Nonlinear Dynamic Analysis of Vowels in Cleft Palate Children with or without Hypernasality

Objectives. To clarify the difference between Lyapunov exponents (LEs) for cleft palate (CP) patients with hypernasality versus without hypernasality and to investigate the relationship between their LEs and nasalance scores (NSs). Material and Methods. Six CP patients with severe hypernasality (mean age 9.2 years) and six CP patients without hypernasality (mean age 8.0 years) were enrolled. Five Japanese vowels were recorded at 44.1 KHz, and the NSs were measured simultaneously. The mean first LE (mLE1) from all one-second intervals was computed. Results. The mLE1 for /o/ in patients with hypernasality was significantly higher than that in patients without hypernasality. The correlation coefficients between the mLE1 and NS for all vowels were not statistically different. Conclusion. The voice signal of /o/ for the patients with hypernasality was more instable than in those without hypernasality. The chaotic phenomenon was independent of nasal resonance in CP voice

Evaluation of the effect of oral appliance treatment on upper-airway ventilation conditions in obstructive sleep apnea using computational fluid dynamics

Objective: To evaluate the effect of oral appliance (OA) treatment on upper-airway ventilation conditions in patients with obstructive sleep apnea (OSA) using computational fluid dynamics (CFD). Methods: Fifteen patients received OA treatment and underwent polysomnography (PSG) and computed tomography (CT). CT data were used to reconstruct three-dimensional models of nasal and pharyngeal airways. Airflow velocity and airway pressure measurements at inspiration were simulated using CFD. Results: The apnea–hypopnea index (AHI) improved from 23.1 to 10.1 events/h after OA treatment. On CFD analysis, airflow velocity decreased at the retropalatal and epiglottis-tip levels, while airway pressure decreased at the retropalatal, uvular- and epiglottis-tip levels. The AHI of patients with OSA before OA treatment was correlated with airway pressure at the epiglottis-tip level. Discussion: Treatment with OA improved the ventilation conditions of the pharyngeal airway and AHI. Results of CFD analysis of airway pressure and airflow velocity helped determine the severity and ventilatory impairment site of OSA, respectively

Atypical Lipomatous Tumor of the Tongue:Report of a Case

The term atypical lipomatous tumor (ALT) is synonymous with well-differentiated liposarcoma (WDL). This tumor occurs very rarely in the tongue. Thus, it is difficult to predict its prognosis. Although recurrence of ALT/WDL is thought to be unlikely after complete excision, long-term follow-up is necessary when considering the pathologic conditions of this tumor at other sites. Here, we report a case of an ALT of the tongue, with a review of the literature. A 68-year-old man was referred to our hospital because of a tumor on the left side of his tongue. Upon palpation, the tumor was 12mm in diameter, circumscribed, elastic and hard, well demarcated, movable, and painless. We diagnosed the lesion as a lipoma and extirpated the tumor under local anesthesia. Because the specimen was histopathologically diagnosed as an ALT, as a precaution, we excised an additional 5mm from the area surrounding the original tumor under general anesthesia. Three years after the operation, the tongue demonstrated good healing without paresthesia or dysfunction, and to date there has been no evidence of recurrence

Secretory Carcinoma of Salivary Gland with High-Grade Histology Arising in Hard Palate: A Case Report

Secretory carcinoma (SC) is a recently described salivary gland tumor reported in the fourth edition of World Health Organization classification of head and neck tumors. SC is characterized by strong S-100 protein, mammaglobin, and vimentin immunoexpression, and harbors a t(12;15)(p13;q25) translocation which leads to ETV6-NTRK3 fusion product. Histologically, SC displays a lobulated growth pattern and is often composed of microcystic, tubular, and solid structures with abundant eosinophilic homogenous or bubbly secretion. SC is generally recognized as low-grade malignancy with low-grade histopathologic features, and metastasis is relatively uncommon. In this case, we described a SC of hard palate that underwent high grade transformation and metastasis to the cervical lymph node in a 54-year-old patient. In addition, this case showed different histological findings between primary lesion and metastasis lesion. Therefore, the diagnosis was confirmed by the presence of ETV6 translocation. Here, we report a case that occurred SC with high-grade transformation in the palate, and a review of the relevant literature is also presented

