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Objective: To describe the presence of obstructive sleep apnea syndrome (OSAS) in children with craniofacial anomalies (CFA), associate biodemographic characteristics and polygraph variables, and analyze the therapeutic management decided after the sleep study and the evaluation by a multidisciplinary team., Patients and Method: Retrospective study. Polygraphs were performed on patients aged between 1 month and 19 years with CFA. An initial and projected management was established categorized into ventilatory support, tracheostomy, surgery, dental, and medical treatment. Descrip tive and inferential statistics were performed, evaluating the association between demographic and polygraph variables and therapeutic management., Results: 34 patients were included with a median age of 4.0 years (IQR 0.9 - 6.5). Diagnosis was 41.2% cleft lip and palate, 35.3% craniosynostosis, and 23.5% micrognathia. Polygraphs were altered in 70.6% of the cases; of these, 26.5% were diagnosed as mild, 5.9% moderate, and 38.2% severe OSAS. There was an association between minimum satu ration and diagnosis of OSAS (p = 0.0036), and in the presence of OSAS with the initial management applied (p=0.0013). There was no significant relationship between the different types of CFA with the initial therapeutic management (p = 0.6565). Initial and projected managements, respectively: Venti latory support (11.8% and 2.9%), tracheostomy (11.8% and 0%), surgery (35.2% and 26.5%), dental (20.6% and 53%), and medical treatment (20.6% and 17.6 %)., Conclusions: 70% of the patients with CFA presented OSAS. The greatest severity was found in Cleft Lip and Palatine and Craniosynostosis. Therapeutic management was mainly oriented towards initial surgical and planned dental treatments based on the diagnosis of OSAS and not on the type of CFA.

Introduction and Objectives: Tonsilloliths and abnormal stylohyoid complex may have similar symptoms to others of different aetiology. Individuals with cleft lip and palate describe similar symptoms because of the anatomical implications that are peculiar to this anomaly. The aim of this study was to determine the prevalence of abnormal stylohyoid complex and tonsilloliths on cone beam computed tomography in individuals with cleft lip and palate., Methods: According to the inclusion and exclusion criteria, 66 CT scans out of of 2,794 were analysed, on i- Cat ® vision software with 0.8 index Kappa intra-examiner., Results: The total prevalence of ossification of the incomplete stylohyoid complex in individuals with cleft lip and palate was 66.6%; the prevalence of these findings in females was 75% and 61.9% in males. The total prevalence of tonsilloliths was 7.5%., Conclusion: It is important to ascertain calcification of the stylohyoid complex and tonsilloliths in the radiological report, due to the anatomical proximity and similarsymptomatology to other orofacial impairments inindividuals with cleft lip and palate, focusing on females with oral cleft formation, patients with incisive trans foramen cleft and incisive post foramen cleft because they are more prevalent. Greater knowledge of the anatomical morphometry of individuals with cleft lip and palate greatly contributes towards the selection of clinical behaviours and the quality of life of these patients, since cleft lip and palateis one of the most common anomalies., (Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.)

Introduction: Cleft palate patients with language impairment require specific therapy., Objective: Study two modalities of speech intervention in cleft palate children with associated linguistic impairment, a conventional approach providing speech therapy, twice a week, and a speech summer camp for a period of three weeks., Materials and Methods: Twenty-five cleft palate patients with language impairment were studied. A matched control group was gathered. Patients included in the first group attended a three week duration speech summer camp. Control patients included in the second group received speech therapy twice a week., Results: At the onset of either the summer camp or the speech intervention period, the severity of language impairment was evenly distributed with non-significant differences across groups (p > 0.05). After the summer camp or 9 months of speech therapy sessions, both groups showed a significant decrease in the severity of language impairment (p < 0.05). At the end of the summer camp, and the therapy period, non-significant differences, were found between groups (p > 0.05)., Conclusions: Speech summer camp is a reliable and efficient method to provide speech therapy for left palate patients with language impairment.

There are numerous surgical procedures for the repair of Cleft Palate (CP). Since 1998, in children with CP we use a modified Wardill-Kilner technique, with a large section of the nasal mucous layer at the level of the muscular insertion on the hard palate and lateral nasopharingeal wall, obtaining a push-back and reorientation of the muscular fibres without dissection, diminishing this way the risks of haemorrhages and fibrosis, simplifying the intervention. It allows a lower operative time and a short internment. The aim of our study was to evaluate the results of this operative procedure specially in the development of the speech in 73 children operated on from 1998 until 2000 in our hospital. We verify a competence of the velopharingeal sphincter with ideal results in speech in 88,8% of the cases.

