Histochemical Study of Levator Veli Palatini Muscle in Patients with Velopharyngeal Incompetence
This study was undertaken to investigate the relation b etween histochemical findings of levator veli palatini muscle fiber compositions and fiberscopic findings of velopharygeal movement in patients who underwent operation for cleft palate. Eight of these patients who were candidates for pharyngeal...
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| Published in | Journal of Japanese Cleft Palate Association Vol. 24; no. 1; pp. 61 - 69 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Cleft Palate Association
30.04.1999
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0386-5185 2186-5701 |
| DOI | 10.11224/cleftpalate1976.24.1_61 |
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| Abstract | This study was undertaken to investigate the relation b etween histochemical findings of levator veli palatini muscle fiber compositions and fiberscopic findings of velopharygeal movement in patients who underwent operation for cleft palate. Eight of these patients who were candidates for pharyngeal flap surgery for velopharyngeal incompetence were the subjects. Velopharyngeal function for each subject was investigated using nasopharyngeal fiberscope prior to surgery. Specimens of the levator veli palatini muscle were removed at the time of surgery. Specimens were fixed by quick-freezing, and stained with H-E and ATPase histochemistry in cryostat sections. The results were as follows: 1. For two subjects showing adequate timing of velum movement, this was the coronal pattern of velopharygeal movement, and the muscle fibers were arranged in mosaic pattern of type 1,2A and 2B fibers. 2. For four subj ects showing poor velum movement, this was coronal to circular or circular to sagital, and the muscle fibers compositions were variable compared to those of subjects with adequate velopharyngeal movement. 3. For the remaining two subjects sho wing immobile velum, no muscle fiber was observed. It was suggested that histochemical findings correspond to fiberscopic findings of velopharygeal movement. |
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| AbstractList | This study was undertaken to investigate the relation b etween histochemical findings of levator veli palatini muscle fiber compositions and fiberscopic findings of velopharygeal movement in patients who underwent operation for cleft palate. Eight of these patients who were candidates for pharyngeal flap surgery for velopharyngeal incompetence were the subjects. Velopharyngeal function for each subject was investigated using nasopharyngeal fiberscope prior to surgery. Specimens of the levator veli palatini muscle were removed at the time of surgery. Specimens were fixed by quick-freezing, and stained with H-E and ATPase histochemistry in cryostat sections.The results were as follows:1. For two subjects showing adequate timing of velum movement, this was the coronal pattern of velopharygeal movement, and the muscle fibers were arranged in mosaic pattern of type 1,2A and 2B fibers.2. For four subj ects showing poor velum movement, this was coronal to circular or circular to sagital, and the muscle fibers compositions were variable compared to those of subjects with adequate velopharyngeal movement.3. For the remaining two subjects sho wing immobile velum, no muscle fiber was observed. It was suggested that histochemical findings correspond to fiberscopic findings of velopharygeal movement.
