bluuebunny/crossref_metadata_2025_split huggingface dataset:
Three-Dimensional Bolton–Brush Growth Study Landmark Data: Ontogeny and Sexual Dimorphism of the Bolton Standards Cohort
Authors: Dean David , Hans Mark G. , Bookstein Fred L. , Subramanyan Krishna 
Published: October 2018

Objective The treatment of craniofacial reconstructive surgery patients may benefit from comparison to average referent three-dimensional landmark data. These data may be useful for diagnosis, treatment planning, prosthetic design, or outcomes assessment. With regard to subadult patients, we hypothesize that the pattern of ontogenetic shape change of same sex, same ethnicity, referent populations will show gross uniformity. We present a preliminary shape analysis of 50 three-dimensional landmarks derived from 317 Bolton–Brush Growth Study biorthogonal image pairs. We determine which landmarks can be collected from scanned radiographs reliably by four operators for the precisely locatable points, ontogenetic trends in landmark configuration shape change, and patterns of sexual dimorphism. Participants Participants were Bolton standards individuals (16 male and 16 female) who contributed biplane cephalograms seven or more times with annual or greater spacing between ages 3 and 18 years. Design After removing outliers, we searched for ontogenetic heterogeneity, including sexual dimorphism and within sex-specific Procrustes coordinate shape spaces. Results A cut-off of 4.3-mm interoperator error left 32 landmarks in our analysis. Three different approaches (principal component analysis, age-trend analysis, and principal components of age residuals) all found no patterns of individual variation around sex-specific average trends of shape change. Male shape change peaks at age 15, a correlate of the growth spurt. Conclusions Simultaneous frontal and lateral anatomic landmark identification improves three-dimensional localization reliability. Three-dimensional craniodental shape change from ages 8 to 18 within the Bolton standards presents little heterogeneity. Considerations of ethnicity aside, these may be initial grounds for use of these data as a normative referent.
A Comparative Study of Prespeech Vocalizations in Two Groups of Toddlers with Cleft Palate and a Noncleft Group
Authors: Willadsen Elisabeth , Enemark Hans 
Published: October 2018

Objective This study examined the prelinguistic contoid (consonant-like) inventories of 14 children with unilateral cleft lip and palate (C-UCLP) at 13 months of age. The children had received primary veloplasty at 7 months of age and closure of the hard palate was performed at 3–5 years. The results of this investigation were compared to results previously reported for 19 children with cleft palate and 19 noncleft children at the age of 13 months. The children with clefts in that study received a two-stage palatal surgery. This surgical procedure was formerly used at our center and included closure of the lip and hard palate at 3 months of age and soft palate closure at 22 months of age. Design Retrospective study. Setting The participants were videorecorded in their homes during play with their mothers. The videotapes were transcribed independently by three trained speech pathologists. Patients Fourteen consecutive patients born with C-UCLP and no known mental retardation or associated syndromes served as subjects. Results The children who received delayed closure of the hard palate demonstrated a significantly richer variety of contoids in their prespeech vocalizations than the cleft children in the comparison group. Both groups of subjects with clefts had significantly fewer plosives in their contoid inventory than the noncleft group, and there was no difference regarding place of articulation between the group that received delayed closure of the hard palate and the noncleft group.
Three-Dimensional Computer Morphometry of the Maxilla and Face in Infants with Pierre Robin Sequence-A Comparative Study
Authors: Bacher Margit , Bacher Ulrike , Göz Gernot , Pham Thinh , Cornelius Carl-Peter , Speer Christian P. , Goelz Rangmar , Arand Jörg , Wendling Fritz , Buchner Peter , Bacher Adelbert 
Published: October 2018

