Análisis morfológico de rugosidades palatinas en una población costarricense / Morphological analysis of palatal rugae pattern in Costa Rican population

Resumen El presente estudio tuvo como objetivo establecer los patrones morfológicos presentes en las rugosidades palatinas de una población costarricense mediante el método de Trobo y efectuar un análisis estadístico con las variables de sexo, edad y afinidad biológica. Se eligiron al azar 70 pacientes a los que se realizaron impresiones y modelos dentales superiores, se documentó el sexo, edad y afinidad biológica de cada uno, junto con el consentimiento informado. Se analizó estadísticamente la distribución de patrones de género, edad y afinidad biológica. Las técnicas para el análisis de la información fueron las distribuciones de frecuencia, cruce de variables, comparación de medias con base en el análisis de variancia, coeficiente de correlación de Spearman; pruebas de Chi cuadrado, para evaluar la independencia entre las características de edad y sexo. Estas pruebas señalan un predominio de tipos de rugas palatinas rectas y de tipo simples tanto en la población masculina como femenina, sin encontrarse variación en el número de rugas asociadas a sexo o afinidad biológica; pero sí se determinó diferencia por grupo de edad, disminuyen en número conforme se incrementa la edad. Por otra parte no se presentó dimorfismo por sexo, lateralidad ni posición.

Abstract The present study aimed to establish the morphological patterns present in the palatal rugae in a Costa Rican population by means of the Trobo method and to carry out a statistical analysis with the variables of sex, age and biological affinity. Seventy patients were randomly chosen to whom impressions and superior dental models were made, the sex, age and biological affinity of each one was documented, together with the informed consent. The distribution of gender, age and biological affinity patterns was statistically analyzed. The techniques for the analysis of the information were the frequency distributions, crossing of variables, comparison of means based on the analysis of variance, Spearman's correlation coefficient; Chi square tests, to evaluate the independence between the characteristics of age and sex. These tests indicate a predominance of straight and simple types of palatal rugae in both the male and female population, with no variation in the number of rugae associated with sex or biological affinity; but a difference was determined by age group, they decrease in number as age increases. On the other hand, there was no dimorphism due to sex, laterality or position.

Incidência de fistula após palatoplastia à Von Langenbeck com veloplastia intravelar estendida / Incidence of cleft palate fistula after von Langenbeck palatoplasty with extended intravelar veloplasty

Introdução: A fissura labiopalatina é a deformidade craniofacial mais frequente e sua incidência é estimada em 1:600 nascidos vivos no Brasil. O objetivo desse estudo é avaliar a incidência de fístulas para os pacientes submetidos à palatoplastia com veloplastia intravelar estendida. Métodos: Trata-se de estudo descritivo retrospectivo com 25 pacientes que foram operados pelo mesmo cirurgião no período de setembro de 2011 a setembro de 2012. A técnica de Von Langenbeck, juntamente com a veloplastia intravelar estendida, foi realizada em todos os pacientes. Foram excluídos do estudo os pacientes com fístulas palatinas, portadores de síndromes ou outras malformações. A idade média da realização da palatoplastia foi de 30,6 meses, variando de 12 meses a 159 meses. Foram selecionados 19 pacientes: onze (58%) do gênero masculino e oito (42%) do gênero feminino. A fissura palatal isolada foi a mais comum, encontrada em nove (47%) pacientes. A fissura transforame esquerda estava presente em sete (37%) pacientes e três (16%) pacientes eram portadores de fissura transforame bilateral. Resultados: Somente dois (11%) pacientes evoluíram com fístula palatina até o acompanhamento pós-operatório de 6 meses. Conclusão: A técnica de Von Langenbeck associada à veloplastia estendida mostrou-se com baixa incidência de fístulas palatinas (11%) quando comparada ao índice encontrado na literatura mundial (7% a 42%).

