bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examination of the Standard Deviation of Mean Nasalance Scores in Subjects with Cleft Palate: Implications for Clinical Use
Authors: Vallino-Napoli Linda D. , Montgomery Allen A. 
Published: October 2018

Objectives: To evaluate the standard deviation of the nasalance scores in patients having normal and abnormal nasal resonance and to determine its potential value for clinical use. Additionally, the mean nasalance scores were examined across varying degrees of hypernasality. Design: Prospective study design. Setting: Pediatric tertiary care hospital. Patients: One hundred and forty-eight subjects, ranging in age from 4;0 to 37;0 years, having repaired cleft lip and/or palate and normal resonance, inconsistent, mild, or moderate/severe hypernasality. Procedures: Oral-nasal acoustic measurements were made using the Nasometer. The standard deviation and mean nasalance scores were calculated for subjects reading three standard passages (Zoo Passage, Rainbow Passage, Nasal Sentences). Results: The major finding in this study showed that the standard deviation score cannot distinguish speakers beyond a gross normal and abnormal resonance diagnostic category. The values obtained could not be used to distinguish among the varying degrees of hypernasality. A secondary finding was that a mean nasalance score in the high 20s could be used to differentiate speakers with borderline velopharyngeal function from those who were non-nasal. Conclusions: In general, the standard deviation value serves little overall clinical utility; however, it may be of benefit in some specific clinical situations. In support of previous research, the mean nasalance score continues to be the best measure of nasalance. It should serve as a supplement to but not a sub stitute for clinical judgments.
Changes in Craniofacial Development Due to Modifications of the Treatment of Unilateral Cleft Lip and Palate
Authors: Šmahel Zbyněk , Müllerova Živa , Nejedly Aleš , Horak Ivan 
Published: October 2018

Objective The objective of this study was to evaluate the craniofacial morphology of children with unilateral cleft lip and palate (UCLP) resulting from differing management protocols practiced in Prague from 1945 to 1976. Design The craniofacial morphologies of four groups of patients were compared. Two groups were assessed retrospectively (individuals born from 1945 to 1963), and two groups were followed on a longitudinal basis (individuals born from 1966 to 1976). Setting The study was conducted at the Cleft Lip and Palate Center at the Department of Plastic Surgery, Prague, which has a catchment area population of 6 million. Patients The subjects were a consecutive series of adult males (n = 84) who had complete UCLP without associated malformations. Interventions Patients born from 1945 to 1955 did not receive centralized orthodontic therapy. From 1945 to 1965, the alveolar process in the area of the cleft was not surgically repaired. Primary bone grafting was used for the group born from 1965 to 1972, and primary periosteoplasty was used in the subsequent period. Throughout the period covered by the study, the palate was operated on by pushback and pharyngeal flap surgery. From 1945 to 1965, the lip was repaired initially according to Veau, and later according to Tennison and Randall, and during this time, fixed appliances were used for orthodontic treatment. Results The results for the period from 1945 to 1955 are characterized by mandibular overclosure with anterior crossbite. Centralized orthodontic treatment in the later period improved sagittal jaw relations due to the posterior displacement of the mandible and an edge-to-edge bite was attained, but maxillary retrusion was unchanged. Primary bone grafting increased retrusion of the maxilla, which was compensated by further posterior displacement of the mandible. An edge-to-edge bite was also obtained. Primary periosteoplasty reduced maxillary retrusion, and the marked proclination of the upper dentoalveolar component with fixed appliances resulted in a positive overjet. It was no longer necessary to push the mandible back to the extent required in bone grafting. Conclusion Effective orthodontic treatment made the greatest contribution to improved facial development. It allowed compensation of maxillary retrusion by changes in the position of the mandible or by proclination of the upper dentoal-veolar component with fixed appliances. The applied surgical methods using primary bone grafting caused deterioration of the anterior growth of the maxilla.
The Influence of Dentures on Nasalance Values in Speech
Authors: Scarsellone Jana M. , Rochet Anne P. , Wolfaardt John F. 
Published: October 2018