口蓋閉鎖術後における鼻咽腔閉鎖機能と口蓋帆挙筋の組織化学的所見との関係を検討する目的から,咽頭弁移植術の適応となった8例を対象に鼻咽腔内視鏡所見と口蓋帆挙筋の組織化学的所見について検索した.対象症例は咽頭弁移植術の術前に鼻咽腔閉鎖機能を鼻咽腔内視鏡により検索した後,術中に口蓋帆挙筋を採取し凍結固定を行い,クリオスタット標本を作製してH-E染色,ATPase染色を施し鏡検した.その結果は以下の通りであった.1.軟口蓋の挙上運動が良好で,鼻咽腔閉鎖様運動が「coronal pattern」を示した症例は,組織化学的に筋線維はType1,2A,2B線維により構成されモザイク状を呈していた.2.軟口蓋の挙上運動が,「coronal to circular」または「circular to sagital」の閉鎖様運動を示した症例は,組織化学的に多様な所見が観察された.3.軟口蓋の挙上運動が認められなかった症例では,採取した組織内に筋線維はほとんど存在しなかった.本研究より鼻咽腔内視鏡による鼻咽腔閉鎖所見と口蓋帆挙筋の組織化学的所見はほぼ一致していることが明らかとなった. This study was undertaken to investigate the relation b etween histochemical findings of levator veli palatini muscle fiber compositions and fiberscopic findings of velopharygeal movement in patients who underwent operation for cleft palate. Eight of these patients who were candidates for pharyngeal flap surgery for velopharyngeal incompetence were the subjects. Velopharyngeal function for each subject was investigated using nasopharyngeal fiberscope prior to surgery. Specimens of the levator veli palatini muscle were removed at the time of surgery. Specimens were fixed by quick-freezing, and stained with H-E and ATPase histochemistry in cryostat sections. The results were as follows: 1. For two subjects showing adequate timing of velum movement, this was the coronal pattern of velopharygeal movement, and the muscle fibers were arranged in mosaic pattern of type 1,2A and 2B fibers. 2. For four subj ects showing poor velum movement, this was coronal to circular or circular to sagital, and the muscle fibers compositions were variable compared to those of subjects with adequate velopharyngeal movement. 3. For the remaining two subjects sho wing immobile velum, no muscle fiber was observed. It was suggested that histochemical findings correspond to fiberscopic findings of velopharygeal movement. |
| Author | SATO, Koichi TAKADA, Satoshi HARA, Hisanaga TACHIMURA, Takashi OHNO, Tomoya WADA, Takeshi |
| Author_FL | 高田 訓 原 久永 佐藤 耕一 舘村 卓 大野 朝也 和田 健 |
| Author_FL_xml | – sequence: 1 fullname: 高田 訓 – sequence: 2 fullname: 舘村 卓 – sequence: 3 fullname: 大野 朝也 – sequence: 4 fullname: 原 久永 – sequence: 5 fullname: 和田 健 – sequence: 6 fullname: 佐藤 耕一 |
| Author_xml | – sequence: 1 fullname: TAKADA, Satoshi organization: 2nd Department of Oral Surgery, Ohu University School of Dentistry – sequence: 1 fullname: WADA, Takeshi organization: Division for Oral and Facial Disorders, Osaka University Faculty of Dentistry – sequence: 1 fullname: HARA, Hisanaga organization: Division for Oral and Facial Disorders, Osaka University Faculty of Dentistry – sequence: 1 fullname: SATO, Koichi organization: Dapartment of Oral and Maxillofacial Surgery, Miyazaki Medical College – sequence: 1 fullname: TACHIMURA, Takashi organization: Division for Oral and Facial Disorders, Osaka University Faculty of Dentistry – sequence: 1 fullname: OHNO, Tomoya organization: 2nd Department of Oral Surgery, Ohu University School of Dentistry |