Introduction: Cleft lip and palate is the most common craniofacial deformity, with an estimated incidence of 1 case per 600 live births in Brazil. The aim of this study was to determine the incidence of fistula among patients undergoing palatoplasty with extended intravelar veloplasty. Methods: This retrospective descriptive study evaluated 25 patients operated between September 2011 and September 2012 by the same surgeon. The von Langenbeck technique combined with extended intravelar veloplasty was performed in all patients. The study excluded patients with palatal fistulas, syndromes, or other malformations. The age at palatoplasty varied between 12 and 159 months, and the average age was 30.6 months. Nineteen patients were selected, comprising 11 (58%) male patients and 8 (42%) female patients. Isolated cleft palate was the most common deformity, found in 9 (47%) patients. Unilateral (left) trans-foramen cleft was present in 7 (37%) patients, and bilateral trans-foramen cleft was seen in 3 (16%) patients. Results: Only 2 (11%) patients had palatal fistula in a postoperative follow-up period of 6 months. Conclusion: The von Langenbeck technique associated with extended veloplasty resulted in a low incidence of cleft palate fistulas (11%) compared with the rate found in previous studies (7%-42%).

Influential factors affecting the postoperative velopharyngeal function among aged cleft palate patients / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To determine the factors affecting post-operative velopharyngeal function of cleft palate patients aged over two years old.</p><p><b>METHODS</b>The data on 245 patients, including first visit case records and those in the database, were searched and recorded. Post-operative velopharyngeal function and clinical features, such as cleft ratio, adequate ratio, diagnosis, operative age and method, were analyzed retrospectively.</p><p><b>RESULTS</b>Cleft ratio and adequate ratio in the velopharyngeal competence (VPC) group were not statistically different from those in the velopharyngeal incompetence (VPI) group. The difference in VPC rate in different age groups and diagnosis was not significant. The post-operative VPC rates under different methods were significantly different.</p><p><b>CONCLUSION</b>The current therapeutic schedule for patients younger than two years old is inappropriate for patients older than two years old. Cleft ratio is not the main factor affecting postoperative velopharygeal function. Sommerlad-Levator Veli Palatini reconstructional operation combined with sphincter pharyngoplasty can obviously improve the velopharyngeal function of patients aged 2 years old and up. This method should be applied in primary palatoplasty.</p>

Analysis of velopharyngeal morphology in operated cleft palate patients with levator veli palatini retropositioning according to Sommerlad / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the relationship between velopharyngeal morphology and velopharyngeal function in operated cleft palate patients with velopharyngeal competence (VPC) with levator veli palatini retropositioning according to Sommerlad.</p><p><b>METHODS</b>Three groups were included in the study. The experimental group comprised 18 incomplete cleft patients (group T1) repaired with VPC repaired with levator veli palatini retropositioning according to Sommerlad and 14 incomplete cleft patients (group T2) with velopharyngeal incompetence (VPI) repaired with Langenbeck's technique. The control group was composed of 13 normal adults. The outcome of the velopharyngeal function by nasopharyngoscopy and lateral cephalogram was assessed. Skeletal landmarks and measurements were derived from the tracing of lateral cephalograms. The measurements included velar length, pharyngeal depth, and adequate ratio of velar length to pharyngeal depth. The cranial base, cervical vertebrae, posterior nasal spine, and the position of the posterior pharyngeal wall (PPW) in the pharyngeal triangle were also analyzed. All data were subjected to student's t-test of statistical significance.</p><p><b>RESULTS</b>All 18 subjects in group T1 obtained complete velopharyngeal closure. Velopharyngeal closure in seven, five, and two subjects in group T2 was 70%, 50% to 70%, and less than 50%, respectively, according to the results of nasopharyngoscopy. The lateral velar length (25.7 mm + 2.3 mm) in group T1 was similar to that of the control group (29.9 mm + 2.7 mm) (P > 0.05). The pharyngeal depth in group T1 was shorter than that in the other two groups, and the adequate ratio (1.43 + 0.26) was similar to that in the normal group (1.45 + 0.26). Group T2 had a significantly short velar length (22.9 mm + 2.3 mm) and normal pharyngeal depth, resulting in a small length/depth ratio (0.95 + 0.14) than that in group T1 and the control group. PPW in the pharyngeal triangle was positioned superiorly in group T2 compared with the control group.</p><p><b>CONCLUSION</b>The velopharyngeal morphology of operated cleft palate patients with VPC with levator veli palatini retropositioning according to Sommerlad was found to be similar to that of the normal control group. VPI cleft palate patients are characterized by a shorter palate, smaller adequate ratio (< 1.0), slightly counterclockwise-rotated pharyngeal triangle, and superiorly positioned PPW.</p>