Objective The purpose of this study was to investigate the effects of maxillary dentures on nasalance values in normal elderly individuals. Design A three-factor within-subjects experimental design was employed to analyze the nasalance scores obtained. Participants Twenty English-speaking women aged 61 to 81 years, who wore complete maxillary dentures, participated In the study. Intervention A Nasometer was used to collect nasalance data. Participants read three standard passages aloud, three times each, in two conditions: with and without their maxillary dentures. Results Results revealed that nasalance values were signiflcantly lower with the maxillary dentures removed (p < .01), although the difference In nasalance between the two denture conditions averaged no more than 2%. Nasalance scores obtained both with and without maxillary dentures fell within one standard deviation of the mean for a reference group of comparably aged English-speaking women. Conclusions The results suggest that the existing collection of normal reference data for nasalance may be safely used for elderly individuals regardless of their status with respect to natural or prosthetic maxillary dentition.
Assisted Feeding is more Reliable for Infants with Clefts—A Randomized Trial
Authors: Shaw William C. , Bannister R. Patricia , Roberts Christopher T. 
Published: October 2018

Objective To compare the effectiveness of squeezable and rigid feeding bottles for infants with clefts. Design Patients were randomly assigned at birth to feeding with a squeezable bottle (assisted feeding) or to feeding with a rigid bottle and were followed for 1 year. The data were analyzed on the basis of intention to treat. Setting The trial was conducted within the existing arrangements for hospital and home care for children with clefts within the National Health Service in the north of England. Patients The patients were 101 consecutively born children with cleft lip and/or palate who were otherwise healthy. All patients completed the trial. Two were excluded from the analysis when unrelated developmental problems became apparent. Main outcome measures Anthropometric measures—nude weight, crown-heel length (CHL), and occipito-frontal circumference (OFC)—were recorded. Results There were statistically significant differences between the two groups in weight at 12 months (p = .038, with an adjusted mean difference of 0.43 kg) and in head circumference (p = .004 with an adjusted mean difference of 0.77 cm), indicating increased growth in the squeezable bottle group. The difference in CHL was not significant at conventional levels (p = .082). Whereas 25 of 52 (48%) rigid bottles required modification by the health visitor, this was needed for only 4 of 49 (8%) squeezable bottles. There was a highly significant difference when numbers of modifications for each method were compared (p < .0001). Despite modifications, six infants feeding with a rigid bottle (11%) were transferred to a squeezable bottle due to problems with feeding, but none were transferred from squeezable to rigid bottles. Thus, the squeezable bottle generally appeared to be a more satisfactory method, requiring less support or intervention after initial instruction. Conclusions Both feeding methods achieved similar anthropometric outcomes, with a beneficial effect on head circumference and weight in the assisted feeding group. We recommend that this last observation be treated with caution. The squeezable bottles were easier to use, and we recommend that they be routinely prescribed.
A Left Transverse Facial Cleft with a Median Cleft of the Lower Jaw
Authors: Aygit A. Cemal , Ayhan M. Semih , Orak Fethi 
Published: October 2018

Objective: A 13-day-old girl with a left transverse facial cleft and a median defect of the lower jaw is reported in detail. Left macrostomia was repaired using a W-plasty technique, and preauricular appendages were excised. The median defect of the mandible demonstrated by computed tomography scan on the first examination had disappeared at 1 year of age. Conclusion: Congenital clefts of the mandible can fuse at a later stage; thus, it is necessary to wait to treat the mandibular defect until the infant is slightly older.
A Three-Dimensional Quantitative Analysis of Lips in Normal Young Adults
Authors: Ferrario Virgilio F. , Sforza Chiarella , Serrao Graziano 
Published: October 2018

