Assessing third-year medical students' knowledge of and exposure to cleft palate before and after plastic surgery rotation.

The purpose of this study was to evaluate third-year medical students' knowledge of and exposure to cleft palate before and after a rotation in plastic surgery. A 26-item questionnaire was administered to 37 students before and after their 12-week rotation that included the evaluation and management of patients with cleft palate. The questions addressed various aspects of the disorder, including identification of the members of a cleft palate team. Students were also asked about their clinical and academic exposure to cleft palate. When the students' responses to the 19 basic information items about cleft palate and associated problems were compared before and after the rotation, positive changes were documented for 14 of the 19 questions, minimal negative changes for 4, and no change for 1 question. The overall percentage of students indicating any type of clinical or academic exposure to cleft palate increased significantly after the rotation. Findings from this study suggest that an undergraduate clinical rotation in plastic surgery can increase the knowledge of and exposure to cleft palate. It was clear that supplemental learning can occur in other settings outside the classroom through interactions between faculty and students without additional curricular time.

Perceptual characteristics of consonant errors associated with malocclusion.

The characteristics of articulation errors made by subjects having a class II, class II with open-bite, class III, or class III with open-bite malocclusion were compared. Regardless of the type of occlusal defect, errors occurred primarily on the sibilants /s, z/ and "sh, ch, j, dz," which were characterized mostly by combined visual and auditory distortions. Errors on the stop consonants /p, b, m, t, d, n/ occurred less frequently and, in all cases, consisted of isolated visual distortions. The type of malocclusion had a specific influence on the nature of the sound error. Subjects having a class II malocclusion, with or without an open bite, were able to assume a variety of tongue and mandibular postures that allowed them to approximate an /s/ or /z/. These compensations did not occur in subjects with a class III malocclusion. In these cases, the tongue remained distal to the mandibular incisors, causing the air stream to scatter. This study suggests that certain groups of sounds were more susceptible to specific types of misproductions and to particular types of occlusal defects.

Modification of the traditional bone conduction hearing aid.

The purpose of this technical note is to describe a modification of the traditional bone conduction hearing aid used for the treatment of hearing impairment associated with atresia, microtia, or auditory canal anomalies. This modified unit offers a viable alternative to patients wanting an alternative to the traditional model or an implantable bone conduction aid.

Medical students' knowledge of and exposure to cleft palate.

To compare the knowledge and experience of medical students in 1989 with that of those surveyed in 1973, a questionnaire about the various aspects of cleft palate was completed by 209 medical students from West Virginia University and the Louisiana State University Medical Center at Shreveport and New Orleans. Results revealed that 1989 students were more familiar with the embryology of cleft palate, racial and gender differences, and intellectual and psychologic issues (p less than .05). In contrast, the 1973 students were more able to define cleft palate, submucous cleft palate, and pharyngeal flap. There was no difference between the two groups of students in the amount of clinical exposure to cleft palate. These findings support the need for greater emphasis on cleft palate at the pre- and postdoctoral levels, as well as within continuing education programs. As part of current programs, the standard of practice of multidisciplinary team management for an individual with cleft palate should be underscored.

Dental students' knowledge of an exposure to cleft palate.

A questionnaire was administered to 108 dental students from West Virginia University to assess their knowledge of cleft palate. Results revealed areas of deficiency in basic knowledge and exposure to clefting. When these data were compared to those from an earlier study (Lass et al., 1973) differences were found of varying type. A comparison between dental and medical students revealed that the basic knowledge of cleft palate and associated problems were not different between the two groups. However, the dental students had done more reading than the medical students and had the topic of cleft palate included in their coursework.

Speech, velopharyngeal function, and hearing before and after orthognathic surgery.

Articulation, voice, resonance, hearing sensitivity, and middle ear function were examined in 34 patients before and 3, 6, 9, and 12 months after orthognathic surgery. Thirty of the 34 patients had articulation errors before surgery. Errors on the sibilants /s/ and /z/ occurred most frequently, followed by those on /j,zh,ch/ and /sh/. Errors were predominantly distortions with both visual and acoustic components. After surgery, articulation improved spontaneously in the absence of intervention. Most of the preoperative articulation errors were eliminated by 3 months postoperative, but, thereafter, a gradual decline was noted so that by 12 months, errors occurred on /s/ and /z/. Voice, resonance, velopharyngeal port area, and hearing sensitivity were not altered by surgery. This study suggests that severe skeletal malocclusions requiring surgical correction have deleterious effects on the patients' articulation of consonants and that surgical alteration leads to the correction of most of these errors.

The pressure-flow method: some fundamental concepts.

The pressure-flow method introduced by Warren and DuBois is a useful method for estimating velopharyngeal orifice area. However, this investigation shows that unless geometric similarity of subject and model exists, the value of the flow coefficient k used in the equation to estimate velopharyngeal orifice area cannot be established from model tests. Use of k = 0.65 is questioned as that value is typical of thin plate orifices, a geometry that is not a good representation of the velopharyngeal passage. Values of k from the literature and from steady state tests using a model similar to Warren's are presented to show the effect of various inlet shapes. The influence of inlet shape supports the conclusion that k may be significantly higher than 0.65, conceivably approaching values in the range of 0.9 to 0.97, depending on the orifice geometry.