Pterygoid hamulus bursitis as a cause of craniofacial pain: a case report

Pain on the soft palate and pharynx can originate in several associated structures. Therefore, diagnosis of patients who complain of discomfort in these areas may be difficult and complicated. Pterygoid hamulus bursitis is a rare disease showing various symptoms in the palatal and pharyngeal regions. As such, it can be one of the reported causes of pain in these areas. Treatment of hamular bursitis is either conservative or surgical. If the etiologic factor of bursitis is osteophytic formation on the hamulus or hypertrophy of the bursa, resection of the hamulus is usually the preferred surgical treatment. We report on a case of bursitis that was managed successfully by surgical treatment and a review of the literature.

Palatoglossus muscle neuroanatomy: a review

The palatoglossus muscle is classically described as an extrinsic muscle of the tongue. However, this descriptionis not consensus among the researchers, is one that sometimes it is not considered a muscle of the tongue.Thus, the objective of this study is to discuss some neuroanatomical aspects of palatoglossus muscle that mayhelp explain this aspect. Furthermore, this study shall be useful for clinicians, surgeons and academics thatmanipulate and keep particular interest for this anatomical site.

Denervation change of tensor veli palati in obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the denervation change of Tensor Veli Palati in patients with OSAHS by determine the mRNA and protein expression of NCAM.@*METHOD@#The OSAHS group was consisted of 30 OSAHS patients and the normal control group was consisted of 10 chronic tonsillitis patients without OSAHS. Real-time quantitative RT-PCR and Western blot methods were used to determine the NCAM expression in specimens.@*RESULT@#(1) The mRNA and protein expression level of NCAM in the OSAHS group increased significantly compared with that in control group (P < 0.05). (2) There was positive correlation between AHI and the protein expression level of NCAM in the OSAHS group (r = 0.803, P < 0.01).@*CONCLUSION@#These results indicate that the denervation change of tensor veli palati appear in OSAHS patients, and the severity of OSAHS are relevant with the degree of denervation.

Efectividad del anclaje esquelético temporal para el cierre de espacios: Revisión sistemática de literatura / Effectiveness of temporary skeletal anchorage for space closure:A systematic review

Introducción y Objetivo: El manejo del anclaje es fundamental para el éxito del tratamiento en ortodoncia fi ja, sin embargo no hay consenso acerca de la efectividad del anclaje esquelético para la retracción de los dientes anteriores. El objetivo fue evaluar la efectividad del anclaje esquelético para el cierre de espacios en el arco maxilar.Materiales y Métodos: Se realizó una revisión sistemática de literatura a partir de las bases de datos PubMed, Lilacs, Cochrane, Scielo. Se incluyeron ensayos clínicos controlados, donde el anclaje esquelético fuera utilizado para el cierre de espacios; tresrevisores analizaron los resúmenes y textos completos para considerar el cumplimiento de los criterios de inclusión y exclusión de manera independiente, en un formato de extracción de datos.Resultados: Se identifi caron 324 artículos, de los cuales 316 fueron rechazados después de la evaluación, de los ocho estudios inicialmente seleccionados, cinco fueron excluidos. Sólo tres estudios cumplieron con los criterios de inclusión. Se realizó un metanálisis con el método de efectos aleatorios para el movimiento mesial del molar superior, en el cual los dispositivos de anclaje esquelético temporal mostraron ser más efectivos en el control del anclaje en -2,72 mm (-4,10,- 1,33 IC95%) al compararlos con los métodos de anclaje ortodóntico convencional, esta diferencia fue estadísticamente signifi cativa. Conclusiones: El anclaje esquelético temporal parece ser más efectivo para controlar el movimiento mesial del molar durante el cierre de espacios, comparado con el anclaje ortodóntico convencional, sin embargo la evidencia científi ca en la literatura es escasa.

