ABSTRACT
BACKGROUND@#The submucous cleft palate (SMCP) is a type of cleft palate that may result in velopharyngeal insufficiency (VPI). Palate muscles completely separate oral and nasal cavities by closing off the velopharynx during functional processes such as speech or swallow. Also, hypernasality may arise from anatomical or neurological abnormalities in these functions. Treatments of this issue involve a combination of surgical intervention, speech aid, and speech therapy. This case report demonstrates successfully treated VPI resulted from SMCP without any surgical intervention but solely with speech aid appliance and speech therapy.CASE PRESENTATION: A 13-year-old female patient with a speech disorder from velopharyngeal insufficiency that was caused by a submucous cleft palate visited to our OMFS clinic. In the intraoral examination, the patient had a short soft palate and bifid uvula. And the muscles in the palate did not contract properly during oral speech. She had no surgical history such as primary palatoplasty or pharyngoplasty except for tonsillectomy. And there were no other medical histories. Objective speech assessment using nasometer was performed. We diagnosed that the patient had a SMCP. The patient has shown a decrease in speech intelligibility, which resulted from hypernasality. We decided to treat the patient with speech aid (palatal lift) along with speech therapy. During the 7-month treatment, hypernasality measured by a nasometer decreased and speech intelligibility became normal.@*CONCLUSIONS@#Surgery remains the first treatment option for patients with velopharyngeal insufficiencies from submucous cleft palates. However, there were few reports about objective speech evaluation pre- or post-operation. Moreover, there has been no report of non-surgical treatment in the recent studies. From this perspective, this report of objective improvement of speech intelligibility of VPI patient with SMCP by non-surgical treatment has a significant meaning. Speech aid can be considered as one of treatment options for management of SMCP.
ABSTRACT
In the cases of surgical approach for adrenal pheochromocytoma, successful ligation and severance of the adrenal vein at the start can make intraoperative circulatory kinetics stable and subsequent operative procedures very easy. Recently, we adopted the thoracoabdominal approach in 5 cases of 6 pheochromocytoma instead of transabdominal or translumbar approach which had so far been adopted for such tumors. The results revealed that the thoracoabdominal approach was very advantageous compared with these conventional approaches. Its main advantages include a wide and shallow operative field, early ligation and severance of the adrenal vein mobilization of the tumor, easy operative procedure and short operation time, etc.
Subject(s)
Adrenalectomy , Kinetics , Ligation , Pheochromocytoma , Surgical Procedures, Operative , VeinsABSTRACT
The term "Milk of calcium" has been borrowed from a somewhat similar condition encountered in the gallbladder. The coexistence of stone in a caliceal diverticulum is well known but milk-of-calcium is unusual in this structure. Recently we experienced a case of milk-of-calcium in a pyelocaliceal diverticulum in a 44 year old man, so we report this case with a brief review of the literature.
Subject(s)
Adult , Humans , Diverticulum , GallbladderABSTRACT
Urachal carcinoma is an uncommon neoplasm associated with a poor prognosis. We have encountered two another cases of urachal adenocarcinoma recently 5 years after our first report. The common sign of urachal cancer was painless hematuria. We diagnosed the specific site of origin preoperatively by means of computerized tomography. One patient was performed partial cystectomy and another was total cystectomy with double barrel ureterocutaneostomy. A brief review of the literature of urachal adenocarcinoma was also made.
Subject(s)
Humans , Adenocarcinoma , Cystectomy , Hematuria , PrognosisABSTRACT
Congenital penile curvature without chordee is a rare anomaly and a surgically correctable lesion which can usually distinguished from chordee and other acquired causes of penile curvature. The lesion is usually found in young men in the third decade of life. The curvature is usually present since birth but there are no complaints until puberty. Physical examination with the penis in the flaccid state is usually normal. We report a case of ventral curvature of the penis in 20-year-old-male. Correction of the penile curvature with Nesbit`s operation was Performed.