Childhood Hearing Health and Early Language Exposure: A Culturally Sensitive Approach.

Implementation of the universal newborn hearing screening has changed the landscape for children born deaf or hard of hearing, and with this, pediatricians must be knowledgeable about the screening and referral process, state protocols, and how to support patients and their families in their unique journeys. Early access to language-spoken, signed, both-forms the foundation for successful outcomes for the development of fluent language. For children using spoken language, early access to sound is critical and can often be achieved with the assistance of hearing devices, even in the newborn period. For all language modalities, state-funded Deaf mentor programs allow families to have meaningful exposure to the Deaf community. The authors come from different professions in the health care and education fields, including General Pediatrics, Otolaryngology Head and Neck Surgery, and the state Department of Education, and use different languages, including spoken and American Sign Language.

Evaluation of role of trace elements in oral submucous fibrosis patients: A study on Gujarati population.

INTRODUCTION: Oral submucous fibrosis (OSMF), a precancerous condition, is highly prevalent in the Indian subcontinent. Among many trace elements, copper and iron are required for the functioning of numerous enzymes. The biochemical alterations of these trace elements in the serum of patients with premalignant conditions can help in determining the staging of the disease, its appropriate treatment and as an indicator for prognosis. AIMS AND OBJECTIVES: The objective of the study was to evaluate the role of iron and copper as well as to identify the better predictor of the two in the diagnosis and progression of OSMF. MATERIALS AND METHODS: The study sample consisted of 150 patients, out of which the cases group consisting of 100 OSMF patients and control group consisting of 50 individuals. All the cases were confirmed of having OSMF by histopathological examination. The blood sample was obtained from all 150 patients and evaluated by digital autoanalyzer photometer for serum level of copper and iron by the colorimetric method. The results obtained for cases and controls were compared by statistical analysis. RESULTS: The mean serum copper level increases while the mean serum iron level decreases with the advancement in the severity of clinical and histological stages of OSMF. CONCLUSION: Biopsy is the gold standard to diagnose OSMF, but it is an invasive and time-consuming technique. However, nowadays, many recent advances are used to diagnose OSMF at an early stage and reduce its progression into late and reversible stages. The trace elements serve as potential prognostic and diagnostic markers for OSMF patients.

Accuracy of two dental and one skeletal age estimation methods in 6-16 year old Gujarati children.

INTRODUCTION: Age estimation is of immense importance not only for personal identification but also for treatment planning in medicine and dentistry. Chronologic age conveys only a rough approximation of the maturational status of a person, hence dental and skeletal ages have been explored as maturity indicators since decades. The tooth maturation provides a valuable indicator of dental age and serves as a better index of the maturation of a child as compared to other maturity indicators. AIMS AND OBJECTIVES: To test the applicability of Demirjian's and Willem's dental age assessment methods as well as Greulich and Pyle skeletal age assessment method in children residing in Gandhinagar district. MATERIALS AND METHODS: The study consisted of randomly selected 180 subjects (90 males and 90 females) ranging from 6 to 16 years age and residing in Gandhinagar district. Dental age estimation was performed from radiovisuograph (RVG) images of mandibular teeth of left quadrant by both Demirjian's and Willem's methods. Skeletal age estimation was done from right hand wrist radiograph by Greulich and Pyle method. The differences between the chronological age and the estimated dental and skeletal ages were statistically tested using paired 't' test. The correlation between chronological age, dental and skeletal age estimation methods was confirmed statistically by Pearson's correlation. The reproducibility of the estimations was statistically tested using the Pearson's Chi-square test. RESULTS: Amongst the age estimation methods used in this study, the Willem's dental age estimation method proved to be the most accurate and consistent. CONCLUSION: Although various age estimation methods do exist, the results are varied in different populations due to ethnic differences. However, till new tables are formulated, the Willem's method (Modified Demirjian method) can be accurately applied to estimate chronological age for the population residing in Gandhinagar district.

Apert's syndrome: Report of a rare case.

Apert's syndrome (AS), a form of acrocephalosyndactyly, is a rare congenital disorder with autosomal dominant mode of transmission; characterized by craniosynostosis, midface hypoplasia, and syndactyly of hands and feet. The rarity of the syndrome and similarity of features with other craniosynostosis syndromes makes it a diagnostic dilemma. Genetic counseling and early intervention form an essential part of treatment. Because of the paucity of reported cases in Indian literature and typical features in oral cavity, a dentist should be competent to diagnose and form a part of the multidisciplinary management team. Here, we report a case of a 14-year-old boy with AS.

Early identification of young children with hearing loss in federally qualified health centers.

OBJECTIVE: While newborn hearing screening has improved outcomes for children diagnosed with hearing loss, the screening protocol is incomplete in the critical early developmental years, particularly among underserved populations. To address this gap, 7 federally qualified health centers (FQHCs) implemented a periodic, objective infant-toddler hearing screening program during well-child visits. The study aimed to determine the ability of these primary care providers to implement the hearing screening protocol and to identify children in need of audiologic follow-up. METHOD: This study represents a prospective chart review. Children aged 0 to 3 years presenting to participating clinics for well-child care visits were offered the hearing screen, which included a brief risk factor questionnaire, otoacoustic emissions (OAEs), and tympanometry. Main outcome measures were time to screen, accuracy of physician interpretation of the tympanogram results, and screening results requiring immediate audiology follow-up. RESULTS: Among 1965 OAE screens, 75% took <10 minutes, and 205 patients (10%) failed OAEs in at least 1 ear; based on tympanometry, middle ear effusions were present in 102 of these cases (50%), while 45 cases (22%) raised concerns for sensorineural hearing loss. Physicians accurately interpreted tympanogram results in 89% of cases. There were 5 patients identified with confirmed permanent sensorineural hearing loss. CONCLUSION: Findings demonstrate that infant-toddler hearing screening in FQHCs is feasible to conduct, and it may effectively identify cases of postnatal hearing loss. This is one of the first studies in a primary care setting using OAE technology coupled with tympanometry, allowing physicians to better triage patients for immediate audiology referral.

Diagnostic ultrasound in the head and neck region.

UNLABELLED: Improvements in ultrasound (US) resolution have led to the application of this non-ionizing imaging modality in the diagnosis of soft tissue disorders affecting the head and neck region. Although operator experience is paramount in image interpretation, US has the advantage of being inexpensive, safe and widely available. Ultrasound is the first line imaging modality for suspected salivary gland tumours and is useful in evaluating superficial neck swellings, such as lymph node disease, soft tissue cysts and vascular malformations. Ultrasound also improves the success rate when used for guidance during fine-needle aspiration cytology (FNAC). CLINICAL RELEVANCE: This paper aims to provide the general practitioner with an overview of the basic principles of image formation, the advantages and disadvantages of US, and an outline of its indications for conditions that might present to the dental practitioner.

Kikuchi disease: an unusual cause of cervical lymphadenopathy in an Afro-Caribbean woman.

Cervical lymphadenopathy is often seen in maxillofacial surgery departments and many common causes have been identified. We discuss an unusual case of cervical lymphadenopathy and weight loss in an Afro-Caribbean patient.