Introduction and Objetive: Anchorage management is essential for successful fi xed orthodontic treatment; however there is no consensus about the effectiveness of skeletal anchorage for anterior teeth retraction. The aim of this review was to evaluate the effectiveness of skeletal anchorage forspace closure in the maxillary arch. Materials and Methods: A systematic review of the literature was performed in PubMed, Cochrane, Lilacs, Scielo databases. Controlled clinical trials were included, where skeletal anchorage was used for space closure. Three reviewers examined the abstracts and full texts to determine fulfi llment of the inclusion and exclusion criteria independently in a data extraction form. Results: 324 papers, out of which 316 were excluded after the evaluation of title and abstract of the eight initially selected trials. Only three trials met the inclusion criteria.A meta-analysis was performed with a random effects method for the mesial movement of upper molars in which the temporary skeletal anchorage devices showed to be more signifi cantly moreeffective in controlling anchorage -2,7 mm (-4,10,-1,33 CI 95%) when compared to the conventionalanchorage control methods.Conclusions: Temporary skeletal anchorage seems to be more effective in controlling the movement of molars during mesial space closure, when compared to the conventional orthodontic anchorage although evidence in the literature is limited.

The relationship between the predictors of obstructive sleep apnea and difficult intubation / 대한마취과학회지

BACKGROUND: The study was performed in order to determine the risk factors for difficult tracheal intubation in obstructive sleep apnea patients. METHODS: For 115 male patients with obstructive sleep apnea syndrome and who were undergoing palatal muscle resection (PMR), we investigated the correlation between their age, height, weight, body mass index (BMI), their Epworth Sleepiness Scale (ESS), their apnea-hypopnea index (AHI), their neck circumference and the difficulty of tracheal intubation. RESULTS: The factors significantly related to difficult tracheal intubation in obstructive sleep apnea patients were a high AHI and a large neck circumference. There was no significant correlation between weight, BMI, arterial hypertension, ESS and difficult tracheal intubation in obstructive sleep apnea patients. CONCLUSIONS: In this study, a high AHI and a large neck circumference can predict difficult tracheal intubation in obstructive sleep apnea patients.

Comparative Analysis for the Surgical Outcomes of Uvulopalatal Flap and Palatal Muscle Resection in Patients with Obstructive Sleep Apnea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare the surgical outcomes of uvulopalatal flap (UPF) and palatal muscle resection (PMR) techniques in the treatment of obstructive sleep apnea (OSA). SUBJECTS AND METHOD: Forty-three consecutive patients (40 men and 3 women) with OSA were included. Only patients with Fujita type I obstruction were enrolled in this study. Patients with macroglossia or retrognathia were excluded from the study. Twenty patients underwent a UPF and twenty-three patients underwent a PMR. In both groups, nasal surgery was performed if necessary. Questionnaires based on Visual Analogue Scale (VAS) about snoring, apnea, morning headache, tiredness, daytime sleepiness and Epworth Sleepiness Scale (ESS) were analyzed before and after each surgical treatment. Preoperative and postoperative polysomnography (PSG) were completed by every patient. RESULTS: In UPF group, every aspect of VAS except morning headache was significantly improved after surgery. In PMR group, every aspect of VAS and ESS were significantly improved after surgery. Comparing the surgical outcomes between two groups, every VAS and ESS showed much better result in PMR than UPF group. In both UPF and PMR group, the mean apnea-hypopnea index decreased significantly after surgery. However, there's no significant difference between two groups in the PSG findings. CONCLUSION: PMR could be a better surgical technique than UPF with respect to subjective outcome although both UPF and PMR are effective surgical techniques for the treatment of OSA with Fujita type I obstruction.