Objective To supply information about (1) sex-related dimensions (linear distances and ratios, vermilion area, volume) of normal adult lips, (2) presence of sexual dimorphism, and (3) correlations between anthropometric characteristics of the lip and nose. Methods The three-dimensional coordinates of soft tissue landmarks on the lips and nose were obtained using an optoelectronic instrument in 90 healthy young adult women and 90 healthy young adult men. From the landmarks, several linear distances (mouth width, total vermilion height, nose height, anatomic nose width, total lip height, upper lip height), the ratio of vermilion height to mouth width, and some areas (vermilion of the upper lip, vermilion of the lower lip, total vermilion) and volumes (upper lip volume, lower lip volume, total lip volume) were calculated. Linear correlation analyses between pairs of variables were also conducted within each sex. Results All lip dimensions (distances, areas, and volumes) were significantly larger in men than in women (p < .005), but no sex differences were found in the vermilion height to mouth width ratio. Overall, mouth and nose dimensions were not significantly correlated, with the exceptions of the upper and lower lip volumes in both sexes and of the mouth and nose widths in the female sample, in which a modest part of the variance in one measurement could be explained by the other. Conclusion The dimensions of the mouth and the nose did not seem to be strictly related. Data collected in the present investigation could represent a database for the quantitative description of human lip morphology in adult subjects.
Repairing the Cleft Lip Nasal Deformity
Authors: De La Torre Jorge I. , Gallagher Pamela M. , Douglas Barry K. , Tenenhaus Mayer 
Published: October 2018

Objective The repair of the cleft lip nose and nasal deformity remains a challenging endeavor for reconstructive surgeons. Psychosocially, this complex, multifaceted deformity significantly stigmatizes the patient. Numerous techniques have been advocated by multiple authors for the treatment and reconstruction of these deformities, usually requiring serial staged reconstructions. Method Described is our technique for early primary repair of the cleft lip nasal deformity. The use of multiple suspension sutures to repair the nasal defect facilitates the repair of even very wide cleft lips. Conclusions These maneuvers provide an aesthetic and functional repair of the nasal defect in conjunction with the lip repair. Long-term results have minimized the need for surgical revision.
Comparative Study between Children with and without Cleft Lip and Cleft Palate, Part 2: Electromyographic Analysis
Authors: Ravera María José , Miralles Rodolfo , Santander Hugo , Valenzuela Saúl , Villanueva Pia , Zúñiga Claudia 
Published: October 2018

Objective This study was conducted to compare electromyographic (EMG) activity of superior orbicularis oris muscle between children with repaired cleft lip and cleft palate and children without clefts. Methods This study included 28 children with mixed dentition. They were divided into two groups. The study group included 14 children with repaired unilateral cleft lip and cleft palate, ranging in age from 6 to 12 years, who presented clinically with a short upper lip, abnormal lip seal, and inhibition of sagittal development of the midface as assessed radiographically. The control group included 14 children without clefts ranging in age from 8 to 11 years. All had normal lip seal, nasal breathing, and a clinically normal body posture. Design Bipolar surface electrodes were used for EMG recordings of resting level activity and during swallowing of saliva, speech, and chewing and swallowing of an apple. Results and Conclusions A significantly higher level of activity at rest and during swallowing of saliva was observed in the cleft lip and cleft palate group. Similar activity during speech and chewing and swallowing of an apple was observed in both groups. The higher level of activity at rest and during swallowing of saliva in children with cleft lip and cleft palate seems to suggest that upon higher functional demands their activity increases less than in children without clefts. From a clinical point of view, if increased EMG activity at rest and during swallowing of saliva reflects increased force on the maxilla, then our findings may corroborate Bardach's findings (1990) that surgical treatment of cleft lip has an iatrogenic effect on facial growth, although the lack of significant correlation between the cephalometric data and EMG findings in the present study.
Craniofacial Growth in Unoperated Craniofacial Malformations
Authors: Figueroa Alvaro A. , Friede Hans 
Published: October 2018

Objective and Purpose To review current information on craniofacial growth of unoperated patients with craniofacial malformations and stimulate the study of abnormal craniofacial growth through conventional and newer methods. This will lead to improved diagnosis and the understanding of the etiopathogenesis of craniofacial malformations. It is expected that this knowledge will also assist clinicians in planning treatment strategies to better manage these challenging conditions.
Lip Movement in Patients with a History of Unilateral Cleft Lip
Authors: Rutjens Christel A. W. , Spauwen Paul H. M. , van Lieshout Pascal H. H. M. 
Published: October 2018

