Minor physical anomalies in children with hearing impairment and normal controls.

The aim of this research was to assess differences in the frequency of individual minor physical anomalies (MPA) between healthy controls and children with hearing impairment (HI) and to find out whether some MPAs are more informative in discriminating between two groups than cumulative Waldrop's scores. The aim was also to investigate the influence of gender on MPA in children with HI and those with normal hearing (NH). The study was carried out on a sample of 424 children (121 children with hearing impairment (82 boys and 39 girls) aged from 5 to 18 and 303 healthy schoolchildren with normal hearing (152 boys and 151 girls) aged from 8 to 16). In HI children, the mean value of MPA was 2.2 times higher than in the controls. Binary Logistic Regression Model is entirely (with all 18 predictors) statistically significant, that is, it recognizes partial deafness. The comparisons between the studied groups of boys and girls HI and boys and girls NH showed a higher relative involvement of MPA in boys than in girls. MPA comparison of HI boys versus NH boys and HI girls versus NH girls according to topographic regions revealed that for HI children there were higher mean scores than for the same-sex controls from all regions, but differences are particularly pronounced in the ear and tongue region. However and that the difference is statistically significant for the majority of regions but this difference tended to be more pronounced in girls with relatively better expressed peripheral dysmorphia in the former and craniofacial dysmorphia in the latter. From the obtained results, it can be seen that in HI children, common etiological factors were probably in effect leading to physical anomalies and hearing impairments. Given the present findings of increased MPAs in HI children, further investigations are necessary to determine whether these developmental abnormalities arise from genetic factors or as a consequence of environmental influences.

Palatal and dental arch morphology in Down syndrome.

The analysis of palatal vault morphology and maxillary dental arch shape was carried out in the sample of 42 Down syndrome (DS) patients with trisomy 21. The data were compared to those of healthy controls from the same population matched for age and sex. Palatal morphology and upper dental arch shape were studied on hard plaster casts of the patients and controls. No sexual dimorphism in palatal and dental arch shape was observed in DS and controls. Normal palatal shape was more frequent in controls than in DS subjects (52.38% vs. 28.57%; p < 0.05). DS patients displayed significantly higher frequency of shelf-like or "stair palate" (38.1%) than controls (11.9%) (p < 0.02). The younger age group (3-14 year) showed much higher frequency of "stair palate" than controls (26.19% vs. 2.38%; c2 = 9.72; p = 0.003). The older group of DS patients did not show increased frequency of such shape of the palatal vault. There was no significant difference in dental arch shape between DS patients and controls. High frequency of shelf-like palate in DS subjects is decreasing by age. The obtained results indicate that palatal vault morphology is subjected to the age related changes. These changes can be attributed to the growth of caraniofacial structures and increased tonus of tongue and other orofacial muscles.

[Minor physical anomalies in children with hearing impairment]. / Zastupljenost tjelesnih minor anomalija u djece ostecena sluha.

The prevalence of minor physical anomalies was studied on a sample of 116 children with idiopathic hearing impairment (66 boys and 50 girls). The control group consisted of 246 children with normal hearing (123 boys and 123 girls) aged from 8 to 12 years. The number of minor anomalies found per child (W1) was compared and the sum of the weighted scores according to Waldrop (W2) in children with normal hearing (CNH) and children with impaired hearing (CIH). A higher minor physical anomalies score was determined per child in the CIH group. In the CNH group there were 4 or more (33.6%) with multiple anomalies, while in the CNH group there were only 7.7% with four or more anomalies. A high score (W2) of five or more anomalies was determined in 18.9% of children in the CIH group and not one subject in the control group. Differences between the CIH and CNH groups for the mean score W1 and W2 were highly significant. The mean score W1 for CIH was 2.90 and for CNH 1.70. The mean score W2 for CIH was 2.93 and for CNH 1.46. According to the obtained results etiological factors probably had a parallel effect in CIH during early development, which lead to physical and hearing impairment. The high incidence found of multiple minor anomalies in CIH suggests a significant role of genetic factors in the aetiology of the basic disorder in the group of analysed children.

Dental and minor physical anomalies in children with developmental disorders--a discriminant analysis.

A discriminant analysis was performed in a sample of 303 children with developmental disorders (DD) and 303 healthy controls (C) in order to test whether some oro-dental and physical minor anomalies could discriminate these groups of children. DD sample comprised 176 mentally retarded (MR) children. 70 children with impaired hearing (IH) and 57 children with impaired vision (IV). The control group included 303 healthy subjects, matched for sex and age. The analysis comprised seven common oral and dental anomalies: median diastema, hypodontia, impacted teeth, microdontia, dens invaginatus, upper lip frenulum and frenulum of the tongue. Minor physical anomalies were assessed by the method proposed by Waldrop et al., as the average number of minor anomalies per individual (W1) and as the weighted score of minor anomalies (W2). Three discriminant functions were obtained by analysis of nine initial variables. Distinct discrimination and considerable distances were found between the centroids of the controls and all groups of DD children. The first two discriminant functions were significant for discrimination between the groups and they explained 98.6% of the total variance. The first function contained 90.2% of information and was defined by the number and weighted scores of minor anomalies. The second variable explained 8.4% of the total variability and was defined by three dental anomalies. The results obtained by the discriminant analysis show that application of dental and minor physical anomalies enables discrimination between the group of healthy children and the groups of children with different developmental disorders.