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ObjectiveTo analyze the correlation between the changes of swallowing function and aspiration in stroke patients using videofluroscopic swallowing study. MethodsFrom January, 2014 to December, 2021, 240 stroke patients who underwent videofluroscopic swallowing study in the radiology department of Xuzhou Central Hospital were retrospectively analyzed. They were divided into aspiration group (n = 108, ≥ grade 5) and non-aspiration group (n = 132, < grade 5) according to Rosenbek Penetration/Aspiration Scale (PAS). The swallowing function changes in the oral and pharyngeal phases were compared between two groups according to Videofluoroscopic Dysphagia Scale, the risk factors of aspiration were analyzed using Logistic multivariate regression. ResultsThere were significant differences in incomplete lip closure, impaired bolus formation, apraxia, incomplete tongue-to-palate contact, premature bolus loss, prolonged oral transit time, delayed triggering of pharyngeal swallow, epiglottis folding dysfunction, pyriform sinus residue, and coating of pharyngeal wall (χ2 > 5.802, P < 0.05). Prolonged oral transit time (OR = 3.964, P = 0.036), delayed triggering of pharyngeal swallow (OR = 5.684, P < 0.001), epiglottis folding dysfunction (OR = 11.571, P < 0.001) and pyriform sinus residue (OR = 4.524, P = 0.002) were correlated with aspiration. ConclusionProlonged oral transit time, delayed triggering of pharyngeal swallow, epiglottis folding dysfunction and pyriform sinus residue are risk factors of aspiration after stroke.
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Objective:To explore the relationship between dysphagia and the lesion site after an ischemic stroke.Methods:The records of 178 cerebral infarction patients were divided into a supratentorial group of 111 and an infratentorial group of 67, according to the site of their lesions. The supratentorial group was further divided into left, right and bilateral groups of 59, 34 and 18, respectively. Fluoroscopic videos of the patients′ swallowing were used to measure lip closure, bolus formation, apraxia, tongue-to-palate contact, premature bolus loss, oral transit time, triggering of pharyngeal swallowing, vallecular residue, larynx elevation, pyriform sinus residue, pharynx wall coating, pharynx transit time, aspiration, and leakage.Results:There were significant differences between the supratentorial and infratentorial groups in bolus formation, apraxia, oral transit time, triggering of pharyngeal swallowing, larynx elevation, and aspiration. Moreover, significant differences were found in the incidence of aspiration among the left, right and bilateral supratentorial groups.Conclusions:Patients with supratentorial infarction are more likely than those with infratentorial infarction to develop oral dysphagia, including poor bolus formation, apraxia and prolonged oral transit time. Those with infratentorial infarction are more likely to have pharyngeal dysphagia, including poor triggering of pharyngeal swallowing, obstructed larynx elevation, and aspiration. Those with bilateral cerebral hemisphere infarction are more likely to aspirate than those with an infarct in the left cerebral hemisphere.
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Objective:To localize the impacted maxillary canine and to observe the root resorption of adjacent incisor in 3 dimen-sions using cone beam computed tomography(CBCT).Methods:92 impacted maxillary canines in 63 patients were scanned by CBCT.The three-dimensional images were obtained by multiplanar reconstructions(MPR).The cusp tip of each impacted canine was localized and set to the X,Y and Z planes after the observation of sagittal,coronal and axial views.The root resorption of adjacent in-cisors was observed.Results:In the X-axis,92% of impactions were mesial by 1 0.4 to 1 5.1 mm,8% distal by 2 to 5 mm;in the Z-axis,60% of impactions were palatal by 1 to 4 mm,40% buccal by 0 to 4 mm.41 .3% of the impacted canines were without root resorption of adjacent incisor,36.5% with slight,1 4.3% with moderate and 7.9% with severe root resorption of the adjacent inci-sor.Conclusion:The most frequent location of impacted maxillary canine is palatal and mesial with high incidence of root resorption of adjacent incisor.
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Objective; To evaluate the efficacy of Twin-block appliance in Class Ⅱ division 1 of adolescents. Methods: Several e-lectronic databases (PubMed, The Cochrane library, Embase, CBMdisk, CNKI, VIP)were searched. Abstract that appears to fulfill the initial selection criteria were selected by consensus and original articles were retrieved. Five Chinese journals were hand searched for possible missing articles. Randomized controlled trials(RCTs) that evaluate the efficacy of Twin-block appliance in Class Ⅱ division I adolescents without any surgical intervention or syndromic characteristics were considered. A comparable untreated control group was required to factor out normal growth changes. The quality of included studies was evaluated according to Cochrane Reviewers Handbook 4.2.6 Meta-analysis was performed by using RevMan 5.0.0 software. Results: Four RCTs including 289 patients were identified. The results of our meta-analysis showed a significant increase on SNB angle, Ar-Gn, Nasolabial angle and Labial-mental fold compared with control group(P<0.05). Whereas overjet, overbite, ANB angle and Ls-E had a significant decrease. In addition, SNA angle and Li-E didnt show statistical significant changes(P>0. 05). Conclusion; In Class II division 1 of adolescents, Twin-block appliance can effectively decrease their overjet, overbite, ANB angle, and induce anterior-posterior growth of mandible. The effect on restrain forward growth of the maxilla was unclear. More RCTs are required to evaluate the efficacy of Twin-block appliance.
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Objective:To compare the differences of cranial base morphology between high-angle and low-angle malocclusion patients with geometric morphometrics.Methods:Pretreatment lateral cephalograps of 80 skeletal Class I patients(40 hypodivergent,40 hyperdivergent)were selected.All cephalographs were scanned,and 13 homologous landmarks of cranial base were identified and digitized.Average geometries of cranial bas e were created by means of Procrustes analysis.Thin-plate spline analysis was applied to cranial base configurations to determine local morphology differences between the two vertical facial types.Results:1.high-angle patients had the cranial base characteristics as follow:(1)Horizontal and vertical expansion occured in the sphenoida region,(2)The anterial and posterior cranial bases circled S point opposite direction revolving,which caused cranial base angle to reduce significantly.2.The low-angle the cranial base characteristics was just opposite with high-angle′s.Conclusion:The shape of cranial base was different between high-angle and low-angle malocclusion patients.