Objective: The influence of a repaired cleft lip on the stability of coordination between upper and lower lip in nonspeech and speech tasks was investigated. Design: First, we looked at the effects of a secondary cleft lip repair in three individuals. Second, we compared subjects with a history of repaired unilateral cleft lip and subjects with no history of cleft lip (controls). Lip coordination was measured using continuous estimates of relative phase. Participants: Subjects were nine children and adolescents with a primary unilateral cleft lip and palate repair and 4 participants without cleft matched for age across different age categories. Results: In general, the averaged relative phase angle (RPA) angle values were smaller than 180 degrees, indicating an upper lip lead for lip closure. Controls showed a tendency toward a more symmetric type of coordination (close to 180 degrees), compared with subjects with a repaired unilateral cleft lip. The controls also showed less variation in coordination between the lips. For the more complex speech tasks, a general increase in variability of the RPA values for all subjects was observed, most likely suggesting a more flexible type of coordination. Regarding the effect of a secondary cleft lip repair, only one of the three patients showed a clearly less symmetric and less stable type of coordination, compared with preoperation results. Conclusions: There appear to be differences in lip coordination between speakers without and speakers with a repaired unilateral cleft lip. Furthermore, it seems that the stability of lip coordination tends to increase with age.
Developing a Behavior Rating Scale for Comparing Teachers’ Ratings of Children with and without Craniofacial Anomalies
Authors: Broder Hillary L. , Smith Fraser B. , Strauss Ronald P. 
Published: October 2018

Objective: Published psychometric tools are often insensitive to the experience of children with craniofacial anomalies (CFAs). The purposes of this study were to develop a valid and reliable assessment of behavior among children with and without CFAs and to compare teacher ratings of these two groups of children. Methods: Teachers were asked prospectively to assess social competence and peer acceptance among 99 consecutively evaluated school-aged patients with CFAs and 99 “controls” (classmates without CFA matched by race, gender, intellectual status, general socioeconomic status, and grade). Sixth grade was the median grade of the subjects. Outcome Measure: Child Behavior Rating Scale (CBRS). Results: Using oblique promax rotation, four factors emerged from the CBRS with the CFA patient group and controls. The factors explained 67% of the total variance and 69% of the variance of the two groups, respectively. The four factors were: (1) self-maintenance, (2) social adjustment, (3) independence, and (4) teasing. Cronbach alpha results averaged 0.77 for the CFA group and 0.83 for the controls; test-retest reliability estimates were .93. Results demonstrate the consistency of the factors and high level of interrelationship among the items across subject groups. Expected differences (p < .05) were found among subject groups on the total score and factor 4. Conclusion: The CBRS demonstrates psychometric worthiness. The findings indicated that patients with CFA had lower total scores on the CBRS, and they were rated as experiencing more teasing than their matched peers.
Nasoalveolar Molding and Gingivoperiosteoplasty versus Alveolar Bone Graft: An outcome Analysis of Costs in the Treatment of Unilateral Cleft Alveolus
Authors: Pfeifer Tracy M. , Grayson Barry H. , Cutting Court B. 
Published: October 2018

Objective The purpose of this study was to compare the financial impact of two treatment approaches to the unilateral cleft alveolus. The recently advocated nasoalveolar molding (NAM; Grayson et al., 1999) and gingivoperiosteoplasty (GPP; Santiago et al., 1998) at the time of lip repair were compared with the traditional approach of secondary alveolar bone graft. Design The records of all patients (n = 30) with unilateral cleft lip and alveolus treated by a single surgeon during 1985 through 1988 were examined retrospectively. The patients were divided into two groups: group 1 patients (n = 14) were treated by lip repair, primary nasal repair, and secondary alveolar bone graft prior to eruption of permanent dentition; group 2 patients (n = 16) were treated by NAM, GPP, lip repair, and primary nasal repair. Patients who required secondary alveolar bone graft after GPP were noted. The cost of treatment by each protocol was calculated in 1998 dollars. Results The average cost of treatment for a patient treated by lip repair, primary nasal repair, and secondary alveolar bone graft prior to eruption of permanent dentition was $22,744. Of the 16 patients treated by NAM, GPP, lip repair, and primary nasal repair, 10 required no further treatment of the unilateral cleft alveolus; six patients required secondary alveolar bone graft. The average per-patient treatment cost in this group was $19,745. The average cost savings of NAM and GPP, compared with alveolar bone graft is $2999. Conclusions The treatment of unilateral cleft alveolus by nasoalveolar molding and gingivoperiosteoplasty results in substantial cost savings, compared with treatment by secondary alveolar bone graft.
Folate and the Face: Evaluating the Evidence for the Influence of Folate Genes on Craniofacial Development
Authors: Prescott Natalie J. , Malcolm Sue 
Published: October 2018