Magnetic resonance imaging of the levator veli palatini of the cleft palate patients after operation / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To observe the mobility of levator veli palatini muscle during speech in patients with repaired cleft palate and cleft lip.</p><p><b>METHODS</b>MRI of the levator veli palatini muscle was taken during speech and breathing in three groups of patients: control group (cleft lip only, 8 cases), velopharyngeal incompetence (VPI) group (7 cases), velopharyngeal competence (VPC) group (10 cases). The length and the angle of the levator veli palatini muscle were compared.</p><p><b>RESULTS</b>The changes of the length and the angle during speech were not significantly different among the three groups (P > 0.05). The ratio of length changes when speaking "a", "i", and "m" are (13.5 ± 11.7)%, (11.1 ± 10.8)%, (8.2 ± 14.3)%. Mean angle of pronouncing "a", "i", and "m" are [(43.18 ± 4.984)°, (43.08 ± 4.879)°, (39.48 ± 5.046)°]. The levator veli palatini muscle contracted progressively form "m", "i", to "a".</p><p><b>CONCLUSIONS</b>The mobility of the levator veli palatini muscle in patients with repaired cleft palate and cleft lip only is basically the same.</p>

Analysis on the relationship between tensor veli palatini and secretory otitis media in patients with nasopharyngeal carcinoma after radiotherapy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The analyze the relationship between secretory otitis media (SOM) and injury of tensor veli palatini (TVP) muscle injury after radiotherapy, then to explore the pathogenesis of SOM in patients with nasopharyngeal carcinoma (NPC) after radiotherapy.@*METHOD@#The cross section area (CSA) of TVP and medial pterygoid (MP) muscle were measured in MRI of 32 patients with NPC before and after radiotherapy, meanwhile the incidence of SOM were surveyed after radiotherapy, then to analyze the relationship between the change of TVP and the incidence of SOM after radiotherapy.@*RESULT@#Of 48 ears without SOM before radiotherapy, 27 ears developed post-irradiation SOM, including 24 ears with TVP atrophy and 3 ears without TVP atrophy, and 21 ears had no post-irradiation SOM, including 8 ears with TVP atrophy and 13 ears without TVP atrophy. chi2 test showed significant difference (P < 0.01). It indicated that post-irradiation SOM have correlation with TVP atrophy. The more possibility of TVP atrophy occurred after long time radiotherapy.@*CONCLUSION@#The atrophy of TVP in patients with NPC usually occurs 6 months after radiotherapy, and this may result in the post-irradiation SOM. The pathogenesis of post-irradiation SOM need further study functionally.

Research on apoptosis changes of tensor veli palatini in patients with obstructive sleep apnea-hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore apoptosis changes of dilator muscles in the upper airway by detecting the expression of Bax, Bcl-2 in tensor veli palatini in patients with OSAHS.@*METHOD@#The expression of Bax and Bcl-2 were detected in tensor veli palatini in 30 cases with OSAHS and 10 cases chronic tonsillitis without OSAHS by immunohistochemistry and image analytical system, and the results were analyzed.@*RESULT@#(1) The expression levels of Bax in the OSAHS group increased significantly compared to control group (P < 0.05), but there were no significant differences of Bcl-2 expression between two groups, the ratio of Bax/Bcl-2 increased significantly (P < 0.05). (2) There were positive correlations between AHI and the expression levels of Bax (r = 0.697, P < 0.01) respectively in the test group.@*CONCLUSION@#The results indicate that apoptosis occurred in tensor veli palatini in patients with OS AHS, and the more severity of OSAHS, the more apoptosis.

Dissecção radical da musculatura do véu palatino em casos secundários de pacientes fissurados / Radical undermining of the soft palate muscles in secondary cleft patients

