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Introduction Speech, one of the main functions affected by cleft palate, involves a complex orchestra of sound deformation by various organs including the larynx, pharynx, epiglottis, palate, tongue, lip, and other structures complementing them. Although the effects of palatoplasty are traditionally evaluated subjectively, objective parameters have seldom been described to compare the pre- and postrepair functions. The study tries to extract the palatal and pharyngeal muscles while uttering various Hindi syllables and tries to find the percentage contraction of these structures as an objective assessment. Materials and Methods Digital Imaging and Communications in Medicine (DICOM) images while uttering each syllable of the Hindi syllable are obtained by subjecting a healthy volunteer to a dynamic magnetic resonance imaging (MRI). Using freeform geomagic software, 3D models of the structure of the pharynx and palate were created, which were then used to create a finite element model. Different anatomical constraints were applied to the muscles obtained. The finite element model was tested for convergence and a suitably fine mesh was used to obtain the results. The percentage of contraction of the palate and pharynx for uttering different syllables was thus evaluated. Results The palate and the posterior pharyngeal walls yielded different contractions for different syllables independent of each other. The highest contraction for the palate and posterior pharyngeal wall was for the syllable /k/ and the lowest regarding the palate was for /h/ and /eː/ for the pharyngeal wall. Conclusion Using computational modeling, quantification of speech in terms of percentage contraction of the palate and pharynx has been attempted for the Hindi language. Once validated with a larger population, the database may be used to quantify speech deformities due to structural pathologies in terms of palatal and pharyngeal contractions and help us assess the effectiveness of corrective surgeries for them. [ABSTRACT FROM AUTHOR]

The latissimus dorsi muscle flap is a robust option for reconstructing defects over the back, but the use of this flap in infants is not widely documented. We did this flap to cover a defect that was created after wide local excision of a rhabdomyosarcoma on the back of a 2-month-old infant. Reconstructive surgery was completed successfully, and postoperative recovery was uneventful. [ABSTRACT FROM AUTHOR]

Background: Various surgical techniques for cranial reconstruction of patients with bicoronal synostosis have been suggested. The outcome is, however, still often suboptimal. Methods: In a 5‑month‑old child with apert syndrome, following a craniotomy incision, lambdoid suturotomy was done bilaterally. Two springs were implanted bilaterally over the lambdoid sutures. Cephalic index was obtained from three‑dimensional computed tomography scans, and photographs were analyzed for aesthetic evaluation. Result: The preoperative calvarial shape was hyperbrachycephalic. The CI improved from 92 to 83 units. Duration of surgery was 1 h 45 min, blood loss was 30 mL, and total hospital stay was 3 days. No major complications were observed. Spring removal was done at 6 months postoperatively and frontoorbital advancement performed. Conclusion: Spring‑assisted cranioplasty for bicoronal synostosis is a safe and elegant technique, is less invasive than many other cranioplasties, and results in marked improvement in the calvarial shape. [ABSTRACT FROM AUTHOR]

Purpose: Cleft palate is known to cause recurrent otitis media with hearing loss. Various studies have stated the incidence of middle ear disease in patients with cleft palate is around 90%. The anomalous position of the Eustachian tubes in patients with cleft palate leads to otitis media with effusion. If left uncorrected this leads to complications such as cholesteatoma, retraction pockets, and atelectasis leading to permanent hearing loss. In this study, we evaluated the children presenting to our institute with cleft palate for hearing-related issues. Materials and Methods: The study was conducted in our institute from January 2017 to September 2020. It was a cross-sectional study, where 45 children with cleft palate were compared with 36 children with cleft lip who were considered the control group. Hearing of all children was assessed using tympanometry, otoscopy, and brainstem evoked response audiometry (BERA). Results: About 93.3% of children in the cleft palate group had an abnormal tympanic membrane on otoscopy, whereas in the control group only 11.1% of children had an abnormal tympanic membrane on otoscopy. About 97.8% of children in the cleft palate group had a hearing threshold greater than 25 decibels, whereas only 13.9% of children in the control group had a hearing threshold of above 25 decibels. More children in the cleft palate group had an abnormal tympanogram (42.2% had a type B tympanogram and 46.7% had a type C tympanogram) compared to the control group (5.6% had a type B tympanogram and 2.8% had a type C tympanogram). Conclusion: Our study adds to the evidence that there is a high incidence of hearing impairment in children with cleft palate. Hence, we advocate that early identification by screening measures such as otoscopy, tympanometry, auditory brainstem response, and pure tone audiometry during the first visit itself in these children so that early treatment can be initiated. [ABSTRACT FROM AUTHOR]