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Skeletal response to maxillary protraction in patients with cleft lip and palate before age 10 years
Abstracts /Int. J. Pediatr. Otorhinolaryngol.
32 (1995) 275-286
219
speechor language disorders. 80% of these latter children had hearing problems that predominantly consisted of fluctuating conductive hearing lossescausedby otitis media with effusion. 5% had sensorineural hearing losses.Fifty-eight children (14%) with rhinolalia aperta were not improved by speechtherapy and required velopharyngoplasties, using a cranial-based pharyngeal flap. Language skills did not depend on the type of cleft palate presents but on the frequency and amount of hearing loss found. Otomicroscopy and audiometric follow-ups with insertions of ventilation tubes were considered to be most important for language development in those children with repeated middle ear infections. Speechor language therapy was necessaryin 49% of the children.
Predictive factors for tke resolutionof ckiklbod otitis media with effusionfollowing initial surgical treatment Tay H.L.; Mills R.P. CLIN. OTOLARYNGOL.
ALLIED
SCI. (GBR) (1994) 1915 (385-387)
A prospective study of outcome after treatment for giue ear was performed in a sample of 143children aged between 1 and 11years. The resolution or recurrence of effusion following initial surgery was analysed in relation to six potentially relevant factors. Multivariate analysis showed that resolution of effusion was statistically more frequent in ears found to have a dry tap at surgery, children with a history of atopy, thosewho underwent adenoidectomy and it was related to the age of the child at operation. Older children had a better prognosis. Univariate analysis suggestedthat girls have a significantly better outcome than boys, but this was not confirmed in multivariate analysis. The results suggestthat there should be a longer period of observation in atopic individuals and older children. Furthermore, the study showed that ears with dry taps should not be treated with ventilation tubes.
Skeletal responseto maxillary protraction in patients with cleft lip and palate before age 10 years Tindluod R.S. CLEFT PALATE-CRANIOFAC. J. (NOR) (1994) 31/4 (295-308) Over the last 15 years, cleft lip and palate (CLP) patients with maxillary deticiency in the care of the Bergen CLP Team have received interceptive orthopedic treatment to correct anterior and posterior crossbitesduring the deciduous and mixed dentition periods. The present study comprises 72 subjects of various cleft types with anterior crossbite, treated to an acceptable positive overjet by maxillary protraction using a facial mask (Delaire). Lateral cephalograms were taken immediately before and after the active treatment periods. Individuals exhibiting a favorable (fair) skeletal responseto the protraction were compared with those who revealed little, (poor) skeletal response. Two cephalometric variables were chosen for the evaluation of the sagittal skeletal treatment changes: (1) the sagittal maxillomandibular change(changeof angle ss-n-sm[ANB]); and (2) the forward movement of the maxilla (changeof distance NSP-maxp), where maxp (maxillary point) represents the anterior contour of maxilla and NSP is the perpendicular to the nasion-sella-line (NSL) through sella. A numerical change greater than or equal to the value 1.5 (degreesor mm, respectively) was classified as fair versus poor responserevealing a change lessthan 1.5.Fair-response (favorable response)of sagittal maxillomandibular change was found in 63% of the cases(mean increase of angle ANB was 3.3 degrees),more often when protraction started early. The length of maxilla was increased,the skeletal maxilla was moved forward 1.8mm, the upper dentition advanced 3.6 mm, the occlusal line was clockwise rotated, and the anterior face height was increased. Similarly, fair-response of forward movement of maxilla was found in 44% of the cases(mean increase of distance NSP-maxp was 2.4 mm), more often when protraction was started early and after long treatment duration. The maxillary prognathism increased 1.8degrees,the angle ANB increased3 degrees,the length of maxilla increased 1.5 mm, and the upper dentition was advanced 3.7 mm. The anterior face height increasedwith counterclockwise rotation of the nasal line, whereasthe occlusal line was clockwise rotated. A paired fair-response of both skeletal maxillomandibular change and skeletal forward movement of maxilla was found in 35% of the cases.During protraction the mean increase of maxillary prognathism was 2.1 degrees,the maxilla moved forward 3.1 mm, the maxillary de&ion advanced 4.3 mm, the maxillary length increased 1.9mm, the ANB angle increased3.7 degrees,and the lower anterior facial height increased 3.4 mm.
