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Head and Neck Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Warrenkevin Henderson, Hannah Jacobson, Noelle Purcell, Kylar Wiltz
Tensor veli palatini may be longitudinally divided (Macalister 1875; Patel and Loukas 2016). The portion designated as dilator tubae may vary in its development and connections to the rest of the muscle (Barsoumian et al. 1998). The attachment to the pharyngotympanic tube cartilage varies with age (Suzuki et al. 2003). Tensor veli palatini may have an insertion into the palatine bone (Macalister 1875; Standring 2016). It may also have additional insertions into the maxillary tuberosity, or the submucosal tissue close to the palatoglossal arch (Abe et al. 2004; Patel and Loukas 2016). Muscular fibers may be present in the tendon near its insertion, giving tensor veli palatini a digastric appearance (Macalister 1875). Tensor veli palatini may receive an accessory slip from the medial pterygoid or from the outer margin of the scaphoid fossa (Macalister 1875; Patel and Loukas 2016). It may send a slip to the buccinator muscle (Macalister 1875; Patel and Loukas 2016). Some fibers of tensor veli palatini may be continuous with fibers of tensor tympani (Barsoumian et al. 1998; Standring 2016).
Bone Healing and Revascularisation after Total Maxillary Osteotomy
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
A total maxillary osteotomy was performed in adult male rhesus monkeys. The process included using an incision at the mucoperiosteal junction from one maxillary tuberosity to the other. A horizontal supra-nasal osteotomy was performed from the mediolateral aspect of the nasal aperture to the pterygomaxillary suture. Osteotomies were performed between nasal septum and superior surface of maxilla. The maxilla remained pedicled to the intact palatal mucosa and bucco-labial gingiva. An attempt was made to preserve the greater palatine artery in all but three of the animals, in which these vessels were intentionally transected during surgery. After mobilising the maxilla, the teeth were put on their preoperative occlusion without intermaxillary fixation. There is no mention of fixation of the mobilized maxilla. Wounds were closed with interrupted 3-0 silk sutures.
Reconstructive Microsurgery in Head and Neck Surgery
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
John C. Watkinson, Ralph W. Gilbert
Most recently, Brown43 has described the use of the iliac crest transfer for maxillary defects. The flap can be used for premaxillary and infrastructure by turning it horizontally to replace the hard palate. The mucosal defect is not reconstructed but rather the surface of the bone is allowed to granulate and secondarily mucosalize. In classic maxillary defect, the crest is inverted with the vascular pedicle oriented towards the maxillary tuberosity. The muscle is then rotated into the defect and allowed to mucosalize secondarily to recreate the hard palate (Figure 93.13). These two flap orientations both allow secondary osseointegration for dental restoration with a thin mucosalized reconstruction of the hard palate.
Anterosuperior protraction of maxillae using the extraoral device, RAMPA; finite element method
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Yasushi Mitani, Bumkyoo Choi, Jaehyuk Choi
In order to validate the simulation results with the study of a patient case, the maxillary tuberosity (pt. G) was chosen. The transverse displacement (X) for 45° turn/day is 0.0712 mm from Table 4 and thus, the value of 6.764 mm is turned out from the superposition after 95 days (0.0712 × 95). Therefore, the simulation results are reasonably reliable even if the results can be somewhat changed when a real situation including viscoelasticity, inhomogeneity, anisotropy, etc. is considered. Also, note that the simulation results are almost identical in tendency to the case study of a patient shown in Figures 6–10, i.e., the anterosuperior maxillary deformation of the patient has been realized. The prognosis based on this work can be useful for the treatment of a patient with maxillary hypoplasia. Finally, the emphasis in this work is on its effects on the whole body. The anterosuperior protraction of maxillae resulted in improving the cervical vertebrae, causing a good posture for the human body.