The Effect of Cranial Change on Oropharyngeal Airway and Breathing During Sleep

Mandibular micrognathia is one of the characteristics of obstructive sleep apnea syndrome. The purpose of this study was to assess the effects of bimaxillary surgery without maxillary advancement on the upper airway using computational fluid dynamics (CFD) results of comparing pre- and post-operative finite element model. Seven female patients with jaw deformity, who underwent two-jaw surgery (Le Fort1 osteotomy and bilateral sagittal split ramus osteotomy; BSSRO) were enrolled. Maxillary was moved for correcting occlusal plane and mandibular was moved to advancement. Pharyngeal airway space and breathing during sleep were evaluated, comparing the periods of 2 days before and 6 months after the operation. The cross-sectional area of the level of the hard palate (HP) and the level of the tip of the uvula (TU), and airway volume of total, HP-TU, and TP- the level of the base of the epiglottis (BE) were increased. AI and AHI in 2 days before and 6 months after were decreased. As the result of nasal ventilation condition, velocity of HP and TU in 2 days before and 6 months after were decreased. We think that it was revealed that movement of the maxilla without advancement did not affect to the morphology and function of airway

Analysis methods for facial motion

Objective techniques to evaluate a facial movement are indispensable for the contemporary treatment of patients with motor disorders such as facial paralysis, cleft lip, postoperative head and neck cancer, and so on. Recently, computer-assisted, video-based techniques have been devised and reported as measuring systems in which facial movements can be evaluated quantitatively. Commercially available motion analysis systems, in which a stereo-measuring technique with multiple cameras and markers to facilitate search of matching among images through all cameras, also are utilized, and are used in many measuring systems such as video-based systems. The key is how the problems of facial movement can be extracted precisely, and how useful information for the diagnosis and decision-making process can be derived from analyses of facial movement. Therefore, it is important to discuss which facial animations should be examined, and whether fixation of the head and markers attached to the face can hamper natural facial movement

An Acoustic Simulation Method of the Japanese Vowels /i/ and /u/ by Using the Boundary Element Method

This study aimed to establish and verify the validity of an acoustic simulation method during sustained phonation of the Japanese vowels /i/ and /u/. The study participants were six healthy adults. First, vocal tract models were constructed based on computed tomography (CT) data, such as the range from the frontal sinus to the glottis, during sustained phonation of /i/ and /u/. To imitate the trachea, after being virtually extended by 12 cm, cylindrical shapes were then added to the vocal tract models between the tracheal bifurcation and the lower part of the glottis. Next, the boundary element method and the Kirchhoff–Helmholtz integral equation were used for discretization and to represent the wave equation for sound propagation, respectively. As a result, the relative discrimination thresholds of the vowel formant frequencies for /i/ and /u/ against actual voice were 1.1–10.2% and 0.4–9.3% for the first formant and 3.9–7.5% and 5.0–12.5% for the second formant, respectively. In the vocal tract model with nasal coupling, a pole–zero pair was observed at around 500 Hz, and for both /i/ and /u/, a pole–zero pair was observed at around 1000 Hz regardless of the presence or absence of nasal coupling. Therefore, the boundary element method, which produces solutions by analysis of boundary problems rather than three-dimensional aspects, was thought to be effective for simulating the Japanese vowels /i/ and /u/ with high validity for the vocal tract models encompassing a wide range, from the frontal sinuses to the trachea, constructed from CT data obtained during sustained phonation

Quantitative Analysis of Velopharyngeal Movement by Applying Principal Component Analysis to Range Images Produced by a Three-Dimensional Endoscope

Objectives: The purpose of this study was to develop a new technique for analyzing velopharyngeal movement and to investigate its utility. Materials and Methods: Velopharyngeal motion of 20 normal individuals was analyzed. A three-dimensional (3D) endoscope was inserted into the oral cavity, and the movement of the soft palate was measured using an exclusive fixation device. Range images of the soft palate were produced during phonation of the Japanese vowel /a/, and virtual grids were then overlaid on these images. Principal component analyses were applied to the 3D coordinates of the intersections of the virtual grids. The centers of gravity of the virtual grids were calculated, and the magnitude of the shift of the grid intersections during phonation was calculated. Results: The first and the second principal component scores were responsible for the upper posterior direction and the upper direction, respectively. The average magnitude of the shift of the center of gravity was 4.75 mm in males and 4.33 mm in females. Conclusions: Quantitative analysis of velopharyngeal movement was achieved by a method of applying principal component analysis (PCA) to the range images obtained from a 3D endoscope. There was no sex difference in velopharyngeal movement