MGA and VAA are quantitative indicators of vocal fold immobility. Ultrasound is a reliable method of diagnosis of pediatric VFP. To diagnose VFP from an ultrasound image, the criteria are: (1) abnormal mobility (this was the most important and direct evidence), (2) hyperechoic air-column band of the glottic rima during phonation, (3) flaccid vocal fold and (4) asymmetry of the glottal structures.
Fiberoptic Endoscopic Evaluation of Swallowing in children: Feeding outcomes related to diagnostic groups and endoscopic findings
Many children overcome their dysphagia but those with neurologic disorders are less likely to achieve total oral feeding status. In children with dysphagia evaluated by FEES, the long-term feeding status is not significantly associated with the initial FEES findings.
Speech perception in noise: Exploring the effect of linguistic context in children with and without auditory processing disorder
Conclusion: Further study using a larger sample is warranted to deepen our understanding of the nature of APD and identify characteristic profiles to enable better tailoring of therapeutic programs
from the International Journal of Audiology
This study investigates the morphometry of Heschl’s gyrus and its included primary auditory cortex (PAC) in hearing impaired (HI) and normal hearing (NH) infants. Fourty-two infants, age 8–19 months, with NH (n = 26) or hearing impairment (n = 16) were studied using high-resolution 3D magnetic resonance imaging. Gray matter (GM) and white matter (WM) volumes were obtained using software for automatic brain imaging segmentation to estimate the volume of each tissue within manually defined regions for the anterior portion of Heschl’s gyrus (aHG) in each individual subject, transformed to an infant brain template space. Interactions among group (HI, NH), tissue type (GM, WM), and hemisphere (left, right) were examined using analysis of variance. Whole-brain voxel-based morphometry was utilized to explore volume differences between groups across the entire brain. The HI group showed increased GM and decreased WM in aHG compared with the NH group; likely effects of auditory deprivation. The HI group did not exhibit their typical L > R asymmetry pattern that the NH group showed. Increased GM in aHG in HI infants may represent abnormal cortical development in PAC as seen in animal models of sensory deprivation. Lower WM volume is consistent with studies with deaf adults.
from Cerebral Cortex
Consistent with previous studies’ findings, early implantation provided a significant advantage for profoundly deaf children. Performance for both groups was generally quite good for the relatively difficult materials and tasks, suggesting that open-set word and sentence recognition may be useful in evaluating speech performance with older pediatric CI users. Differences in disyllable recognition between Groups 1 and 2 may reflect differences in adaptation to electric stimulation. The Group 1 subjects developed speech patterns exclusively via electric stimulation, while the Group 2 subjects adapted to electric stimulation relative to previous acoustic patterns.
Communication vulnerable patients in the pediatric ICU: Enhancing care through augmentative and alternative communication
Children in pediatric intensive care units (PICUs) may experience a broad range of motor, sensory, cognitive, and linguistic difficulties that make it difficult for them to communicate effectively. Being unable to communicate is emotionally frightening for children and can lead to an increase in sentinel events, medical errors and extended lengths of stay. Implementation of augmentative and alternative communication (AAC) tools and strategies can address the communication needs of children in the PICU by enabling them to communicate their wants, needs and feelings to healthcare providers and family members and participate in their own care more productively.<p><p>from the <a href=”Journal” _mce_href=”http://iospress.metapress.com/content/17214k076508n4k7/”><em>Journal”>http://iospress.metapress.com/content/17214k076508n4k7/”><em>Journal of Pediatric Rehabilitation Medicine</em></a></p>
Measuring communicative performance with the FAPCI instrument: Preliminary results from normal hearing and cochlear implanted children
: Normal hearing children demonstrated increasing FAPCI scores with age, and these preliminary growth curves allow for the interpretation of a cochlear-implanted child’s FAPCI scores in comparison to normal hearing children. Additional research using a larger, longitudinal cohort of normal hearing children will be needed to develop definitive normative FAPCI trajectories.
Patients with postcricoid vascular lesions usually present with mild to moderate feeding difficulties, and stridor or dyspnea with agitation. Histopathology and immunohistochemistry results suggest that postcricoid vascular lesions may often represent congenital vascular malformations instead of infantile hemangiomas.
from The Laryngoscope
Racial/Ethnic and socioeconomic disparities in the prevalence and treatment of otitis media in children in the United States†‡
Racial/ethnic and socioeconomic disparities exist for the prevalence and treatment of children with OM. Socioeconomic deprivation increases the risk of OM in children. Despite the frequency of tympanostomy tube insertion in children in the United States, few studies have addressed inequalities in access or utilization of surgical therapy. Given the changing healthcare climate and the social and economic impact of OM in children, further investigation of racial/ethnic and socioeconomic disparities targeting access to surgical treatment of OM should take precedence in health services research. Laryngoscope, 2010
from The Laryngoscope
The Baha system is a valid treatment in conductive hearing loss via a Softband or implanted. It statistically outperforms the traditional bone-conduction hearing aids and should be used as a first choice in intervention rather than a last option for inoperable conductive hearing loss.
Significant relationships exist between aspiration or penetration and the family’s answers about their child’s medical history. Practitioners should consider a swallow assessment whenever a child has a history which includes variables with a strong association with aspiration or penetration.
Connexin 26 is a gap junction protein encoded by the GJB2 gene. It is expressed in cholesteatoma, and mutations cause proliferative skin disorders and sensorineural hearing loss (SNHL). Deletions of GJB6, which encodes connexin 30, cause SNHL in a digenic manner with a heterozygous GJB2 mutation. We hypothesize that GJB2 and GJB6 mutations might influence the development of cholesteatoma.
Prospective observational study to identify GJB mutations in pediatric cholesteatoma.
Peripheral blood samples from 98 children with cholesteatoma were screened for mutations in the GJB2 gene by direct sequencing of the coding region (exon 2 and the intron/exon boundary). Deletions of the GJB6 gene were tested using multiple ligation probe amplification methods. GJB status was compared with other populations and patient age and extent of cholesteatoma at presentation.
Fourteen children had at least one GJB2 variant (14%). Of these, three had two variants. Two of the variants were neutral polymorphisms. One child with the GJB2 genotype 35delG/35delG also had SNHL. No correlation was found between GJB2 status and patient age or cholesteatoma severity at presentation. No GJB6 deletions were found.
GJB2 gene variants are present in a minority of children with cholesteatoma, but may be more common than in normal populations. It is conceivable that alterations of connexin 26 expression could contribute to the multifactorial disease process in cholesteatoma by modifying the cell-to-cell communication that is important in proliferation and migration of keratinocytes. Laryngoscope, 2009
from The Laryngoscope
Advances in technology and expanding candidacy guidelines have motivated many clinics to consider children with precipitously sloping high-frequency hearing loss as candidates for cochlear implants (CIs). A case study is presented of a pediatric CI patient whose hearing thresholds were preserved within 10 dB of preimplant levels (125-750 Hz) after receiving a fully inserted 31.5-mm electrode array at one ear. The primary goal of this study was to explore the possible benefit of using both a hearing aid (HA) and a CI at one ear while using a HA at the opposite ear. The authors find that although the use of bilateral hearing aids with a CI may only provide a slight benefit, careful attention must be paid to the coordinated fitting of devices, especially at the ear with two devices.