Objective: Genetics has been thought to play a crucial role in the etiology of nonsyndromic cleft lip and palate (CL/P) for over 60 years, but we are still no closer to finding contributing genes. The main hindrance to the progress of CL/P genetic research is the complex multifactorial nature of the disorder with environmental factors playing a significant, if not equally important role. Thus, CL/P is the likely outcome of several developmental and biochemical events that may be different in different individuals or families. Conclusions: Because of the known advantages of folate therapy during pregnancy and the developmental problems that may occur when diets are folate deficient, recent research has looked toward a possible genetic explanation for susceptibility to low folate status. Several gene variants have been identified which, when combined with an inadequate diet, may impede human development, but it still remains to be seen whether these are a major contributor to CL/P. Here we review some of the current viewpoints and the possible impact of folic acid supplementation on clefting incidence.
Comparison of Craniofacial Morphology in Patients with Bilateral Complete Cleft of Primary versus Secondary Palate
Authors: Liao Yu-Fang , Huang Chiung-Shing , Noordhoff M. Samuel 
Published: October 2018

Objective: To identify and compare the craniofacial morphology of patients with bilateral complete cleft of primary palate (BCCPP) and bilateral complete cleft of secondary palate (BCCSP). In addition, to evaluate the differential effects of lip repair and palatal repair on the craniofacial morphology in cleft patients. Subjects: Twenty-four children, 10 boys and 14 girls, mean age of 5.8 years, with BCCPP (BCCPP group). Twenty-five children, 10 boys and 15 girls, mean age of 5.6 years, with BCCSP (BCCSP group). Design: Retrospective analysis. Main Outcome Measures: Cephalometric analysis was used to determine the craniofacial morphology at about 5 years of age. Results: Compared with the BCCSP group, the BCCPP group demonstrated longer maxillary length, more protruded maxilla, more favorable jaw relation, more severely retroclined maxillary incisors, and larger overjet. Conclusions: The subjects with BCCPP had craniofacial characteristics that differed significantly from those with BCCSP. It could also be speculated that palatal repair had more adverse effect on the growth of the maxilla in length; however, that repair influenced less the anteroposterior position of maxillary incisors than lip repair did.
Early Craniofacial Morphology and Growth in Children with Unoperated Isolated Cleft Palate
Authors: Hermann N.V. , Kreiborg S. , Darvann T.A. , Jensen B.L. , Dahl E. , Bolund S. 
Published: October 2018

Objective Analysis of craniofacial morphology and growth in children with untreated isolated cleft palate (ICP) (cleft of the secondary palate only) at 2 and 22 months of age and comparison of the morphology and growth to that of a control group with unilateral incomplete cleft lip (UICL). Material and Methods A total of 98 cleft children (53 with ICP and 45 with UICL) drawn from a larger group representing all Danish children with cleft born in the period 1976 to 1981 were included in the study. Craniofacial morphology and growth were analyzed using three-projection infant cephalometry. Results The ICP group differed significantly from the UICL group. The most striking findings in the ICP group were: short maxilla; reduced posterior maxillary height; increased posterior maxillary width (in the 2-month-old); short mandible; reduced posterior height of the mandible; bimaxillary retrognathia; and reduced pharyngeal depth, height, and area. The facial growth pattern was fairly similar in the two groups except for a somewhat more vertical growth direction in the ICP group. Conclusion The facial morphology in ICP children differs significantly from that of children with UICL of the same age. The differences in facial morphology can be ascribed to the difference in the primary anomaly in the ICP group. The facial growth pattern was fairly similar in the ICP and UICL group; however, a somewhat more vertical growth direction was observed in the ICP group.