1/11. Bilateral congenital choanal atresia and absence of respiratory distress.Bilateral congenital choanal atresia is considered a lethal congenital malformation in an obligatory nasal breathing neonate. Described herein are two cases of bilateral choanal atresia associated with craniofacial anomalies who did not present respiratory distress in the neonatal period. Our first patient had a complete unilateral cleft lip which facilitated oropharyngeal respiration. The second patient presented wory distress in the neonatal period by providing an oropharyngeal airway.- - - - - - - - - - ranking = 1keywords = airway (Clic here for more details about this article) |
2/11. Dental malocclusion and upper airway obstruction, an otolaryngologist's perspective.INTRODUCTION: This paper, through the presentation of eight case reports and a limited literature review, attempts to illustrate the negative effect that upper airway obstruction can have on developing dental occlusion and the positive effect that upper airway relief can have on the 'normalization' of various malocclusion patterns believed to be related to chronic obligate mouth breathing. OBJECTIVE: To study the effect of airway relief (usually through tonsillectomy and/or adenoidectomy) on various patterns of dental malocclusion. methods: Children coming to the office of the lead author (D.J.W.) found to be obligate mouth breathers and who also had dental malocclusion had Polaroid 'bite' pictures taken at the time of their initial visit. One year or more after their surgery for upper airway relief (tonsillectomy and adenoidectomy in these cases) a second 'bite' photograph was taken and compared to the first. RESULTS: In all cases selected in this study there was observed improvement in their dental occlusion within a year following surgery to improve their breathing. CONCLUSION: It is the opinion of the authors of this paper that upper airway obstruction may have a negative effect on the developing transitional dental occlusion and that eliminating the cause of upper airway obstruction can lead to 'normalization' of occlusion in such children. Further orthodontic corrective modalities may be required for optimal occlusal results.- - - - - - - - - - ranking = 136.22193439946keywords = airway obstruction, airway, obstruction (Clic here for more details about this article) |
3/11. Congenital salivary gland anlage tumor of the nasopharynx.OBJECTIVE: Nasal and upper respiratory tract obstruction in the neonatal period can result from a variety of conditions, and may present with variable symptoms. In the absence of dysmorphic features or other abnormalities, causes of nasal obstruction may be difficult to differentiate on initial examination. We report an unexpected and potentially life-threatening condition arising during the work-up of this common neonatal complaint. DESIGN: Case report with literature review. RESULTS: A male neonate presented with complaints of nasal obstruction and feeding difficulties. A common diagnostic approach to neonatal nasal obstruction was performed, resulting in an unexpected and potentially life-threatening, albeit curative, result. Cannulation of the nasal cavity to rule out choanal atresia resulted in a burst of bleeding from the nose and mouth. A finger sweep of the oropharynx produced a dislodged mass lesion. pathology revealed a salivary gland anlage tumor of the nasopharynx. CONCLUSIONS: The diagnosis of a nasopharyngeal mass lesion should be considered in neonates with nasal obstructive symptoms. It is wise to place an index finger in the oropharynx when passing catheters to rule out choanal atresia to feel a dislodged mass lesion before it can become an airway foreign body. Should passage of nasal catheters result in bleeding and/or respiratory distress, the possibility of a displaced mass lesion must be considered immediately to institute prompt intervention.- - - - - - - - - - ranking = 3.8514593756917keywords = airway, obstruction (Clic here for more details about this article) |
4/11. Long-term outcome of skeletal Class II Division 1 malocclusion treated with rapid palatal expansion and Kloehn cervical headgear.The treatment of a patient with a skeletal Class II Division 1 malocclusion, with excessive overjet, complete overbite, airway obstruction, and severe arch length deficiency in the mandibular dental arch, is presented. The maxilla was narrow compared with the mandible, and the posterior teeth were compensated, with the maxillary teeth inclined buccally and the mandibular teeth inclined lingually. The palatal vault was extremely high. Treatment included rapid palatal expansion to correct the transverse maxillary deficiency and Kloehn cervical headgear to correct the anteroposterior skeletal discrepancy. Long-term stability (12-year follow-up) is reported.- - - - - - - - - - ranking = 19.031704914208keywords = airway obstruction, airway, obstruction (Clic here for more details about this article) |
5/11. Craniofacial morphology in an unusual case with nasal aplasia studied by roentgencephalometry and three-dimensional CT scanning.OBJECTIVE: To examine the three-dimensional morphology of internal structures of the craniofacial region and present the orthodontic problems in an unusual case with nasal aplasia. PATIENT: The patient was an 11.5-year-old boy with aplasia of the nose and nasal cavity with extremely constricted nasopharyngeal airway. He did not have mental or somatic retardation. The patient had dacryostenosis. The morphology of the craniofacial structures was characterized by absence of septal structures, including cribriform plate, perpendicular plate of ethmoid bone, vomer, and septal cartilage; bony hypotelorism; midface hypoplasia; short and retrognathic maxilla with Class III jaw relationship; average mandibular plane angle; high arched palate; severe anterior open bite with bilateral posterior crossbites; and dental anomalies (agenesis of four maxillary permanent teeth, microdontia, taurodontism, and short roots). Thus, the patient had characteristic dentofacial phenotype, which might be caused by a combination of the primary anomaly and the functional disturbances secondary to the nasal obstruction.- - - - - - - - - - ranking = 1.7128648439229keywords = airway, obstruction (Clic here for more details about this article) |
