bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Three Methods of Repairing the Hard Palate
Authors: Pigott R. W. , Albery E. H. , Hathorn I. S. , Atack N. E. , Williams A. , Harland K. , Orlando A. , Falder S. , Coghlan B. 
Published: October 2018

Objective To compare growth, speech, and nasal symmetry outcomes of three methods of hard palate repair. Patients Consecutive available records of children born with unilateral bony complete cleft lip and palate over the period 1972 to 1992. Interventions Identical management of lip, nose, alveolus, and soft palate. Hard palate repair by Cuthbert Veau (CV) from 1972 to 1981, von Langenbeck (vL) from 1982 to 1989, or medial Langenbeck (ML) from 1989 to 1991. Outcome Measures For growth: GOSLON yardstick or 5-year model index. For speech: articulation test. Nasal anemometry. For nasal symmetry: Coghlan computer-based assessment. All these measures were developed during the period of data collection but not for this project. Results There was a strong trend toward more favorable anteroposterior maxillary growth with the change from CV to vL to ML techniques. This fell short of statistical significance because of the small sample size. There was a significant reduction in cleft-related articulation faults (p = .01) considered to be related to improved arch form. In the absence of improved rates of velopharyngeal insufficiency or nasal symmetry, increased surgical experience was discounted as a significant contribution to improved growth and articulation outcomes. Conclusions Reduced periosteal undermining and residual exposed palatal shelf from CV to vL to ML improved incisor relationships and articulation.
Facial Clefting and Psychiatric Diseases: A Follow-Up of the Danish 1936–1987 Facial Cleft Cohort
Authors: Christensen Kaare , Mortensen Preben Bo 
Published: October 2018

Objective This study assesses whether patients with facial cleft have an increased risk of psychiatric diseases. Design Through the Danish Facial Cleft Database, patients with facial cleft born between 1936 and 1987 in Denmark were identified, and the admission pattern for these patients with facial cleft was available for the period 1969 through 1993 through the Danish Psychiatric Central Registry. Participants A total of 6,462 patients with facial cleft followed up for a total of 127,068 person-years. Main outcome Measure Hospitalization for psychiatric diseases. The expected number of admissions for the cleft population was calculated by multiplication of the observed person-years with admission rates for Denmark stratified for sex, 1-year age group, and 1-year calendar period. Results A total of 284 patients with facial cleft (4.4%) were hospitalized for psychiatric diseases. The relative risk of hospitalization was 1.65 (95% confidence interval 1.3 to 2.0) for patients with isolated cleft palate (CP) and 1.15 (95% confidence interval 0.99 to 1.29) for patients with cleft lip ± cleft palate (CL[P]). The overall risk estimates were above unity for both CP and CL(P) in all major diagnosis groups, neurosis and autism (for CL[P]) being the only exceptions. The excess risk was not accounted for by patients with known associated anomalies/syndromes. Conclusion The risk of hospitalized mental disorders in general is increased in patients with CP but not to any substantial degree in patients with CL(P). Both groups had an increased risk of mental retardation and substance abuse, but the risk for schizophrenia or bipolar illness was not statistically significantly increased, compared with the background population. Further, our data provide no evidence that the psychosocial stressors associated with CL(P) and its treatment have any substantial impact on the risk for hospitalized mental illness.
Perceptual Evaluation of Speech and Velopharyngeal Function in Children with and without Cleft Palate and the Relationship to Nasal Airflow Patterns
Authors: Dotevall Hans , Lohmander-Agerskov Anette , Ejnell Hasse , Bake Björn 
Published: October 2018

