Velopharyngeal Insufficiency after Palatoplasty with or without Pharyngeal Flap : Fiberscopic Assessment.

A variety of pharyngeal flaps or pharyngoplasties have been postulated, the techniques of which are not difficult in general. However, dynamic velopharyngeal function, open for breathing and closed for speech, is not easy to restore by surgery. The first step toward this goal should be an accurate assessment of the mobility of the lateral pharyngeal wall which plays the major role in dynamic V-P function after pharyngeal flap. Our experiences with the use of fluorovideoscope and fiberscope have led us to think that these are the essential instruments to obtain detailed information on the V-P function such as mobility of the lateral wall, asymmetry of its mobility if any, the level of maximal stricture, and the degree of incompetence. With such information, a pharyngeal flap can be individually tailored to match each V-P insufficiency

Management of Young Children for Nasopharyngoscopic Examination.

Methodology for nasopharyngoscopic evaluation of velopharyngeal function as conducted at Kyoto University, Japan is presented. Special problems encountered in nasopharyngoscopic evaluation of young children and methods of coping with those problems are addressed. Three types of scopes, including endview and side-view ranging in diameter from 3.7 mm to 4.4 mm are used. Methods of introducing local anesthetic and overcomming children's fear and resistance are stressed

Enzyme-linked immunosorbent assay to detect surface marker proteins of extracellular vesicles purified from human urine

Summary: The molecular profile of extracellular vesicles released in urine reflects the pathophysiological processes occurring within originating cells located in diverse nephron segments. Here, we present an enzyme-linked immunosorbent assay for quantitative membrane protein detection in extracellular vesicles in human urine samples. We describe steps for preparing urine samples, biotinylated antibodies, and microtiter plates to purify extracellular vesicles and detect membrane-bound biomarkers. The specificity of signals and the limited variability by freeze-thaw cycles or cryopreservation have been verified.For complete details on the use and execution of this protocol, please refer to Takizawa et al. (2022).1 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics

Treatment and Result of Slight Velopharyngeal Incompetence.

Fifty-five patients who had been diagnosed as slight velopharyngeal incompetence due to either repaired cleft palate CP (19 cases), submucous cleft palate SMCP (21) or congenital velopharyngeal incompetence CVPI (15) at our clinic from May 1976 to April 1982 were studied regarding the effect of speech therapy. They were all first placed under trial speech therapy which consisted of ① encouragement of the physical and mental development, ② articulation training without blowing exercise. Twenty-seven out of the 55 subjects underwent further surgery (mostly pharyngeal flap operation) after speech therapy for over 6 months at our clinic. On the other hand, 14 out of the 55 subjects improved velopharyngeal closure from slight incompetence to competence and corrected their faulty articulations through speech therapy alone. The success rate of speech therapy was higher in SMCP and CVPI than in repaired cleft palate. We emphasize that those who are judged as having slight velopharyngeal incompetence should first be placed under speech therapy for at least 6 months. The indication for further surgery are ① over age 5 years, and ② no improvement obtained in slight velopharyngeal incompetence and faulty articulation even by speech therapy for over one year