Objetivo: Demonstrar a eficácia do reposicionamento do músculo elevador do véu palatinoem pacientes portadores de fissura lábio-palatina anteriormente submetidos a palatoplastiapor outras técnicas. Método: Foram realizadas, 16 cirurgias de repalatoplastia posterior comdissecção radical da musculatura do véu palatino. A nasofibroscopia foi o instrumento demensuração da voz no período pré e pós-operatório, 3, 9 e 15 meses após a cirurgia. Duasfonoaudiólogas com experiência no tratamento do fissurado participaram na avaliação davoz nos períodos pré e pós-operatórios, sendo a hipernasalidade classificada em equilíbriooronasal, hipernasalidade leve, moderada e importante. O índice de Kappa foi utilizado paraavaliar o grau de concordância entre os observadores. O teste de igualdade proporcional foiutilizado com o objetivo de comparar as diferenças de voz no pré e pós-operatórios de 3,9 e 15 meses. O valor de p < 0,05 foi adotado para a significância estatística. Resultados:Seis pacientes eram do sexo masculino, com idade média de 17,93 anos. Houve uma boaconcordância entre as avaliadoras, sendo a menor de 76,6% (índice de Kappa). Com o retroposicionamentoda musculatura houve melhora no índice da hipernasalidade (p < 0,05),principalmente na hipernasalidade leve e moderada. Conclusão: Houve grande melhorado quadro da insuficiência velofaríngea após a dissecção radical, o que evidencia que talprocedimento é necessário e deve ser incluído no algoritmo dos protocolos em casos secundáriose preconiza-se que seja usado, também, em casos primários.

Objective: To demonstrate the efficacy of the muscular set back in secondary cases. Method:16 soft palate re-repair were performed with muscular set back. To evaluate the results of thesurgeries through the voice, nasal endoscopies were done pre and post operative (3, 9 and15 months). The results were evaluated by two speech pathologists specialized in cleft lipand palate patients. And the hypernasality was graded as equilibrium, mild, moderate andsevere. The Kappa index was used to evaluate the agreement between the two observers andthe equality of two proportion test gave the statistics significance, as p < 0.05. Results: Sixpatients were males. The mean age was 17.93 years. There was a good concordance betweenthe two evaluators. The least was 76.6% according to the Kappa index. With the retropositioningof the muscles` bundle there was an improvement in the velopharingeal insufficiency (p< 0.05) mainly in the mild and moderate cases. Conclusion: There was a great improvementin velopharingeal incompetence after radical muscle dissection, showing that this procedureis necessary and must be part of secondary palatoplasty protocols. And also must be usedduring primary soft palate repair.

Síndrome de Eagle: relatos de caso

Introdução: O processo estilóide do osso temporal é uma projeção óssea que corresponde à origem dos músculos estilo-faríngeo, estilo-hiódeo e estiloglosso. A síndrome de Eagle se caracteriza pela presença de sintomas, como otalgia, disfagia, odinofagia e dor facial, associados ao aumento do processo estilóide maior que 30 mm. Objetivo: Apresentar três casos clínicos de pacientes com diagnóstico de síndrome de Eagle e discutir a apresentação clínica e o tratamento desta doença. Conclusão: O tratamento cirúrgico com ressecção de parte do processo estilóide está relacionado à remissão dos sintomas nos pacientes com diagnóstico de síndrome de Eagle. A abordagem a partir de cervicotomia alta determina boas condições de exposição do processo estilóide, com ressecção mais ampla e preservação de estruturas vasculonervosas.

Palatal Muscle Resection(PMR) for the Treatment of Snoring Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We aimed to introduce a new surgical method (Palatal Muscle Resection, PMR) for the treatment of snoring patients. This study contained the surgical technique of PMR and the objective and subjective outcomes of PMR. SUBJECTS AND METHOD: Twenty-one patients with snoring were examined (19 male, 2 female) in a prospective manner. Questionnaires based on the Epworth Sleepiness Scale (ESS) were completed by patients and their respective bed partners before and after PMR. Five patients who underwent PMR have completed pre and post operative (after 4 weeks) polysomnographic (PSG) studies. Visual Analogue Scale (VAS) was analyzed 1, 2, 3, and 7 days after the surgery. Statistical analysis was performed using the Wilcoxon signed rank test. RESULTS: Subjective questionnaires showed statistically significant improvements (ESS; from 10.7 to 6.7). The VAS was decreased from 4.3 in 1 dayto 2 in 7 days. CONCLUSION: The PMR is a simple and painless office-based method to treat snoring. Long term follow up studies with more patients would be required.

