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Computational fluid dynamics （CFD） analysis is useful for quantitative assessment in patients with upper airway obstructions. We compared CFD analysis with rhinomanometry （RM） and acoustic rhinometry （AR）. Twenty patients with nasal and paranasal diseases who required computed tomography assessment underwent RM and AR. We measured the pressure and velocity at four parts of the upper airway using CFD analysis. Then we evaluated the correlation among CFD analysis, RM, and AR. CFD analysis detected obstruction sites in the nasal airway and pharynx in 14 and 2patients, respectively. High negative pressure accompanied the nasal obstruction, even behind the nasal cavity. Nasal airway pressure measured using CFD analysis strongly correlated with nasal resistance in RM （Spearman correlation coefficient＝0.853）. CFD analysis’s sensitivity and specificity to detect the obstruction were 84.6％ and 57.1％, respectively （compared to those of RM） and 83.3％ and 50.0％, respectively （compared to those of AR）. The CFD analysis’s ability to detect obstruction was comparable to that of RM and AR; therefore, it may help evaluate the upper airways in patients with nasal and paranasal diseases. We found impaired nasal ventilation also affected other parts of the upper airway. Further studies with a larger sample size are required to validate the use of CFD analysis for assessing the degree of upper airway ventilation disorders.

A Special Needs Dental Center （hereafter referred to as the Center） was established at Showa University Dental Hospital in April 2012 to treat patients who need special care. In cooperation with the Division of Dentistry for Persons with Disabilities, the Division of Hygiene and Oral Health is mainly engaged in the treatment of patients with eating and swallowing disorders. It has been five years since the establishment of the Center. The present study was aimed to establish an effective medical support method through a comparative study of changes in patient trends. A total of 65 patients who visited the Center from April 2017 to March 2018 were examined and their statistics were compared with those of 60 previously reported patients who initially visited the Center for medical examination in 2012. In 2012, many visits occurred during the nursing period; however, in 2017, the number of patients who visited after the weaning period increased. Other noted trends were increased diversity in primary disease, more patient referrals, fewer patients with severe swallowing dysfunction, and more patients with oral dysfunction. The necessity of eating and swallowing practice is thought to increase when lifestyle and oral environment change. The treatment of eating and swallowing disorders is important in the dental profession. Due to the introduction of insurance coverage in Japan in 2018 for developmental insufficiency of oral function, more pediatric patients with eating and swallowing disorders will likely be treated in the future.

In April 2012, the Center of Special Needs Dentistry (SND) was established at Showa University Dental Hospital to provide function training for children with eating and swallowing disorders. A statistical clinical assessment was performed on new patients ≤18 years of age who visited the Center over a 1-year period (April 2012–March 2013) to assess the conditions present at the initial visit. In all, 60 patients (29 boys, 31 girls, mean (± SD) age 4.2±4.1 years, range 0-18 years of age) were included in the study. Most patients were

With super aged society in Japan, the death rate from choking due to blockage of the oropharynx has increased; it is now greater than that from traffic accidents and it is believed that this rate will continue to increase. The shape and function of the oropharyngeal crossing with the respiratory tract are most influential in ensuring that food is carried from the oral cavity to the pharynx and the esophagus. We sought to clarify the changes in the shape and features of the oropharyngeal airway from teenagers to those in their 70 s. A total of 57 patients were grouped by age (teenagers, 20s, 30s, 40s, 50s, 60s and 70s), and all underwent cone beam computed tomography (CBCT) to measure the oropharynx volume, height, cross-sectional area, and length of the superior and inferior extremities. Kruskal-Wallis analysis indicated that the volume and height of the oropharynx did no significant difference among age groups, but there was a different tendency when cross-sectional areas of the superior and inferior extremities were compared between younger and older patients. Further, the shape of the inferior extremity was also different features between younger and older patients. In humans, the oropharyngeal airway plays an important role in carrying food through the esophagus and facilitating phonation. Ideally, it is important for this airway to maintain a constant volume and height. Recently, there has been an increase in the incidence of oropharyngeal airway blockage accidents among the elderly. Declines in feeding and swallowing functions and changes in the form of the oropharynx are major factors in these accidents.