Objective To analyze the morphology of the maxillary crest in infants with Pierre Robin sequence using an anthropometric coordinate system and to compare the data with those of healthy infants. Setting The study was performed at a craniofacial center servicing a large geographic area. Participants The study involved eight infants aged 1–28 days (average, 7 days) with an established diagnosis of Pierre Robin sequence and six healthy infants aged 1–43 days (average, 22 days). Main outcome Measures Physical models of the maxilla and face obtained by alginate replication were analyzed by computer morphometry yielding the three-dimensional topology of the maxillary crest. Results The maxillary crest of children with Pierre Robin sequence shows an increased inclination relative to the transverse plane (30 ± 3.9 degrees) as compared with that of healthy infants (20 ± 2.9 degrees). The maxillary crest of the patients is shortened in the sagittal direction by comparison with healthy controls. Conclusions The increased inclination of the maxilla in infants with Pierre Robin sequence may aggravate the retroposition of the mandible and may thus be a pathogenetic factor contributing to the severe respiratory problems.
Analysis of Scar Tissue Distribution on Rat Palates: A Laser Doppler Flowmetric Study
Authors: Chu Soowon , Ishikawa Hiroyuki , Kim Takenori , Yoshida Shigemitsu 
Published: October 2018

Objective The aim of this study was to evaluate the effectiveness of laser Doppler flowmetry (LDF) to discriminate postoperative scar tissue distribution on the palate. Methods Nineteen male Wistar rats at the 20th postnatal day were divided into experimental and control groups. In the experimental group, lateral palatal mucoperiosteum was excised to form scar tissue on the palate. At the 11th postnatal week, changes in the palatal blood flow were recorded with LDF in both groups by occluding exposed common carotid arteries. Perfusion values of nonoccluded (stable) and occluded states and the ratio of occluded to stable states were compared for scar tissue and normal tissue areas, and also for the normal tissue areas. After the LDF measurements, India ink–injected specimens and tissue sections were prepared for histological observations. Results and Conclusions Scar tissue areas showed lower perfusion values both in the stable and occluded states, reflecting a lower vascular density in the scar tissue. The ratio of the occluded to stable states was higher in the scar tissue than in the normal tissue areas. In normal tissue areas, perfusion values of both the stable and occluded states appeared to vary, but the ratio did not vary among the areas. In the LDF study, the ratio of the occluded to stable states was considered to be the better parameter for discriminating scar tissue from normal tissue.
Secondary Cleft Lip Nasal Reconstruction: State of the Art
Authors: Cutting Court B. 
Published: October 2018

Objective This paper summarizes the state of the art in secondary cleft lip nasal reconstruction, distilled from the many papers written on the subject and from the author's experience with many of those procedures over the past 25 years. Methods The evaluation starts with the skeletal base and the need for LeFort 1 or alveolar bone grafting is discussed. The boney dorsum is next evaluated and a “monobloc” osteotomy considered. The cartilaginous dorsum follows and a “spreader-strut” graft is entertained. The tip cartilages are approached with either an open Potter or Dibbell preferred or replacement conchal graft if the tip has been destroyed by previous surgery. The skin envelope is then adjusted using methods described by Tajima, Dibbell, and Bardach.
Comparative Study of Mandibular Stability after Sagittal Split Osteotomies: Biocortical versus Monocortical Osteosynthesis
Authors: Fujioka Masaki , Fujii Tohru , Hirano Akiyoshi 
Published: October 2018

Objective A comparative study of clinical mandibular stability following bilateral sagittal split osteotomies by means of monocortical versus bicortical osteosynthesis was undertaken. Design This retrospective study utilized cephalometric radiographs, which were taken at 1 week and 6 months postoperatively. Setting The research was carried out at the Department of Plastic and Reconstructive Surgery of the Nagasaki University School of Medicine. Patients A total of 32 patients who underwent only sagittal split osteotomies and mandibular set back in our unit was included in this study. Of these patients, 17 patients were osteosynthesized monocortically, and 15 patients were osteosynthesized bicortically. Main outcome Measures Four measurements—gonial angle (GA), mandibular plane (MP), SNB, and percentage of upper face to total face height (percent upper to total face)—were completed to evaluate postoperative mandibular movement. Result Statistical analyses of cephalometric measurements (GA, MP, SNB, and percent upper face to total face height) showed that monocortical fixed mandibles were more changeable postoperatively on the GA and percent upper face to total face height, but MP and SNB showed no significant differences among the groups. Conclusion These findings suggested that the postoperative excessive shear force stress, produced by the compressive action of the masseter muscle, transformed the mandibular shape as the distal segment rotated clockwise and proximal segment rotated counterclockwise. Consequently, the mandible was bent at the miniplate. It was concluded that bicortical osteosynthesis was more rigid against this shearing stress than monocortical osteosynthesis.
Secondary Bone Grafting of Alveolar Clefts: A Densitometric Comparison of Iliac Crest and Tibial Bone Grafts
Authors: Sivarajasingam V. , Pell G. , Morse M. , Shepherd J. P. 
Published: October 2018