Objectives The aim was to study the relationship between perceptual evaluation of speech variables related to velopharyngeal function and the pattern of nasal airflow during the velopharyngeal closing phase in speech in children with and without cleft palate. Participants Fourteen children with cleft lip and palate or cleft palate only and 15 controls aged 7 and 10 years. All were native Swedish speakers. Method Three experienced listeners performed a blinded perceptual speech evaluation. Nasal airflow was transduced with a pneumotachograph attached to a nasal mask. The duration from peak to 5% nasal airflow, maximum flow declination rate, and nasal airflow at selected points in time during the transition from nasal to stop consonants in bilabial and velar articulatory positions in sentences were estimated. The analysis was focused on the perceptual ratings of “velopharyngeal function” and “hypernasality.” Results A strong association was found between ratings of “velopharyngeal function” and “hypernasality” and the pattern of nasal airflow during the bilabial nasal-to-stop combination /mp/. Both the sensitivity and specificity were 1.00 for the bilabial temporal airflow measure in relation to ratings of “velopharyngeal function.” The nasal airflow rate during /p/ in /mp/ had a sensitivity of 1.00 and specificity of 0.92 to 0.96 in relation to ratings of “hypernasality.” Conclusion Assessment of the nasal airflow dynamics during the velopharyngeal closing phase in speech presents quantitative, objective data that appear to distinguish between perceptually normal and deviant velopharyngeal function with high sensitivity and specificity.
Temporal Characteristics of Aerodynamic Segments in the Speech of Children and Adults
Authors: Zajac David J. , Hackett Alyssa M. 
Published: October 2018

Objectives The primary purpose of this study was to determine the temporal characteristics of aerodynamic segments in the normal speech of children and adults without cleft palate. A secondary objective was to determine the withinspeaker variability of the segments. Method Speakers consisted of 46 children aged 6 to 8 years, 41 older children aged 11 to 12 years, and 41 adults aged 18 to 37 years (total n = 128) who repeated the word “hamper” during continuous utterances. The pressure-flow method was used to determine the duration of six segments of the oral air pressure and nasal airflow pulses associated with the /mp/ sequence. Descriptive statistics, including coefficients of variation (COV), were computed for each segment as a function of age and sex of the speakers. Analysis of variance (ANOVA) procedures were used to determine the effects of age, sex, or both on the temporal variables. Results ANOVAs indicated statistically significant main effects (p < .008) for age on five of the six temporal measures and for sex on three of the six measures. Five of the six COVs were also statistically significant for age. There were no statistically significant interactions between speaker age and sex for any measure. Conclusions The results indicate distinct patterns of timing for aerodynamic segments of speech produced by children and adults. Overall, adults exhibited less temporal variability than children. The generally longer and more variable segments produced by children suggest diagnostic and treatment implications relative to speakers with velopharyngeal dysfunction.
Gross Unilateral Abnormalities of the Velum and Pharynx
Authors: Mehendale Felicity V. , Sommerlad Brian C. 
Published: October 2018

Objective Velopharyngeal incompetence because of gross unilateral velopharyngeal hypoplasia is rare, particularly in patients with no significant hemifacial microsomia or facial asymmetry. We describe the abnormal anatomy and treatment of three patients with gross congenital velopharyngeal asymmetry. Results and Conclusions Following surgery, all three patients showed a good improvement in velopharyngeal function and speech. Nasendoscopy and lateral videofluoroscopy were important in confirming the abnormal anatomy and pathology and in evaluating the degree of movement of the affected side of the velum and pharyngeal walls as well as the size and location of the defect. Muscles from the normal side were radically dissected and mobilized across the midline to reconstruct the hypoplastic hemivelum. Mucosal lengthening was achieved by suturing the normal mucosa to the mucosa of the hypoplastic hemivelum and the lateral pharyngeal wall or by insetting a posterolateral pharyngeal flap (modified Moore pharyngoplasty) into the nasal surface of the hypoplastic side.
Extensive Facial Clefting in a Patient with Goltz Syndrome: Multidisciplinary Treatment of a Previously Unreported Association
Authors: Ascherman Jeffrey A. , Knowles Sean L. , Troutman Kenneth C. 
Published: October 2018

Objective Goltz syndrome is a rare, X-linked dominant, multisystem disorder found almost exclusively in female patients. Although the cutaneous features predominate in most reports, characteristic abnormalities are also frequently present in the musculoskeletal system and facial region. We report a female infant born with a severe form of Goltz syndrome that included an extremely wide facial cleft, an abnormality not previously reported in a patient with this disorder. Her management demonstrates the advantages of a multidisciplinary approach to effectively care for patients with severe craniofacial abnormalities.
Change in Levator Veli Palatini Muscle Activity for Patients with Cleft Palate in Association with Placement of a Speech-Aid Prosthesis
Authors: Tachimura Takashi , Nohara Kanji , Fujita Yoshinori , Wada Takeshi 
Published: October 2018

