Body Dysmorphic Disorder in Adult Patients With an Orofacial Cleft: An Unseen Psychological Burden.

Objectives: Facial dysmorphic disorder (FDD), a variant of body dysmorphic disorder, occurs when individuals are preoccupied with perceived defects in their facial appearance. Cleft lip and/or palate (CL/P) requires many clinical interventions and has significant psychological impacts on a patient's perception of appearance. This study identified psychological burdens related to living as an adult with CL/P and characterizes the degree of FDD symptoms in an adult craniofacial population.

Mentoring Underrepresented Minority Physician-Scientists to Success.

As the nation seeks to recruit and retain physician-scientists, gaps remain in understanding and addressing mitigatable challenges to the success of faculty from underrepresented minority (URM) backgrounds. The Doris Duke Charitable Foundation Fund to Retain Clinical Scientists program, implemented in 2015 at 10 academic medical centers in the United States, seeks to retain physician-scientists at risk of leaving science because of periods of extraordinary family caregiving needs, hardships that URM faculty-especially those who identify as female-are more likely to experience. At the annual Fund to Retain Clinical Scientists program directors conference in 2018, program directors-21% of whom identify as URM individuals and 13% as male-addressed issues that affect URM physician-scientists in particular.

Volumetric nasal cavity analysis in children with unilateral and bilateral cleft lip and palate.

Objectives/hypothesis: Children with cleft lip and palate (CLP) often suffer from nasal obstruction that may be related to effects on nasal volume. The objective of this study was to compare side:side volume ratios and nasal volume in patients with unilateral (UCLP) and bilateral (BCLP) clefts with age-matched controls.

Study Design: Retrospective case-control study using three-dimensional (3D) nasal airway reconstructions.

Critical issues in craniofacial care: quality of life, costs of care, and implications of prenatal diagnosis.

Since the 2000 Surgeon General's Report on Oral Health (SGROH), substantial areas of inquiry relative to individuals, especially children and youth, with orofacial clefts and other craniofacial conditions have emerged. These areas include access to and cost of care, stigmatization and quality of life, and social and ethical issues around prenatal diagnosis. This update on the 2000 SGROH examines what we have learned about the cost and ability to access cleft and craniofacial care, prenatal diagnosis, and how quality of life is impacted by these conditions and the burden of care.

Direct magnitude estimation of articulation rate in boys with fragile X syndrome.

Purpose: To compare the perceived articulation rate of boys with fragile X syndrome (FXS) with that of chronologically age-matched (CA) boys and to determine segmental and/or prosodic factors that account for perceived rate.

Method: Ten listeners used direct magnitude estimation procedures to judge the articulation rates of 7 boys with FXS only, 5 boys with FXS and a diagnosis of autism spectrum disorder (ASD), and 12 CA boys during sentence repetition. Sentences had similar articulation rates in syllables per second as determined acoustically.

Articulation rate and vowel space characteristics of young males with fragile X syndrome: preliminary acoustic findings.

Purpose: Increased speaking rate is a commonly reported perceptual characteristic among males with fragile X syndrome (FXS). The objective of this preliminary study was to determine articulation rate-one component of perceived speaking rate-and vowel space characteristics of young males with FXS.

Method: Young males with FXS (n = 38), developmental age (DA)-matched males (n = 21), and chronological age (CA)-matched males (n = 16) were audiotaped while engaged in spontaneous conversation and a picture-naming task.

Perceptual and respiratory responses to added nasal airway resistance loads in older adults.

The purpose of the present study was to assess breathing behavior under various nasal resistance load conditions and, in particular, to determine whether respiratory responses to added nasal resistance loads occur before the threshold perception of an added load. The participants were 40 older adults who ranged in age from 59 to 82 years. Nasal airflow and resistance were measured with the pressure-flow technique, which was modified to create calibrated resistance loads.

Hypernasality and velopharyngeal impairment.

Although the primary cause of hypernasality is impaired velopharyngeal (VP) function, a variety of other factors influence the outcome perceived by the listener. The purpose of the current study was to assess the relationship between oral-nasal resonance balance and (1) velopharyngeal orifice area; (2) nasal airflow rate; and (3) duration of nasal airflow. The pressure-flow technique was used to estimate VP area and measure nasal airflow rate and duration.

Cleft nose. Form and function.

Clefts of the lip and palate frequently produce nasal deformities that tend to reduce the size of the nasal airway. Surgical correction of nasal, palatal, and pharyngeal structures may compromise breathing further. A significant number of individuals with cleft noses mouthbreathe to some extent because of the high prevalence of airway compromise.

Hypernasality in the presence of "adequate" velopharyngeal closure.

In some instances, hypernasality occurs despite an instrumental assessment of "adequate" velopharyngeal closure. The pressure-flow technique was used to assess the timing characteristics associated with velopharyngeal closure in 11 such subjects. The group's performance was compared to the aerodynamic characteristics of two other subject groups.

Acoustic assessment of the nasal airway.

Instrumental assessment techniques are needed to acquire quantitative information concerning the form and function of the nasal cavity. Until recently, aerodynamic methods were virtually the only source of such information. Two additional instruments are now available that purport to provide information useful to clinicians interested in assessing nasal form and function.

Nasal airway in breathing and speech.

Clefts of the lip and palate frequently produce nasal deformities that tend to reduce the size of the nasal airway. Approximately 70% of the cleft population have nasal airway impairment and about 80% "mouth-breathe" to some extent. Surgical correction of nasal, palatal, and pharyngeal structures may further compromise breathing.

Controlling changes in vocal tract resistance.

There is some evidence that speech aerodynamics follows the rules of a regulating system. The purpose of the present study was to assess how the speech system manages perturbations that produce "errors" within the system. Three experimental approaches were used to evaluate the physiological responses to an imposed change in airway resistance.

Assessing the effects of odorants on nasal airway size and breathing.

A technique was developed to obtain continuous measurements of both respiratory behavior and nasal patency in response to well-controlled odorant stimulation. An automated apparatus similar to that described by Walker et al. (27) was used to present precise concentrations of an odorant.