Incidence of cleft-related speech problems in children with an isolated cleft lip.

OBJECTIVES: Clinicians agree that children with isolated cleft lip have fewer cleft-associated problems than children with cleft lip and palate. Unfortunately, for isolated cleft lip children, the risk of cleft-associated problems is unknown and maybe underestimated. Often, these children do not get the required follow-up by a multidisciplinary team and thereby not the known benefits in supporting their development. This study examines the incidence of cleft-related speech problems and ear problems in children with isolated cleft lip. MATERIALS AND METHODS: A prospective study was performed on all children born with an isolated cleft lip and treated at the Wilhelmina Children's Hospital in Utrecht between January 2007 and April 2014. Data were collected for sex, date of birth, genetics, cleft lip type, date of cleft lip repair, type of repair, speech/language problems, and ear problems. RESULTS: This study included 75 patients (59% male). The mean age of the children at the moment of speech examination was 32.5 months (SD 6.1). Eighteen of the 75 children (24%) needed speech and language therapy; however, only one child (1.3%) had a cleft-related speech problem. Sixteen of the 75 patients (21%) reported a history of one or more episodes of acute otitis media (AOM)/otitis media with effusion (OME) during the first 6 years. CONCLUSION/CLINICAL RELEVANCE: This is the first prospective study analyzing the incidence of cleft-related speech problems in children with an isolated cleft lip. These children do not have a higher risk of cleft-related speech problems or AOM/OME when compared to the general population. However, children with an isolated cleft do have a higher incidence of speech therapy.

Biopsychosocial impact of voicing and general coping style in teachers.

OBJECTIVE: The aim of the study was to explore the general coping style of female teachers with a relatively low voice handicap compared with teachers with a relatively high voice handicap. PATIENTS AND METHODS: A cross-sectional questionnaire survey was conducted among 450 teachers using the Voice Handicap Index (VHI) and the Utrecht Coping List (UCL). A group of 400 subjects quasi-randomly selected from the general population were used as controls. RESULTS: Teachers with a relatively high voice handicap (VHI >or=75th percentile) scored lower on the UCL subscale 'active confrontation or dealing with the problem' (p = 0.001) and higher on the UCL subscale 'passive reaction pattern' (p = 0.006), compared to teachers with a relatively low voice handicap (VHI

A swollen cheek, an unusual course of acute mastoiditis.

An acute mastoiditis can occasionally present as a swelling in front of the ear. An inflammation of the air cells of the mastoid cavity can spread, via the cells in the root of the zygomatic arch, to the soft tissues of the cheek. Unfamiliarity with this underlying cause of a swollen cheek can lead to delay of proper treatment with potential harm to the patient. This case presents such an uncommon form of mastoiditis in a 3-year-old boy; the failure to recognize the disease initially led to extensive osteomyelitis of the temporal bone. CT scanning was important in establishing the cause of the persistently severe condition of the boy, in spite of bilateral myringotomies and mastoidectomy on the right side. Destruction of bone from the zygomatic arch to the suture between temporal and occipital bone was shown. Extensive removal of diseased bone was achieved neurosurgically, thus leading to uneventful recovery.