Speech outcomes at 5 and 10 years of age after one-stage palatal repair with muscle reconstruction in children born with isolated cleft palate
Published in Journal of Plastic Surgery and Hand Surgery, 2018
Jill Nyberg, Erik Neovius, Anette Lohmander
All the 88 children received a one-stage palatal repair with muscle reconstruction at a mean age of 13.6 months (SD = 4.6 months). The explanation for late surgery was in one child because of repeated infections and in two children due to late detection of the cleft. The surgical procedure was the same in all children, and two senior surgeons performed all the operations, with each surgeon repairing an equal number of each cleft type. Cleft palate repair was carried out under general anaesthesia according to the technique described by Sommerlad [21,23], using 2.5× magnification loupes. Incision lines were marked on the borders of the cleft and along the medial side of the maxillary tuberosity. In CPS, incision lines were extended ∼1 cm in the midline of the hard palate. Local anaesthetic (marcaine with epinephrine) was injected into the soft and hard palate, and incisions were made according to the markings, and the mucoperiosteum in the hard palate was elevated. Dissection was continued posteriorly between the salivary glands and the muscular layer in the soft palate. The nasal layer and the uvula were sutured with interrupted 4–0 Vicryl™. Additional local anaesthetic was injected into the muscular layer to minimise bleeding. After 5 minutes, the tensor aponeurosis was divided posterior to the hard palate, and the muscles were successively dissected from the nasal mucosa and transposed posteriorly ∼15 mm until the levator muscle was identified. The muscle bulges were then sutured at the midline with interrupted 4–0 Ethilon™. Eventually, the oral layer was sutured with interrupted 4–0 Vicryl™ mattress sutures. Occasionally, in wide clefts, incisions had to be extended medial to the alveolar ridge in order to allow suturing of the oral layer at the junction between the hard and soft palate.
Marine sources as an unexplored bone tissue reconstruction material -A review
Published in Egyptian Journal of Basic and Applied Sciences, 2022
Gayatree Nayak, Sanat Kumar Bhuyan, Ruchi Bhuyan, Akankshya Sahu, Dattatreya Kar, Ananya Kuanar
Nowadays, the most daunting considerations of bone tissue engineering are the management of osteoporosis in elderly humans over 60 years of age [6]. The aged females have a major risk than the males because women’s bones are protected by estrogenic hormone, the release of which decreases after menopause. Every year, Europe and the United States have reported approximately 400,000- and 600,000- people recovered from bone regeneration without any side effects [7]. These statistics come with a high cost of more than $2.5 billion. The several available investigative reports predict that this may be doubled in the future, not just in the United States and Europe, but also in other countries [8]. Besides, the limitations and complications of bone tissue regeneration are based on autologous or allogeneic transplantations using autografts and allografts techniques for clinical purposes [9]. To date, an autograft is a gold standard procedure for bone grafts, which also has the highest quality level in bone recovery for both trauma and dentistry fields owing to its histocompatibility and non-immunogenicity. These grafts often lead to secondary trauma as the development of disturbance in donor bone like the iliac or fibula [10]. Dentistry grafts are acquired from intraoral sites like the jawline, maxillary tuberosity, and ascending branch of the ramus. When a larger quantity is required, extraoral sites like iliac or tibia were considered. Autogenous graft utilizes individuals’ cells for regeneration. This minimizes the possibility of contamination and disease transmission like hepatitis. Also have some disadvantages like lack of vascularization, possible visceral injury during harvesting, infection at the donor site, high patient morbidity, pain, less quantity, and limited availability while advantages are excellent osteogenic, osteoconductive, and Osteoinductive properties [11]. In the autograft method, the surgical time is increased due to additional anesthetic procedures which is a clear limitation [12]. On other hand, the allograft technique of bone tissue reconstruction is procured from another individual. This must be done during the life of the donor individual or must be obtained from cadavers and preserved in a tissue repository [10]. Allografts can be used as demineralized or mineralized that are normally preserved under freezing. The allografts have some advantages such as little inferior inductive ability because of insufficient growth factor, availability with different sizes, osteoconductive, and no donor site morbidity. Various shortcomings like the absence of osteogenic and vascularization properties, high cost, comparatively high graft rejection, and risk of transmission from a donor like human T-lymphotropic virus, hepatitis C, hepatitis B, HIV, etc [13]. Allografts are broadly used in foot and ankle surgery which is a costly treatment and also an exhaustive process to eliminate its antigenic capacity. The denovo-formed bone does not comprise regenerative potential due to a lack of Osteo-inductivity [14]. Considering the above mentioned loopholes, the regenerative approaches demand the usage of compounds with lesser side effects.