Objective To evaluate changes in the optical density of secondary alveolar cleft bone grafts obtained from two different donor sites over time and to determine whether one donor site gives a higher recipient bone density than the other. Methods A prospective study was performed evaluating 40 healthy patients with congenital cleft lip and palate undergoing secondary alveolar bone grafting, 20 (14 boys and 6 girls) having iliac crest and 20 (12 boys and 8 girls) receiving tibial bone grafts. Bone harvest and grafting was carried out by one operator (G.P.). Optical density of iliac and tibial grafts measured using a computerized densitometer, was compared at 6 days, 6 weeks, and 3 months. Due to interference from orthodontic appliances, optical density measurements for 16 subjects were not possible, and these patients were excluded from the study. The length of hospital stay postoperatively for both grafting procedures were recorded. Results A significant decrease in relative bone density was demonstrated during the 3-month postoperative period in both iliac and tibial bone graft groups (p < .05). The difference in densities between iliac crest and tibial groups were not significantly different at any of the time points (paired t test, p > .05). Subjects undergoing iliac crest grafts stayed an average of 5 days in the hospital postoperatively, compared with subjects with tibial grafts who stayed an average of 3 days postoperatively. Conclusion Optical density measurements of bone grafted into alveolar clefts, reported here for the first time, provide a valuable objective assessment of graft progress. Tibial and iliac crest grafts gave similar optical densities at recipient sites over the first 3 months. Iliac crest grafts required significantly longer postoperative stay; an important consideration in selecting donor sites for secondary bone grafting.
Cleft Lip and Palate Care in the United Kingdom—The Clinical Standards Advisory Group (CSAG) Study. Part 1: Background and Methodology
Authors: Sandy Jonathan R. , Williams Alison C. , Bearn David , Mildinhall Sue , Murphy Terrie , Sell Debbie , Murray John J. , Shaw William C. 
Published: October 2018

Objective To review the history of cleft care in the United Kingdom and the rationale and methodology of a national study. Design Descriptive overview to introduce this series of papers. Setting Fifty National Health Service cleft teams. Patients/Participants Two age cohorts, 5-year-olds and 12-year-olds, with nonsyndromic complete unilateral cleft lip and palate and their parents. Main Outcome Measures Facial development and appearance, quality of bone grafts, speech, oral health and patient/parent satisfaction. Conclusions The case for a national assessment of cleft care is made. The methodology of the cross-sectional outcome study is described, together with a survey of training for recently appointed clinicians.
Furlow Palatoplasty to Restore Velopharyngeal Competence following Tonsillectomy Avulsion of a Pharyngeal Flap
Authors: Gosain Arun K. , Remmler Daniel 
Published: October 2018

Objective We report the successful use of a Furlow palatoplasty to salvage velopharyngeal competence following iatrogenic avulsion of a pharyngeal flap that had been previously established to treat velopharyngeal insufficiency associated with a submucous cleft palate. Intervention A tonsillectomy, conducted by a surgeon unaffiliated with a cleft palate team, was used to remove enlarged tonsils that had developed after pharyngeal flap surgery and extended into the lateral ports causing nasal obstruction and hypernasality because of mechanical interference with port closure. A posttonsillectomy evaluation revealed avulsion of the pharyngeal flap, which was successfully treated using a Furlow palatoplasty. Conclusions To our knowledge, this is the first report of iatrogenic avulsion of a pharyngeal flap caused by tonsillectomy. Based on a review of the literature and this case experience, we would conclude that tonsillectomy should not be regarded as a routine procedure in patients previously treated with a pharyngeal flap. If required, it should be performed by a skilled otolaryngologist, preferably one affiliated with a multidisciplinary cleft palate team who is familiar with pharyngoplasty surgery. Finally, our experience would suggest that the Furlow palatoplasty is sufficiently robust to be used as a secondary salvage procedure to restore velopharyngeal sufficiency following iatrogenic avulsion of a pharyngeal flap.
Nasalance Measures in Cantonese-Speaking Women
Authors: Whitehill Tara L. 
Published: October 2018

