Speech intelligibility of children with unilateral cleft lip and palate (Dutch cleft) following a one-stage Wardill-Kilner palatoplasty, as judged by their parents.

This study determined the intelligibility (words, sentences and story telling) of 43 children (mean age 4.9 years) with unilateral cleft lip and palate who received a Wardill-Kilner palatoplasty, as judged by their parents and determined the influence of age and gender. A comparison with normative data for intelligibility of 163 Dutch speaking children was made. Each child and the parents completed The Dutch intelligibility test. Measures reported include group mean intelligibility percentages for words, sentences and story telling for children aged 2.5-5.0 and 5.0-7.6 years. A significant correlation between age of the children and intelligibility was measured. No significant gender-related differences were found. An interesting finding is the absence of significant difference in intelligibility percentage between the children with cleft palate and the normative data for story telling. The reported intelligibility percentages provide important prognostic reference information for surgeons who perform palatoplasty and speech pathologists who assess the speech production of children with cleft palate.

Evaluation of metastatic lymph nodes in head and neck cancer: a comparative study between palpation, ultrasonography, ultrasound-guided fine needle aspiration cytology and computed tomography.

STUDY DESIGN: In head and neck cancer patients, diagnosis of metastatic lymph nodes of the neck is essential for treatment planning and prognosis assessment. In a retrospective study, we compared palpation, ultrasonography, ultrasound-guided fine needle aspiration and computed tomography in patients with head and neck cancer. METHODS: Results of palpation, ultrasonography and computed tomography were available in 78 out of 110 patients diagnosed with head and neck cancer. Ultrasound-guided fine needle aspiration cytology was performed in 26 of these patients. Patients with suspected lymph node(s) observed in one or more techniques underwent neck dissection. RESULTS: Twenty seven patients underwent neck dissection, studying 150 lymph node regions. The sensitivity, specificity, positive predictive value, negative predictive value and efficacy were calculated for palpation (48.7%, 95.5%, 79.2%, 84.1%, 83.3% respectively), ultrasonography (65.8%, 83.0%, 56.8%, 87.7%, 78.7% respectively), ultrasound-guided fine needle aspiration cytology (86.7%, 87.5%, 81.3%, 91.3%, 87.2% respectively) and computed tomography (52.5%, 83.6%, 53.9%, 82.9%, 75.3% respectively). CONCLUSIONS: In the assessment of lymph node metastases of the neck in patients with primary head and neck cancer, we found a high specificity for palpation of the neck and an acceptable efficacy for both ultrasonography and computed tomography being comparable between the two methods. Efficacy of ultrasound-guided fine needle aspiration cytology was high approaching the value of 90%.

Ectopic cervical thymus: case report and review of the literature.

The authors present a case of ectopic cervical thymus in a 4-month-old child. Ectopic cervical thymus is an uncommon etiology of a neck mass in a child. It is often misdiagnosed preoperatively as a possible malignancy. It is usually located along the embryologic course of thymus migration from the angle of the mandible to the superior mediastinum. Its treatment is surgical since malignant transformation and respiratory infection have been described. No case of immune deficit after total thymectomy has been described in the literature.

[Dyspnea in an occult thyroid carcinoma]. / Dyspnoe bij een frust schildkliercarcinoma.

A non-palpable thyroid carcinoma presenting as a subglottic narrowing with respiratory difficulties.