Gastric heterotopia is more frequently in small intestine, gall bladder, biliary tract, Meckel's diverticulum, colon and rectum, but it can be found in other locations. It is especially rare in oral cavity. We only find one case that concurs with cleft palate. We present the case of a neonate with gastric heterotopia and cleft palate in addition to other congenital malformations not related at first. We make a brief revision of literature, showing the pathogenesis of heterotopia and its possible association with the cleft palate.

Aim: Patients with cleft palate and/or lip have similar behaviors to those with auditory processing disorders (APD), then the aim of this study was to investigate auditory abilities in the population with cleft lip/palate., Material and Methods: 100 children between 7 and 12 years old with cleft and 65 between 6 and 10 years old without it. Conventional audiological evaluations such as pure tone, word discrimination audiometry and acoustic immittance measures. A questionnaire (Fisher) was given to parents, with 25 items about behaviors found in children with APD., Results: 100% of children with cleft lip/palate showed some indicative behaviors of APD., Conclusion: There was significant occurrence of suggestive behaviors of APD, what points out the importance of inclusion of auditory processing tests in evaluation of children with cleft lip/palate.

We evaluated 40 children with cleft palate repaired, between 1990 and 1995. Treatment was myringotomy and insertion of a tympanostomy tube, followed by monitoring. In this retrospective study of 40 children aged 8 to 48 months, the prevalence of otitis media with effusion was 84.8%. The condition was persistent in 17.6% of children up to 3 years of age after treatment. Audiological thresholds were evaluated with BERA one or more times. Hearing acuity improved after so, therefore we propose it as the best strategy for ensuring adequate hearing for language development while minimizing morbidity (incidence of complications = 14.7%).

In this syndrome there is a disproportionate dwarfism with kyphoscoliosis, stiffness of the joints, minor facial dysmorphia, myopia and both conductive and sensorineural deafness in 50 percent of patients. It is a dominant autosomic heritable malady of unknown incidence, but both sexes seems equally affected. The patient's condition is diagnosed at birth, because of the short limbs and the enlargement of the joints. In the presented case, diagnosed at birth, the deafness was suppose to be transmissive, owing to the coexistence of a cleft palate, and consequently a grommet was inserted in the tympanum. Only afterwards, when the girl was 12 years old, the cochlear component of the hypoacusis fell in consideration.

The familial association of epilepsy and cleft lip with or without cleft palate (CL (P)) is analyzed assuming both entities share common genetic predisposing factors. The genealogical data stemming from 169 CL (P) probands and 168 epileptic probands yielded information on the prevalence rates of cleft and epileptic relatives. The working hypothesis assumes that the relatives of epileptic and cleft probands should have a greater liability to CL (P) and epilepsy, respectively. The results obtained do not support the hypothesis of an etiologic association given that a greater joint prevalence of epileptic and cleft relatives is only observed when the proband is epileptic and not with a cleft proband. This situation seems to reflect a teratogenic effect of the epileptic genotype which expresses itself in those individuals which simultaneously present a greater liability to cleft.

Tympanometry and otoscopy has been carried out to determine the presence of middle ear disease on patients with cleft palate and the influence of corrective surgery. This explorations have been evaluated preoperatively and at one and six months postoperative follow-up. There is a high incidence of otitis media with effusion in patients with cleft palate, almost 60 per 100 in our study. The influence of cleft palate surgery repair has not revealed as a mayor factor on its resolution, although a visible benefit has been observed in the long term controls. We recommend a otorhinolaryngological follow-up in these patients.

Thirty-one patients with surgically repaired cleft palate who had velopharyngeal deficiency and compensatory articulatory defects in comparison to hyperrhinophony were studied. All patients were submitted to a videonasopharyngescopic and videofluoroscopic study of multiple incidence before and after speech therapy in order to correct the compensatory articulation. The movement proportions of the pharyngeal velum structures increased significantly after the correction of the compensatory articulation. Even moreso, the size of the pharyngeal velum defect decreased significantly. The results of this study support the postulate which recommends that the articulatory abnormalities associated to hyperrhinophony should be corrected before surgery for pharyngeal velum insufficiency secondary to the closure of the cleft palate.

The influence of adenoidectomy on speech has been well documented, essentially in cleft palate children. A revision of the speech outcome in 7 adenoidectomized cleft palate children reveals 4 cases of deteriorated speech. The need of a preoperative evaluation to look for risk factors is outlined, specially in cases of submucous cleft palate. The evolution of cases with permanent postadenoidectomy velar insufficiency with nasometry, shows increasing severity of nasality .

Authors present a new and complete from of EEC syndrome (ectrodactyly, ectodermal dysplasia and cleft lip-palate), analysing its' clinical, genetic and therapeutic aspects. Syndrome malformations involving mainly mesenchymal tissue and with diverse clinical expression suggest a heterogenetic heredity. Participation of environmental and unknown factors is not excluded.