Objective: The purpose of this study was to examine whether a speech-aid prosthesis normalizes the activity of the levator veli palatini muscle for patients with cleft palate who exhibit velopharyngeal incompetence. Design: Each subject was instructed to produce repetitions of /mu/, /u/, /pu/, /su/, and /tsu/ and to blow with maximum possible effort. Electromyographic (EMG) activity of the levator veli palatini muscle was recorded with and without a hybrid speech-aid prosthesis in place. Participants: The participants were five patients with repaired cleft palate who were routinely wearing a hybrid speech-aid prosthesis. Results: With the prosthesis in place, the mean value of levator activity changed positively in relation to oral air-pressure change during blowing. Differences in levator activity in relation to speech samples were similar to those in normal speakers. With the prosthesis in place, levator activity for speech tasks was less than 50% of the maximum levator activity for all subjects. The findings were similar to those reported previously for normal speakers. Conclusion: Placement of the prosthesis changed EMG activity levels of the levator veli palatini muscle to levels that are similar to normal speakers. It is possible that, with the increase in the differential levator activity between speech and a maximum force task, the velopharyngeal mechanism has a greater reserve capacity to maintain velopharyngeal closure compared with the noprosthesis condition.
Effects of Cheiloplasty on Maxillary Dental Arch Development in Infants with Unilateral Complete Cleft Lip and Palate
Authors: Huang Chiung-Shing , Wang Wein-I , Liou Eric Jein-Wein , Chen Yu-Ray , Chen Philip Kao-Ting , Noordhoff M. Samuel 
Published: October 2018

Objective: To identify and analyze quantitatively the development of the maxillary dental arch before and after cheiloplasty. Design: Prospective, longitudinal study of maxillary dental arch development at age of 1, 3, 6, and 12 months. Setting: All patients were treated at a university hospital craniofacial center. Patients: Twenty-seven infants with nonsyndromic, unilateral complete cleft lip and palate. Intervention: Millard's rotation-advancement cheiloplasty was performed between the ages of 3 and 4 months. Results: The anterior portion of the nonclefted segment (I-G), anterior ridge length of the nonclefted segment (I-C), and anterior ridge length of the clefted segment (L-C′) continuously increased from 1 to 12 months of age. The anterior cleft width (G-L), anterior arch depth (I⊥CC), anterior basal angle (∠GC-CC′), and anterior arch curature angle (∠GIC) continuously decreased after the cheiloplasty. Conclusions: Cheiloplasty could mold the anterior portion of the maxillary dental arch palatally by exerting continuous pressure.
Relationship between Primary Palatal Form and Maxillofacial Growth in Japanese Children with Unilateral Cleft Lip and Palate: Infancy to Adolescence
Authors: Honda Yasuo , Suzuki Akira , Nakamura Norifumi , Ohishi Masamichi 
Published: October 2018

Objective: The purpose of this retrospective study was to evaluate the relationship between the severity of maxillary defects and maxillofacial growth from infancy to adolescence in children with complete unilateral cleft lip and palate (UCLP). Subjects: Thirty-one Japanese children with UCLP who had received cheiloplasty, palatoplasty, and orthodontic treatments at the Kyushu University Dental Hospital were selected. Materials and Methods: A three-dimensional laser scanner was used to measure maxillary dental casts taken at cheiloplasty. Surface areas and volumes of the palatal tissue were calculated. Lateral cephalographs that were taken both at cheiloplasty and 15 years of age or over (average age 16.5 years) were traced and digitized. Angular and linear measurements were calculated from the x, y-coordinates. Using correlation analyses, defects in the palatal tissue were compared with maxillofacial morphology both at cheiloplasty and in adolescence or maxillofacial growth during that time span. Results: (1) The surface areas or volumes of the palatal tissue were significantly correlated with the following maxillofacial measurements at infancy and adolescence: Or-depth; A-depth; PNS-height; ANS-height; N-Ba; S-N; S-Ba; N to P.P; A'-Ptm’; Cd-Pog; Cd-Gn; Cd-G; and the N-S-Ba, S-N-A, and A-N-B angles. (2) They were also significantly correlated with the following maxillofacial growth measures from infancy to adolescence: A-depth, S-Ba, and the N-S-Ba and S-N-A angles. Only the N-S-Ba angle showed a negative correlation. Conclusion: The patient who had more palatal tissue at cheiloplasty showed better maxillofacial growth.
Cervical Root Resorption in Two Patients with Unilateral Complete Cleft of the Lip and Palate
Authors: De Moor Roeland J.G. , De Vree Hilde M. , Cornelis Carol , De Boever Jan A. 
Published: October 2018

