Speech Analysis in Patients with Velopharyngeal Incompetence Following Surgical Correction

A total of 35 patients with velopharyngeal incompetence were treated by surgical correction from 1995 to 2001. Twenty-six patients underwent lateral port control superior based pharyngeal flap and 9 patients underwent sphincteric pharyngoplasty. Speech analysis and fluorolaryngo-graphy was performed preoperatively and postoperatively. The nasality of open vowel, round vowel and sentence and articulation accuracy in 26 patients who underwent the pharyngeal flap improved from 37.7+/-10.71%, 49.1+/-9.54%, 50.1+/-9.03% and 68.9+/-10.11% preoperatively to 20.4+/-9.77%, 25.4+/-10.11%, 38.5+/-9.34% and 80.1+/-6.47% postoperatively, and hypernasality and articulation accuracy improved significantly (p<0.05). In case of 9 patients who underwent sphincteric pharyngoplasty, results were from 41.2+/-11.27%, 42.4+/-17.04%, 53.8+/-7.63% and 72.3+/-10.87% preoperatively to 20.7+/-8.27%, 20.8+/-14.34%, 29.7+/- 11.47% and 80.7+/-12.47% postoperatively, and hypernasality improved significantly (p<0.05). As far as postoperative fluorolaryngography is concerned, the velopharyngeal space was closed in patients with postoperative normal range of nasality. In conclusion, these results suggest that patients with velopharyngeal incompetence will improve speech dysfunction effectively if is chosen appropriately either superior based pharyngeal flap or sphincteric pharyngoplasty.

Wound Healing Effect of the Chitosan Sponges Containing the T-CAM or Regenin

Tetra cell adhesion molecule(T-CAM) is a new recombinant mixture of fibronectin and ig-h3. Fibronectin and ig-h3 are extracellular matriprotein involved in each phase of wound healing, and the combination of these materials may generate a synergistic effect in wound healing. Regenin is easily attainable from protein recombination. It can be developed as wound healing material, and also it has a good effect in cell adhesion and proliferation. We combined the chitosan with regenin or T-CAM at different concentration, which are gene recombination material. They were applied to the artificial wound of white rabbit to compare the healing effect in each group. Round full thickness skin defects, 3 cm in diameter, were made bilaterally on the dorsolateral aspect of New Zealand white rabbit. Experimental group was divided into 6 groups, according to concentration of T-CAM and regenin with chitosan-based dressing materials as followings; Group C: control group - oint material dressing, Group Ch: chitosan base only, Group T1: chitosan base in combination with 25 microgram/ml of T-CAM, Group T2: chitosan base in combination with 625 microgram/ml of T-CAM, Group R1: chitosan base in combination with 25 microgram/ml of Regenin, Group R2: chitosan base in combination with 625 microgram/ml of Regenin. Gross findings by means of percentage of wound contraction, percentage of wound epithelization and percentage of total wound healed area were compared with surface tracing of the remained wound area at the time of 7, 14, 21 days after wound formation. Wound biopsy were performed at the time of 7, 14, 21 days after wound formation. T1, T2 group and R1, R2 groups have less infiltration of inflammtory cell, fast appearance of new vessels, fibroblast, increased volume of collagen fiber comparing to C and Ch group. there's more statistical significance between T1 and T2 group. The same results were shown in Regenin group. In conclusion, our results suggest that T-CAM and Regenin have good effect in wound healing and higher concentration of T-CAM and Regenin is more effective in wound healing than lower concentration. In addition, comparision of same concentration of T-CAM and Regenin group presented almost same results.

Comparison of Wound Healing Effect of Different Forms of Chitosan

This study is to compare the effect of wound healing using three different types of chitin, which include the shapes of sponge, velvet, thick non-woven fabrics, and thin non-woven fabrics. The sponge type had more capacity to absorb the first discharge of a wound than the velvet type and the two non-woven fabrics types. Instead of absorbing the discharge effectively, the velvet type showed a difficulty to take off the dressing stuff from a wound since it was solidly stuck to the wound. The sponge type showed less infiltration of inflammatory cells, producing angiogenesis and fibroblast faster than any other types. Next, the thick non-woven fabrics type was a little more effective than the thin non-woven fabrics type: However, there was no difference between two types. The velvet type sustained the infiltration of inflammatory cells for the longest duration, producing slower angiogenesis and fibroblast. In wound contraction and wound healing, the sponge type was most effective with statistical significance than any other types(p0.05). In conclusion, the sponge type showed the best effectiveness to absorb the early discharge, facilitating the progress of inflammatory phase to increase the healing rate. It induced an early healing of wound caused by wound contraction rather than by wound epithelization.