Characteristic of mandibular muscle activity in patients with obstructive sleep hypopnea apnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To establish an index that can evaluate the genioglossus muscle activity and investigate the relationship between the genioglossus muscle activity and the severity of patients with obstructive sleep hypopnea apnea syndrome (OSAHS).</p><p><b>METHODS</b>Mandibular muscle electromyography (EMG) and polysomnography (PSG) were used in fifty patients with OSAHS. The difference of mandibular muscle activity between the twice muscle activity of fifteen patients and between in non rapid eye movement (NREM) stage and rapid eye movement (REM) stage on fifty patients were analyzed. The relationship between the index and age, body mass index (BMI), apnea hypopnea index (AHI), and the lowest oxygen saturation was evaluated.</p><p><b>RESULTS</b>There was no statistical difference between the twice muscle activity in fifteen patients. The average index in NREM was 1.84 +/- 0.64 (x(-) +/- s, the same below), in REM was 1.68 +/- 0.48. The difference of mandibular muscle activity between in NREM stage and REM stage was significant (t = 2.849, P < 0.05). By pearson test there was relationship between the index and age and AHI, the correlation coefficient was -0.336, -0.339, -0.338 and P < 0.05. There was no relationship between the index and BMI and the lowest oxygen saturation.</p><p><b>CONCLUSIONS</b>This index that is stable can evaluate the mandibular muscle activity to some degree.</p>

Estimulação mecânico-térmica dos pilares palatoglosso / Mechanical-thermal stimulation of the palatoglossus pillars

RACIONAL: Os pilares palatoglosso foram admitidos como a principal sede dos receptores responsáveis por iniciar a fase faríngea da deglutição. Essa fase reflexa iniciar-se-ia em resposta ao estímulo produzido pelo progresso do bolo e da língua em sentido posterior. Esses conceitos deram base à manobra mecânico-térmica que visa estimular os receptores desses pilares, produzindo respostas motoras capazes de potencializar a recuperação da função faríngea comprometida. O conceito de possível resposta motora ao estímulo desses pilares, embora comum, não é unanimemente aceito. OBJETIVO: Verificar as possíveis respostas motoras produzidas pelo estímulo mecânico- térmico sobre os pilares palatoglosso. MÉTODOS: Por entender que indivíduos sadios são capazes de prover respostas reflexas mais efetivas do que as que seriam obtidas em pacientes, avaliaram-se 51 voluntários adultos sadios de ambos os sexos reproduzindo o estímulo sobre os pilares, usando sonda metálica de ponta romba resfriada em água mantida a 10°C. RESULTADOS E CONSIDERAÇÕES: O estudo mostrou que o estímulo mecânico-térmico sobre os pilares não foi capaz de produzir qualquer resposta motora envolvida na dinâmica da fase faríngea da deglutição. É possível que as respostas contráteis observadas em alguns estudos devam-se ao reflexo de gag inadequadamente interpretado ou a contrações voluntárias inconscientes por esforço de manutenção da abertura da boca e externalização da língua durante a exposição dos pilares para execução da manobra de estimulação mecânico-térmica.

BACKGROUND: The palatoglossus pillars were admitted as the main receptive responsible area by the pharyngeal swallowing reflex produced by food and tongue posterior progression. This concept sustain the mechanical-thermal maneuver used to recovery the committed pharyngeal function. A pharyngeal motor answer by pillar stimulation is common accepted but not unanimously. AIM: To verify the possible pharyngeal motor answers by palatoglossus pillars mechanical thermal stimulation. METHODS: Healthy volunteers are more able to provide effective reflex answers by pillars stimuli than patients. In this way we evaluated 51 healthy adult volunteers from both sexes reproducing the pillars stimuli using metallic probe. The cold condition was obtained by probe immersion in water maintained to 10°C. RESULTS AND CONSIDERATIONS: The study showed that the mechanical thermal stimuli over pillars was not able to produce any active answer linked to the swallowing pharyngeal phase. It is possible that literature observed answers were due to the gag reflex inadequately interpreted or unconscious voluntary contractions effort produced by the opening mouth and tongue externalization during the pillars exposition to execution of the mechanical thermal stimulation maneuvers.

Spectral characteristics of resonance disorders in submucosal type cleft palate patients