The influence of tight tongue-ties and tongue-tie clips on speech development.

Ankyloglossia or tongue-tie is a condition where the anatomical variation of the sublingual frenulum can limit normal tongue function. In Denmark, as in other countries, an increase in the number of children treated for ankyloglossia has been described over the past years. Whether or not ankyloglossia and its release affect the speech has also been increasingly discussed on Danish television and social media. In this review, the possible connection between ankyloglossia, its surgical treatment, and speech development in children is discussed.

Tinnitus caused by essential palatal tremor.

Palatal tremor (PT) is a rare cause of objective tinnitus. Symptomatic PT is caused by injuries of the Guillain-Mollaret triangle with contraction of levator veli palatini. Essential PT causes are unknown and is produced by contraction of tensor veli palatini, with pathognomonic audible ear click. This is a case report of a 36-year-old female, who developed bilateral objective tinnitus, as well as vertigo, blepharospasm, and neck tension after a free fall trauma 30 metres in the net. She was diagnosed with essential PT and treated with botulinum neurotoxin injections in the soft palate.

Laryngeal dystonia.

Laryngeal dystonia (LD) is a rare neurological disorder emerging in middle-aged persons as a chronic and disabling voice disorder. It is a focal dystonia affecting intrinsic laryngeal muscle control only during speech, resulting in voice breaks, effortful phonation, and strangled voice. Due to lack of awareness and lack of well-defined diagnostic criteria, it can be difficult for patients to be diagnosed and treated. This review, the first Danish publication on the subject of LD, presents the latest terminology, a brief history, treatment options and the psychosocial consequences of LD.

[Diagnosis of developmental dyspraxia].

In the absence of any known neurological condition or intellectual impairment, dyspraxia, also known as developmental coordination disorder, should be considered. Dyspraxia is the inability to plan, organize and execute movements. At all ages, dyspraxia can be congenital or acquired. While some learn to cope with their motor difficulties over the years, the majority will retain them as adults. Children with significant functional impairment should be identified and assessed as early as possible, since failure to address the motor and other commonly associated (co-morbid) features may have major consequences in adult life.

[Oral and verbal dyspraxia in an otherwise healthy child].

In the absence of any known neurological condition, dyspraxia is the inability to plan and execute movement. This case report describes a girl with swallowing difficulties, who was diagnosed with oral dyspraxia, as all other possible explanations had been ruled out. A percutaneous endoscopic gastrostomy was performed at the age of 6.5 months, and as a five-year-old she was still dependent on supplementary nutrition through the tube, even though she had gradually learned to swallow. Her difficulties to correctly pronounce syllables and words were later diagnosed as childhood apraxia of speech, another subtype of dyspraxia.

[Verbal and oral dyspraxia in children and juveniles].

Childhood apraxia of speech and oral dyspraxia are subtypes of dyspraxia: a neurological motor disorder with absence of neuromuscular deficits. The core impairment is in planning and/or programming spatiotemporal parameters of movement sequences, which results in errors in speech sound production and prosody, or in oral motor movements and gestures. Correct diagnostics and focus on differential diagnoses and co-morbidity are crucial, as treatment differs from other types of speech- and oral motor disorders. Early and specialized intervention is recommended.

Increased number of ear-nose-throat malpractice complaints in Denmark.

INTRODUCTION: Danish ear, nose and throat (ENT) physicians have little knowledge of the type of decisions made at the Danish National Board of Patients' Complaints (NBPC). The aim of this study was to analyze and describe the epidemiology of ENT malpractice complaints by showing their distribution and volume in order to facilitate learning and evaluate the underlying factors. MATERIAL AND METHODS: This retrospective register study analyzed all ENT malpractice complaints processed by the NBPC in the 1998-2008 period. RESULTS: In 18% of the 480 ENT malpractice complaints, the settlement resulted in criticism of one or more ENT health-care professionals. A steady increase in the number of ENT malpractice complaints was found over the study period and the total increase observed for the study period was 72%. Younger generations of ENT patients complained more and those older than 70 years complained less than the respective age groups of ENT patients treated at public hospitals. The mean incidence of ENT malpractice complaints was lowest in the Northern Jutland Region and highest in the Capital Region which was the most densely populated region. ENT departments at public hospitals receive complaints six times more frequently than ENT practicing clinics, even though the latter handle more patient contacts. The numbers of complaints and criticisms per specialist physicians at public hospitals were almost identical to those of specialist physicians serving at ENT practicing clinics. CONCLUSION: An increasing trend in the number of the ENT malpractice complaints was found in the 1998-2008 period. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.

Systematic analysis of ear-nose-throat malpractice complaints may be beneficial for patient safety.

INTRODUCTION: The analysis of malpractice complaints can provide valuable information on patient safety. This study offers a detailed examination of the backgrounds concerning reasons and outcomes of ear, nose and throat (ENT) malpractice complaints handled by the National Board of Patients' Complaints (NBPC), 1998-2008. MATERIAL AND METHODS: All NBPC decisions related to the ENT specialty from 1998-2008 in Denmark were analysed. RESULTS: Deficient medical recording was criticized even though the complainant did not mention this in the complaint. The juridical theme of medical error was the most complained about, but the least criticized compared with six other juridical themes. In contrast, retained packaging, wrong-site surgery, laser burns and peeling injuries were medical errors with high rates of criticism. Complaints concerning accidental surgical complications did not lead to criticism. Tonsillectomy was the most frequently alleged ENT operation in our study data. CONCLUSION: Thorough preoperative information about potential surgical complications undersigned by the patient and the newly introduced safe surgery procedures are likely to reduce both faults and complaints. Malpractice complaints have not hitherto been used as a learning instrument. We propose a systematic registration of these incidents to enable more learning in the future. The new act on the handling of malpractice complaints may make it easier to avoid malpractice and to learn from malpractice complaints and may thus improve patient safety in Denmark. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.