32 (1995) 275-286
219
speechor language disorders. 80% of these latter children had hearing problems that predominantly consisted of fluctuating conductive hearing lossescausedby otitis media with effusion. 5% had sensorineural hearing losses.Fifty-eight children (14%) with rhinolalia aperta were not improved by speechtherapy and required velopharyngoplasties, using a cranial-based pharyngeal flap. Language skills did not depend on the type of cleft palate presents but on the frequency and amount of hearing loss found. Otomicroscopy and audiometric follow-ups with insertions of ventilation tubes were considered to be most important for language development in those children with repeated middle ear infections. Speechor language therapy was necessaryin 49% of the children.
Predictive factors for tke resolutionof ckiklbod otitis media with effusionfollowing initial surgical treatment Tay H.L.; Mills R.P. CLIN. OTOLARYNGOL.
ALLIED
SCI. (GBR) (1994) 1915 (385-387)
A prospective study of outcome after treatment for giue ear was performed in a sample of 143children aged between 1 and 11years. The resolution or recurrence of effusion following initial surgery was analysed in relation to six potentially relevant factors. Multivariate analysis showed that resolution of effusion was statistically more frequent in ears found to have a dry tap at surgery, children with a history of atopy, thosewho underwent adenoidectomy and it was related to the age of the child at operation. Older children had a better prognosis. Univariate analysis suggestedthat girls have a significantly better outcome than boys, but this was not confirmed in multivariate analysis. The results suggestthat there should be a longer period of observation in atopic individuals and older children. Furthermore, the study showed that ears with dry taps should not be treated with ventilation tubes.
Skeletal responseto maxillary protraction in patients with cleft lip and palate before age 10 years Tindluod R.S. CLEFT PALATE-CRANIOFAC. J. (NOR) (1994) 31/4 (295-308) Over the last 15 years, cleft lip and palate (CLP) patients with maxillary deticiency in the care of the Bergen CLP Team have received interceptive orthopedic treatment to correct anterior and posterior crossbitesduring the deciduous and mixed dentition periods. The present study comprises 72 subjects of various cleft types with anterior crossbite, treated to an acceptable positive overjet by maxillary protraction using a facial mask (Delaire). Lateral cephalograms were taken immediately before and after the active treatment periods. Individuals exhibiting a favorable (fair) skeletal responseto the protraction were compared with those who revealed little, (poor) skeletal response. Two cephalometric variables were chosen for the evaluation of the sagittal skeletal treatment changes: (1) the sagittal maxillomandibular change(changeof angle ss-n-sm[ANB]); and (2) the forward movement of the maxilla (changeof distance NSP-maxp), where maxp (maxillary point) represents the anterior contour of maxilla and NSP is the perpendicular to the nasion-sella-line (NSL) through sella. A numerical change greater than or equal to the value 1.5 (degreesor mm, respectively) was classified as fair versus poor responserevealing a change lessthan 1.5.Fair-response (favorable response)of sagittal maxillomandibular change was found in 63% of the cases(mean increase of angle ANB was 3.3 degrees),more often when protraction started early. The length of maxilla was increased,the skeletal maxilla was moved forward 1.8mm, the upper dentition advanced 3.6 mm, the occlusal line was clockwise rotated, and the anterior face height was increased. Similarly, fair-response of forward movement of maxilla was found in 44% of the cases(mean increase of distance NSP-maxp was 2.4 mm), more often when protraction was started early and after long treatment duration. The maxillary prognathism increased 1.8degrees,the angle ANB increased3 degrees,the length of maxilla increased 1.5 mm, and the upper dentition was advanced 3.7 mm. The anterior face height increasedwith counterclockwise rotation of the nasal line, whereasthe occlusal line was clockwise rotated. A paired fair-response of both skeletal maxillomandibular change and skeletal forward movement of maxilla was found in 35% of the cases.During protraction the mean increase of maxillary prognathism was 2.1 degrees,the maxilla moved forward 3.1 mm, the maxillary de&ion advanced 4.3 mm, the maxillary length increased 1.9mm, the ANB angle increased3.7 degrees,and the lower anterior facial height increased 3.4 mm.