Objective: Case reports on cervical root resorption in patients with complete cleft of the lip and palate are scarce. Moreover, cervical root resorption is sometimes diagnosed several years after a combined orthodontic and surgical therapy in patients with cleft. In this article a review of the literature is presented, and a description and the management of the cervical lesion is provided. An additional objective of this report is to advocate for alveolar bone grafting before the age of 12 years while the vulnerable cervical region of the teeth adjacent to the cleft defect is still protected by a thick layer of bone.
Photogrammetric Assessment of the Soft Tissue Profile in Unilateral Cleft Lip and Palate
Authors: Bearn David R. , Sandy Jonathan R. , Shaw William C. 
Published: October 2018

Objective To describe the soft tissue profile of children with unilateral cleft lip and palate from profile photographs and assess the reliability of this method. Design Retrospective analysis of prospectively collected data. Setting A national study in the United Kingdom. Subjects Caucasian children born in the United Kingdom between April 1, 1982, and March 31, 1984, and aged between 12 and 14 years at data collection. A cleft side and noncleft side profile photograph was available for each of 175 children. Method Seven angular measurements were made using Dentofacial Planner Plus software, and the profile appearance was rated by an expert panel. Results Reliability for repeated measurement of the same photograph was acceptable for all but li-sms-pgs (labiomental fold). Similar levels of reliability were found when comparing measurements from the cleft side and non-cleft side photograph. Logistic regression showed that the variables nst-sn-ls (nasolabial angle), sss-ns-pgs (maxillary prominence), and gs-prn-pgs (facial convexity) were associated with the profile score. Conclusions Soft tissue profile analysis from photographs is reliable and robust under a range of conditions. Soft tissue profile measurements are associated with panel ratings of profile.
Ethical and Scientific Decision Making in Distraction Osteogenesis
Authors: Shaw W.C. , Mandall N.A. , Mattick C.R. 
Published: October 2018

Objective To propose a prospective registry for distraction osteogenesis research. Results The search strategy identified 82 reports, of which 11 were review articles, 17 were animal studies, 5 were theoretical models, and 49 were case reports/series. Conclusions So far, the literature concerning distraction osteogenesis does not allow reliable choices to be made on the most appropriate form of distraction osteogenesis in different clinical decisions or whether it is superior to osteotomy or nontreatment. A prospective registry is proposed to hasten critical appraisal of distraction osteogenesis.
Position of the Hyoid Bone in Cleft Lip, Alveolus, and Palate: Variation of Normal Anatomy or Sign Accompanying the Malformation?
Authors: Kaduk Wolfram M.H. , Grabowski Rosemarie , Gundlach Karsten K.H. 
Published: October 2018

Objective To compare the hyoid bone position in patients with clefts of lip, alveolus, and palate with orthodontic patients with no cleft. Design Retrospective cephalometric long-term study. Patients Lateral cephalograms of 23 patients with a complete unilateral cleft were compared with those of 24 orthodontic patients with no cleft with an Angle class 1 occlusion. Twenty-five of the patients were girls, and 22 were boys. The age of the patients with cleft at the beginning of the study was 8.1 ± 0.7 years and at the end 14.8 ± 0.6 years. The patients without cleft were 8.4 ± 0.8 years old at the beginning and 14.4 ± 0.6 years at the end of the study. Main Outcome Measures Cephalometric analysis was used to determine the skull growth pattern as well as the positions of the head and hyoid bone twice in all 47 persons. Results With increasing age of the patients, the skull growth pattern changed from vertical to horizontal growth, but no significant differences were found between patients with and without cleft. Head position did not differ significantly between patients with and without cleft. However, hyoid bone position differed significantly. The hyoid in patients with cleft was located more caudally and more anteriorly than in patients without cleft. Conclusion The hyoid bone in a subset of north German adolescents with complete unilateral cleft lip and palate was found to be caudal and anterior, compared with a control group.
Phonological Development of Toddlers with Unilateral Cleft Lip and Palate who were treated with and without Infant Orthopedics: A Randomized Clinical Trial
Authors: Konst Emmy M. , Rietveld Toni , Peters Herman F.M. , Prahl-Andersen Birte 
Published: October 2018