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| References | 14)原久永, 舘村卓, 高英保, 他: 持続的鼻腔内陽圧負荷装置を用いた鼻咽腔閉鎖機能賦活法(CPAP療法)のnasalanceによる評価. 日口蓋誌, 23: 23-35, 1998. 2) Ibuki, K., Karnell, M. P. and Morris, H. L.: Reliability of the nasopharyngeal fiberscope (NPF) for assessing velopharyngeal function. Cleft Palate J., 20: 97-104, 1983. 18) Dubowitz, V. and Brooke, M. H.: Muscles biopsy: A modern approach. In major problems in neurology. ed. by Walton, J. N., vol 2, 98-102, W. B. Saunders, Philadelphia. 1973 8) Tachimura, T., Hara, H. and Wada, T.: Oral air pressure and nasal air flow rate on levator veli palatini muscle activity in patients wearing a speech appliance. Cleft Palate J, 32: 382-389, 1995. 6)高田訓, 根本隆一, 滝沢知由, 他; 高齢者未手術口蓋裂症例の義歯プロテーゼによる治療経験と鼻咽腔閉鎖機能について. 日口蓋誌, 21: 35-41, 1996. 3) Witzel, M. A. and Posnick, J. C.: Patterns of location of velopharyngeal valving problems: atypical findings on video nasophary ngoscopy. Cleft Palate J., 26: 63-67 1989. 24) Kon, H., Takada, S., Takizawa, T., et al: Histological and Histochemical Examination of the Denervation Muscle and Reinnervation Muscle in Rabbits, (abst). Int. J. Oral Maxillofac. Surg., 26: 151, 1997. 17)埜中征哉: 臨床のための筋病理入門第二版, 10-43, 日本医事新報社, 東京, 1989. 12) Kuehn, D. P., Moon, J. B. and Folkins, J. W.: Levator veli palatini muscle activity in relation to intranasal air pressure variation. Cleft Palate J., 30: 361-368, 1993. 25)滝沢知由: ラット咬筋剥離後の回復経過に関する実験的研究., 奥羽大学歯学誌, 24: 161-173, 1997. 9) Tachimura, T., Hara, H., Koh, H., et al: Effect of temporary closure of oronasal fistulae on levatol veli palatini muscle activity. Cleft Palate J, 34: 505-511, 1997. 1)山岡稔: 内視鏡による口蓋裂患者の鼻咽腔閉鎖運動に関する研究日口外誌, 19: 29-43, 1973. 20) Takada, S., Ohno, T., Tachimura, T., et al: Histochemical study of levator ve li palatini muscle in patients with veloph a ryngeal incompetence, (abst. ). 52nd A CPA: 63, 1995. 15)和田健, 舘村卓訳: 口蓋裂言語障害の病理・診断・治療., 357-442, 医歯薬出版, 東京, 1995. 19)滝沢知由, 高田訓, 金秀樹, 他: 口蓋帆挙筋の組織化学的検索, (抄). 日口蓋誌23: 183, 1998. 4) Stringer, D. A. and Witzel, W. A.: Comparison of multi-view videofluoscopy and nasophryngoscopy in the assessment of velopharyngeal insufficiency. Cleft Palate J., 26: 88-90. 1989. 11) Kuehn, D. P.: New therapy for treating hypernasal speech using continuous p ositive airway pressure (CPAP), Plast. Rec o nstr. Surg., 88: 959-966, 1991. 16)小沢鋏二郎, 嶋田裕, 真崎知生: 筋発生の細胞生物学, 259-313, 学会出版センター, 東京, 1983. 7)舘村卓, 和田健, 原久永, 他: 発音補正装置装着時における口蓋帆挙筋活動に対する口腔内圧および鼻腔漏出気流量の影響, 日口蓋誌, 16: 180-189, 1991. 5)舘村卓, 和田健: 栓塞子付き口蓋挙上装置(Bulb-PLP: Bulb attached Pafatal Lift Prosthesis)の考案. 日口蓋誌, 13: 253-261, 1988. 13)舘村卓, 原久永, 高英保, 他: 鼻咽腔閉鎖機能に対する持続的鼻腔内陽圧負荷(CPAP: Continuous Positive Air Pressure)の効果-口蓋帆挙筋に対する口腔内圧・鼻腔内圧の影響. 日口蓋誌, 19: 11-19, 1994. 21) Moon, J., Thompson, S., Jaeckel, E., et al: Muscle fiber type distribution in human livator palatini, (abst. ). 53rd ACPA: 52, 1996. 23)高田訓: 凍結乾燥同種神経移植後の移植神経ならびに末梢筋組織の修復経過に関する実験的研究. 奥羽大歯学誌, 19: 332-351, 1992. 10)福田登美子, 和田健, 舘村卓, 他: 鼻咽腔閉鎖不全に対する発音補正装置の効果. 日口蓋誌, 23: 75-82, 1998. 22)岡田里美, 埜中征哉, 石浦章一, 他: ラットの筋線維の発育・分化に関する組織化学的研究. 神経内科, 15: 363-370, 1981. |
