into cot death was undertaken as part of the European Concerted Action on sudden infant death syndrome. Children between 1 week and 2 years of age who died suddenly and unexpectedly were reported. Non cot death cases were excluded after a consensus by three pathologists. The study comprised 73 cot death cases and two controls per case, matched for date of birth. Compared to national data, the coverage was 91%. We investigated whether in the Netherlands new risk or preventive factors might have emerged. The present report focuses on the relative risks of dummy use, thumb sucking, breast versus bottle feeding, and sleeping with the mouth open. CONCLUSION: Dummy use seems to be an important preventive factor for cot death in the Netherlands, independent of other risk factors such as prone sleeping and bedding. We recommend dummy use at least for bottle-fed infants. We found no indication that dummies influence the frequency or duration of breast feeding but more data are needed. Mouth breathing appears to be associated with an increased risk for cot death, but again further research is needed.

Bottle Feeding↗
PubMed2006

Dynamics of capsule swallowing by healthy young men and capsule transit time from the mouth to the stomach.

We examined the dynamics of capsule swallowing by healthy young men using the anterior-posterior view of videofluoroscopy as a first step in a study on capsule swallowing by dysphagic patients. The subjects were 14 healthy men who did not have any complaint of dysphagia. They were asked to swallow a #4 hard gelatin capsule filled with barium sulfate with 15 ml of water during the videofluoroscopic examination. This examination was repeated three times for each subject (total of 42 trials). In four of the 14 subjects, a swallowed capsule was retained at the upper esophageal sphincter, or the broncho-aortic constriction of the esophagus, or the lower esophageal sphincter. Except where retention occurred, the average capsule transit time from the mouth to the stomach was 6.0 +/- 2.4 s. Three of the four subjects who had capsule retention did not realize that the swallowed capsule was retained en route to the stomach. By considering the dynamics of swallowing a capsule with 15 ml of water in healthy men, we should be able to reveal the dynamics of capsule swallowing in dysphagic patients, and the capsule transit time from the mouth to the stomach.

Adult↗
PubMed2006

Attention to eyes and mouth in high-functioning children with autism.

In the present study, we used a probe-detection task to compare attentional allocation to the eyes versus mouth regions of the face in high-functioning boys with autism relative to normal control boys matched for chronological age and IQs. We found that with upright faces, children from both groups attended more to the eyes region than to the mouth region, and to the same extent. This pattern of behavior was observed for not only initial orientation of attention, but also when enough time was provided for attention to be disengaged from its initial locus. The present findings suggest that atypical face processing in autism does not result from abnormal attentional allocation to the different face parts.

Attention↗
PubMed1982

Effect of diet on the colonization of the mouth by Actinomyces viscosus (T-6) in Osborne-Mendel rats.

Oral colonization by A. viscosus, strain T-6 was studied in Osborne-Mendel rats which were fed either sucrose, glucose, starch or casein alone ad libitum by mouth. Essential nutrients were given to the rats twice daily by stomach tube. All three carbohydrates supported implantation by Actinomyces to varying degrees. Implantation did not occur when the animals were fed casein. Casein did not have any antimicrobial effect on Actinomyces already established in the rat mouth; it was impossible to eliminate an established Actinomyces flora. Feeding the animals all the dietary components through the stomach tube did not result in eradication of Actinomyces from an established flora. The Actinomyces was considerably diminished when coprophagy was prevented.

Actinomyces↗