6/11. Dynamic MRI evaluation of tongue posture and deglutitive movements in a surgically corrected open bite.tongue thrust usually develops in the presence of anterior open bite in order to achieve anterior valve function. In the literature, tongue thrust is described both as the result and the cause of open bite. If it is an adaptation to malocclusion, then tongue posture and deglutitive tongue movements should change after treatment. In this case report, an adult who had skeletal open bite and Class II malocclusion caused by mandibular retrusion was treated surgically. The mandible was advanced in a forward and upward direction with a sagittal split osteotomy. The open bite and Class II malocclusion were corrected and an increase in the posterior airway space (PAS) was observed. Pretreatment and posttreatment dynamic magnetic resonance imaging (MRI) revealed that tongue tip was retruded behind the incisors and contact of the tongue with the palate increased. It was also determined that the anterior and middle portions descended, whereas the posterior portion was elevated at all stages. Advancement of the mandible, correction of open bite, and an increase in PAS affected not only the tongue posture and deglutitive movements, but also the breathing pattern of the patient.- - - - - - - - - - ranking = 1keywords = airway (Clic here for more details about this article) |
7/11. Obligate mouth breathing during exercise. Nasal and laryngeal sarcoidosis.A young black man presented with simultaneous nasal and laryngeal sarcoidosis, each uncommon entities. Despite severe upper airway obstruction and emergent tracheostomy, there was an uncharacteristic rapid response to oral steroids alone. The patient's predominant initial complaint of early mouth breathing during routine army physical training demonstrates a symptom complex and an alternate mechanism of dyspnea to consider in sarcoidosis.- - - - - - - - - - ranking = 19.031704914208keywords = airway obstruction, airway, obstruction (Clic here for more details about this article) |
8/11. The stability of maxillary expansion.The assessment and treatment by rapid maxillary expansion of 516 cases referred by medical practitioners for the treatment of poor nasal airway is reported. The technique is simple and most suitable for the correction of crossbite and Class III malocclusion and for establishing a nasal airway in habitual mouth breathers with a history of ENT problems.- - - - - - - - - - ranking = 2keywords = airway (Clic here for more details about this article) |
9/11. The pharyngeal effect of partial nasal obstruction.The case histroy and cinematoradiographic findings of a baby with partial nasal obstruction are presented. This infant's restriction to air entry at the nose led to severe airway obstruction during inspiration by a forward movement of the posterior pharyngeal wall and backward movement of the tongue and lower jaw. At the height of inspiration, there was total airway occlusion in the pharynx. These events can be explained by the pressure drop that takes place behind a restriction if air is sucked through it forcibly from an area of atmospheric pressure. Studies of postpalatal pressures in adults and infants demonstrate such a drop in pressure during nasal breathing if the nose is partly obstructed. If the adult or infant is able to respond to the diminished nasal airway by mouth breathing, there is no postpalatal pressure drop. It is suggested that partial nasal obstruction in a sleeping obligatory nasal-breathing infant could result in a sucking back of the tongue over the larynx in this "cafe coronary" type of situation. This could be the mechanism of the obstructive type of apnea recorded by Steinschneider, and of the asphyxial type of death that is suggested by autopsies on some "cot death" victims. This hypothesis is consistent with the frequency of infection of rhinitis and pharyngitis in victims of sudden infant death syndrome and with the seasonal incidence. Prevention of this obstructive type of apnea would depend on the recognition of infants showing inspiratory and expiratory changes in pharyngeal airway size as can be seen externally by the movements in the carotid triangle of the neck and confirmed by roentgenography or cinematoradiography.- - - - - - - - - - ranking = 26.308893977746keywords = airway obstruction, airway, obstruction (Clic here for more details about this article) |
10/11. Influence of respiratory pattern on craniofacial growth.The purpose of this paper has been to explore the relationship between upper airway obstruction and craniofacial growth. A review of the literature and of a preliminary study by the author in collaboration with investigators at the Children's Hospital of Pittsburgh indicate both the spectrum of skeletal and dental configurations which are associated with upper airway obstruction and the significant changes in patterns of facial growth which are observed following removal of the obstruction. Four clinical cases were presented. While admittedly only case reports, these do illustrate the potential interaction between alterations in respiratory function and craniofacial growth pattern. The four clinical cases are representative of one type of facial problem which has been classically associated with the mouth-breathing individual; that is a steep mandibular plane. We fully recognize that there are many other manifestations of the environmental problem of upper respiratory obstruction. However, these cases do illustrate the relationship between function and form (i.e. obstruction and deviant facial growth). In order for this relationship to be more fully documented, data from controlled randomized clinical trials must be analyzed.- - - - - - - - - - ranking = 40.202004360185keywords = airway obstruction, airway, obstruction (Clic here for more details about this article) |
| | Next -> |