Objectives To establish and evaluate stimulus materials for nasalance measurement in Cantonese speakers, to provide normative data for Cantonese-speaking women, and to evaluate session-to-session reliability of nasalance measures. Participants and setting One hundred forty-one Cantonese-speaking women with normal resonance who were students in the Department of Speech and Hearing Sciences, University of Hong Kong. Procedures Participants read aloud four speech stimuli: oral sentences, nasal sentences, an oral paragraph (similar to the Zoo Passage), and an oral-nasal paragraph (similar to the Rainbow Passage). Data were collected and analyzed using the Kay Nasometer 6200. Data collection was repeated for a subgroup of speakers (n = 28) on a separate day. Nasalance materials were evaluated by using statistical tests of difference and correlation. Results Group mean (standard deviation) nasalance scores for oral sentences, nasal sentences, oral paragraph, and oral-nasal paragraph were 16.79 (5.99), 55.67 (7.38), 13.68 (7.16), and 35.46 (6.22), respectively. There was a significant difference in mean nasalance scores for oral versus nasal materials. Correlations between stimuli were as expected, ranging from 0.43 to 0.91. Session-to-session reliability was within 5 points for over 95% of speakers for the oral stimuli but for less than 76% of speakers for the nasal and oral-nasal stimuli. Conclusions Standard nasalance materials have been developed for Cantonese, and normative data have been established for Cantonese women. Evaluation of materials indicated acceptable differentiation between oral and nasal materials. Two stimuli (nasal sentences and oral paragraph) are recommended for future use. Comparison with findings from other languages showed similarities in scores; possible language-specific differences are discussed. Session-to-session reliability was poorer for nasal than oral stimuli.
Social Anxiety in Chinese Adults with Oral-Facial Clefts
Authors: Berk Nancy W. , Cooper Margaret E. , Liu You-e , Marazita Mary L. 
Published: October 2018

Objective This study examined social anxiety and measures of psychosocial adjustment in Chinese adults with oral-facial clefts, their unaffected siblings, and age-matched controls. Design This cross-sectional study utilized a matched case-control study design. Participants Eighty-five adult cleft lip and cleft palate (CL/CP) subjects and 85 unaffected siblings (one adult sibling of each CL/CP subject) were recruited in Shanghai, China, from a larger CL/CP study. Eighty-five unaffected controls, gender- and age-matched to the CL/CP subjects, were recruited from Shanghai work units including factories, universities, and other institutions. Outcome Measures Social Avoidance and Distress Scale, Fear of Negative Evaluation, Rosenberg Self-Esteem Scale, Interpersonal Support Evaluation List. Results Affected adults reported significantly more social anxiety than unaffected siblings and controls. Affected adults also scored significantly lower on measures of self-esteem and social support than unaffected siblings and controls. Unaffected siblings and controls were not found to differ on any of these measures. Conclusions Findings suggest that individuals with oral-facial clefts may be more disadvantaged with respect to social affiliation and adaptation than unaffected adults. Cross-cultural research is essential in enabling us to determine whether similar trends exist across cultures.
The Effect of Neurocranial Surgery on Basicranial Morphology in Isolated Sagittal Craniosynostosis
Authors: DeLeon Valerie Burke , Zumpano Michael P. , Richtsmeier Joan T. 
Published: October 2018