| References_xml | – reference: 1)山岡稔: 内視鏡による口蓋裂患者の鼻咽腔閉鎖運動に関する研究日口外誌, 19: 29-43, 1973. – reference: 10)福田登美子, 和田健, 舘村卓, 他: 鼻咽腔閉鎖不全に対する発音補正装置の効果. 日口蓋誌, 23: 75-82, 1998. – reference: 23)高田訓: 凍結乾燥同種神経移植後の移植神経ならびに末梢筋組織の修復経過に関する実験的研究. 奥羽大歯学誌, 19: 332-351, 1992. – reference: 18) Dubowitz, V. and Brooke, M. H.: Muscles biopsy: A modern approach. In major problems in neurology. ed. by Walton, J. N., vol 2, 98-102, W. B. Saunders, Philadelphia. 1973 – reference: 14)原久永, 舘村卓, 高英保, 他: 持続的鼻腔内陽圧負荷装置を用いた鼻咽腔閉鎖機能賦活法(CPAP療法)のnasalanceによる評価. 日口蓋誌, 23: 23-35, 1998. – reference: 20) Takada, S., Ohno, T., Tachimura, T., et al: Histochemical study of levator ve li palatini muscle in patients with veloph a ryngeal incompetence, (abst. ). 52nd A CPA: 63, 1995. – reference: 4) Stringer, D. A. and Witzel, W. A.: Comparison of multi-view videofluoscopy and nasophryngoscopy in the assessment of velopharyngeal insufficiency. Cleft Palate J., 26: 88-90. 1989. – reference: 11) Kuehn, D. P.: New therapy for treating hypernasal speech using continuous p ositive airway pressure (CPAP), Plast. Rec o nstr. Surg., 88: 959-966, 1991. – reference: 3) Witzel, M. A. and Posnick, J. C.: Patterns of location of velopharyngeal valving problems: atypical findings on video nasophary ngoscopy. Cleft Palate J., 26: 63-67 1989. – reference: 7)舘村卓, 和田健, 原久永, 他: 発音補正装置装着時における口蓋帆挙筋活動に対する口腔内圧および鼻腔漏出気流量の影響, 日口蓋誌, 16: 180-189, 1991. – reference: 5)舘村卓, 和田健: 栓塞子付き口蓋挙上装置(Bulb-PLP: Bulb attached Pafatal Lift Prosthesis)の考案. 日口蓋誌, 13: 253-261, 1988. – reference: 25)滝沢知由: ラット咬筋剥離後の回復経過に関する実験的研究., 奥羽大学歯学誌, 24: 161-173, 1997. – reference: 15)和田健, 舘村卓訳: 口蓋裂言語障害の病理・診断・治療., 357-442, 医歯薬出版, 東京, 1995. – reference: 19)滝沢知由, 高田訓, 金秀樹, 他: 口蓋帆挙筋の組織化学的検索, (抄). 日口蓋誌23: 183, 1998. – reference: 12) Kuehn, D. P., Moon, J. B. and Folkins, J. W.: Levator veli palatini muscle activity in relation to intranasal air pressure variation. Cleft Palate J., 30: 361-368, 1993. – reference: 17)埜中征哉: 臨床のための筋病理入門第二版, 10-43, 日本医事新報社, 東京, 1989. – reference: 2) Ibuki, K., Karnell, M. P. and Morris, H. L.: Reliability of the nasopharyngeal fiberscope (NPF) for assessing velopharyngeal function. Cleft Palate J., 20: 97-104, 1983. – reference: 8) Tachimura, T., Hara, H. and Wada, T.: Oral air pressure and nasal air flow rate on levator veli palatini muscle activity in patients wearing a speech appliance. Cleft Palate J, 32: 382-389, 1995. – reference: 21) Moon, J., Thompson, S., Jaeckel, E., et al: Muscle fiber type distribution in human livator palatini, (abst. ). 53rd ACPA: 52, 1996. – reference: 16)小沢鋏二郎, 嶋田裕, 真崎知生: 筋発生の細胞生物学, 259-313, 学会出版センター, 東京, 1983. – reference: 13)舘村卓, 原久永, 高英保, 他: 鼻咽腔閉鎖機能に対する持続的鼻腔内陽圧負荷(CPAP: Continuous Positive Air Pressure)の効果-口蓋帆挙筋に対する口腔内圧・鼻腔内圧の影響. 日口蓋誌, 19: 11-19, 1994. – reference: 9) Tachimura, T., Hara, H., Koh, H., et al: Effect of temporary closure of oronasal fistulae on levatol veli palatini muscle activity. Cleft Palate J, 34: 505-511, 1997. – reference: 24) Kon, H., Takada, S., Takizawa, T., et al: Histological and Histochemical Examination of the Denervation Muscle and Reinnervation Muscle in Rabbits, (abst). Int. J. Oral Maxillofac. Surg., 26: 151, 1997. – reference: 6)高田訓, 根本隆一, 滝沢知由, 他; 高齢者未手術口蓋裂症例の義歯プロテーゼによる治療経験と鼻咽腔閉鎖機能について. 日口蓋誌, 21: 35-41, 1996. – reference: 22)岡田里美, 埜中征哉, 石浦章一, 他: ラットの筋線維の発育・分化に関する組織化学的研究. 神経内科, 15: 363-370, 1981. |
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| SubjectTerms | HARA, Hisanaga Hisanaga HARA histochemistry nasopharyngeal fiberscope levator veli palatini muscle Velopharyngeal incompetence 口蓋帆挙筋 組織化学 鼻咽腔内視鏡検査 鼻咽腔閉鎖不全症 |
| Title | Histochemical Study of Levator Veli Palatini Muscle in Patients with Velopharyngeal Incompetence |
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