The purpose of this study was to clarify characteristics of posed smiles for Class III female patients before and after orthognathic surgery. Just before retrusion surgery and the removal of fixation plates, 2 sets of posed smiles were recorded for 7 Class III female patients. As normal controls, 7 healthy female volunteers were also recorded. Using our video-based motion analyzing system, range images and 5 × 5 virtual grids projected onto the lips were recorded for all patients while making a posed smile. The gravity for each area in the lips was calculated from the intersections of the virtual grids. Principal component analysis was applied to the normalized virtual grids, that is, a homologous model of lip shape, for all frames of the posed smiles. While the sample size was too small to generalize from these results, we found that the upper vermilion shifted posteriorly and laterally in posed smiles for Class III female patients after retrusion surgery as compared with the preoperative posed smiles. In addition, the characteristic lip movements during postoperative posed smiles for Class III female patients did not resemble those of the normal controls.
Two cases where aberrant tissue was attached to the lower lip mimicking the inferior labial frenum were reported. The frenum-like tissue extended from the gingival margin between the lower left deciduous central and lateral incisors in case 1 and between the lower right deciduous central and lateral incisors in case 2, to the dry lower lip. Histologically, the resected specimen was regarded as normal oral mucosa covered with stratified squamous epithelium, without a clear amniotic band. The frenum-like tissue of the lower lip found in both our patients was diagnosed as a category of oral synechiae, of unknown origin.
The 13q deletion syndrome is a rare genetic disorder caused by structural and functional monosomy of chromosome 13. On 13q34, which is the terminal of the long arm, causative genes of coagulation factors VII and X (FVII and FX) are mapped. Patients with a combination of FVII and FX deficiencies are extremely rare and there have been few articles about perioperative coagulation support for such patients. Herein, we report on a case of bilateral cleft lip and palate accompanied by 13q deletion syndrome with deficiencies of FVII and FX.
The chromosomal investigation indicated 46, XX, del(13)(q33) by G-banding. Prothrombin time and activated partial thromboplastin time were found to be 21.0 seconds (sec) (prothrombin time–international normalized ratio 1.76) and 41.6 sec (normal range; 23.9 – 39.7 sec), respectively. The activities of coagulation FVII and FX were 22% and 36%, respectively. A two-stage cheiloplasty was performed at 4 and 7 months of age followed by a palatoplasty at 1 year and 6 months. Tranexamic acid was given intravenously three times a day for three days after each surgery. There were no adverse events such as bleeding from the oral or nasal cavities and healing of the surgical wound was good without dehiscence.
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/. Next, cylindrical shapes virtually extended by 12 cm were added to the vocal tract models to imitate the trachea between the tracheal bifurcation and lower part of the glottis. The Kirchhoff–Helmholtz integral equation was formulated as the wave equation for sound propagation, and the boundary element method was used for discretization. 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 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. These findings demonstrated that /i/ and /u/ could be simulated with high validity in a vocal tract model constructed from CT data obtained during sustained phonation using the boundary element method.
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