Objective Isolated sagittal craniosynostosis produces a scaphocephalic neurocranium associated with abnormal basicranial morphology, providing additional evidence of the developmental relationship of the neurocranium and basicranium. Corrective surgical procedures vary, but the immediate impact of the surgical procedure is restricted to the neurocranium. This study addresses the secondary effects of neurocranial surgery on the cranial base. Design Three-dimensional (3-D) computed tomography (CT) scans were obtained for preoperative (n = 25) and postoperative (n = 12) patients with isolated sagittal synostosis. Landmark data from 14 landmarks on and around the cranial base were collected from 3-D CT reconstructions and analyzed using Euclidean distance matrix analysis. Subsamples of age-matched patients were used to identify basicranial differences in pre- and postoperative patients and to compare postoperative growth patterns identified in longitudinal data with preoperative growth patterns characterized in cross-sectional data. Results Statistically significant differences (p ≤ 0.10) were found in the morphology of the cranial base in preoperative and postoperative patients. The relative positions of the landmarks nasion, right asterion, and left asterion are similar in preoperative and postoperative patients. However, the position of these landmarks relative to the cranial base is different in the two groups, being positioned relatively more anteriorly in postoperative patients. In addition, we found that the cranial base angle, on average, neither increases nor decreases in the first postoperative year. These morphological differences are associated with divergent growth trajectories in the operated and unoperated cranial base. Conclusion Regardless of specific procedure, neurocranial surgery in sagittal synostosis patients affects growth patterns of the cranial base. The lack of change in the postoperative cranial base angle suggests that neurocranial surgery alleviates the occipital rotation and decreased cranial base angle described in the sagittal synostosis basicranium.
Nasal Airflow Patterns during the Velopharyngeal Closing Phase in Speech in Children with and without Cleft Palate
Authors: Dotevall Hans , Ejnell Hasse , Bake Björn 
Published: October 2018

Objectives: (1) To study the nasal airflow patterns during the velopharyngeal closing phase in speech produced by children with and without cleft palate. (2) To compare the nasal airflow patterns in bilabial, dental, and velar articulation in these children. Design: Prospective, cross-sectional study of a consecutive series of children with cleft palate referred for routine speech evaluation and controls. Setting: Sahlgrenska University Hospital, Göteborg, Sweden. Participants: Seventeen children with cleft lip and palate or cleft palate only and 22 controls aged 7 and 10 years. Method: Nasal airflow was transduced with a pneumotachograph attached to a nose mask and registered together with the acoustic speech signal. Sentences containing nasal-to-stop combinations in bilabial, dental, and velar articulatory positions were used. Main Outcomes Measures: The duration from peak to 5% nasal airflow, the maximum flow declination rate, and the nasal airflow at selected points in time during the transition from nasal-to-stop consonants. Results: In the cleft palate group, duration from peak to 5% nasal airflow was clearly longer than among the controls (p < .0001). The declination of airflow was slower (p < .006) and the rate of nasal airflow at the release of the stop consonant was higher (p < .004) in the cleft palate group. Differences between bilabial versus dental and velar articulation were found in the control group. Conclusion: Studies of the temporal and dynamic characteristics of the nasal airflow variations during speech appear potentially useful for the assessment of velopharyngeal function.
“Distraction” of Grafted Alveolar Bone in Cleft Case Using Endosseous Implant
Authors: Buis Jacques , Rousseau Paul , Soupre Veronique , Martinez Herve , Antoine Diner Patrick , Paule Vazquez Marie 
Published: October 2018

Objective: Presentation of a specific surgical technique of vertical alveolar ridge distraction performed on an alveolar bone graft 1 year after the primary grafting procedure designed to correct a labioalveolar cleft. The graft had not obtained the results desired and presented heavily scarred mucosal tissue. Technique: A dental implant placed within the graft once it has been entirely freed by osteotomies functions as an endless screw. To avoid vascular risk, the alveolar bone graft is detached as a whole along its total height. Consequently, no bone remains above it to provide support for a conventional alveolar distractor. An osteosynthetic miniplate, fastened in a horizontal position beneath the nasal mucosae above the graft, is used to replace the missing bony support and to stabilize the implant, which activates the distraction process. Patient: This study is based on our first clinical case with a follow-up of 18 months at present. Result: A vertical displacement of the entire graft was achieved, including its attached mucosal layer, which repositioned both bone and mucosa on a far better level in the cleft area. Thus, a normal length of abutment was obtained permitting prosthetic rehabilitation based on the same endosseous implant, which was left in place within the graft. Conclusion: This technique may prove particularly helpful in certain cases in which a primary alveolar bone grafting procedure has produced borderline results. In such cases, on the one hand, neither the reasonably satisfactory volume of the bone graft itself nor the poor quality of its scarred mucosal tissue argue in favor of a secondary grafting procedure. On the other hand, it is impossible to resort to currently available alveolar distracters since our choice of techniques leaves no bone support above the graft.