Objective To investigate the phonological development of toddlers from 2 to 3 years of age with complete unilateral cleft lip and palate (UCLP) treated during the first year of life with and without infant orthopedics (IO). Design In a randomized clinical trial (Dutchcleft), two groups of children were followed up: one treated with IO (IO group) and another that did not receive IO (non-IO group). Phonological skills were analyzed at 2, 2.5, and 3 years of age using a system for assessing phonological development of Dutch children (Fonologische Analyse van het Nederlands: FAN). The analysis included number of acquired consonants, order of phonological development, use of phonological processes, and occurrence of nasal escape. Patients Criteria for inclusion were complete UCLP, no soft tissue bands, no other malformations, parents fluent in Dutch, birth weight of a minimum of 2500 g, and gestation time of a minimum of 38 weeks. Interventions IO treatment based on a modified Zurich approach was started within 2 weeks after birth and used until soft palate closure at 12 months of age. Children in the non-IO group visited the clinic for an extra check-up at 6 weeks as well as before and after lip repair and soft palate closure. All other interventions were the same across groups. Results Phonological development of most 2.5-year-old IO children was normal or delayed. Most children in the non-IO group followed an abnormal developmental pattern. At age 3, the children in the IO group had acquired more initial consonants. There were no group differences in the use of phonological processes or the occurrence of nasal escape. Conclusions Children treated with IO during their first year of life followed a more normal path of phonological development between 2 and 3 years of age.
Aerodynamic and Cephalometric Analyses of Velopharyngeal Structure and Function following Re-Pushback Surgery for Secondary Correction in Cleft Palate
Authors: Nakamura Norifumi , Ogata Yuko , Sasaguri Masaaki , Suzuki Akira , Kikuta Rumiko , Ohishi Masamichi 
Published: October 2018

Objective The goal of this study was to clarify the efficacy of and indication for re-pushback surgery as secondary treatment for cleft palate. Participants Fifteen patients treated by re-pushback surgery involving intravelar veloplasty (IVV) with buccal mucosal grafting on the nasal surface and followed up more than 6 months were enrolled in this study. Main Outcome Measures Pre- and postoperative velopharyngeal functions were analyzed by perceptual voice analysis, blowing ratio, and nasalance scores during phonation of /i/ and /tsu/. Cephalometric analysis was used to evaluate the relationship between velopharyngeal structure and the outcome of re-pushback surgery. Control data were obtained from the longitudinal files of normal 10-year-old children in Kyushu University Dental Hospital. Results Eight of 15 patients obtained complete velopharyngeal closure (complete group), five patients improved remarkably (improved group), and no effective result was seen in two patients (ineffective group). Nasality disappeared or remarkably improved after the operation in 13 patients. Effective surgical results were found in 86.7% of the patients. Partial flap necrosis was seen in two patients in whom re-pushback surgery was performed using mucosal palatal flaps instead of mucoperiosteal flaps. Preoperative velar length and the length/depth ratio of the re-pushback group were significantly smaller than the controls, but there was no difference after the operation. Furthermore, the preoperative length/depth ratio of the complete group (ranged more than 100%) was significantly greater than those of the other two groups (ranged less than 100%). Conclusion Re-pushback surgery by IVV with free mucous grafting on the nasal surface was effective in managing velopharyngeal incompetence secondarily, improving velopharyngeal structure and function.
Midface Distraction to Alleviate Upper Airway Obstruction in Achondroplastic Dwarfs
Authors: Elwood Eric T. , Burstein Fernando D. , Graham Leroy , Williams Joseph K. , Paschal Michelle 
Published: October 2018

Objective The use of midface distraction in patients with achondroplasia and upper airway obstruction secondary to midface hypoplasia has not been reported. In this report, we review the treatment of two patients with severe midface hypoplasia and obstructive sleep apnea secondary to achondroplasia using midface distraction osteogenesis. Design, Setting, and Patients Two patients with achondroplastic dwarfism and midface hypoplasia with airway obstruction were treated in a tertiary referral center for craniofacial disorders. Results and Conclusions Both patients had their tracheostomies decannulated after midface distraction of 25 mm. Midface distraction osteogenesis is useful to alleviate upper airway obstruction from midface hypoplasia seen in achondroplasia.