Evaluation of Swallowing Function in Relation to Oropharyngeal Dysphagia in Patients with Operated Unilateral Cleft Lip and Palate.

OBJECTIVE: To determine the occurrence of oropharyngeal dysphagia (OD) signs and symptoms in patients with operated unilateral cleft lip and palate (CLP). MATERIALS AND METHODS: This prospective study was conducted on 15 adolescents with operated unilateral CLP (CLP group) and 15 non-cleft volunteers (control group). Initially, the Eating Assessment Tool-10 (EAT-10) questionnaire was administered to subjects. OD signs and symptoms such as coughing, the sensation of choking, globus sensation, the need to clear the throat, nasal regurgitation, difficulties of bolus control multiple swallowing were evaluated by patient complaints and physical examination of swallowing function. Also, the Functional Outcome Swallowing Scale was used to determine the severity of the OD. Fiberoptic endoscopic evaluation of swallowing (FEES) with water, yogurt, and crackers was performed. RESULTS: The prevalence of OD signs and symptoms based on patient complaints and physical examination of swallowing was low (range, 6.7 to 26.7%), and nonsignificant differences were observed between the groups for these parameters as well as for EAT-10 scores. According to the Functional Outcome Swallowing Scale findings, 11 of 15 patients with CLP were asymptomatic. Fiberoptic endoscopic evaluation of swallowing indicated that post-swallow pharyngeal wall residues with yogurt were significant in the CLP group with a prevalence of 53% ( P < 0.05), whereas differences between the groups in terms of cracker and water residues were nonsignificant ( P > 0.05). CONCLUSION: OD in patients with repaired CLP was manifested mainly in the form of pharyngeal residue. However, it did not appear to cause significant increases in patient complaints compared with healthy individuals.

Evaluation of swallowing in transverse maxillary deficiency patients before and after rapid maxillary expansion.

OBJECTIVES: To evaluate swallowing function in relation to oropharyngeal dysphagia (OD) in adolescents who had transverse maxillary deficiency with posterior crossbite and high-arched palate, before, and after rapid maxillary expansion (RME). MATERIALS AND METHODS: Twenty patients (mean age: 13.0 ± 3.1) with bilateral posterior crossbite and high-arched palate (RME group: RMEG) and 20 volunteers (mean age: 13.4 ± 2.6) with Class I crowding without posterior crossbite or high-arched palate (control group: CG) were recruited. OD signs and symptoms were evaluated using the Eating Assessment Tool-10 (EAT-10) questionnaire, patient complaints, and physical examination of swallowing function before (T1) and 7 months after (T2) RME. Additionally, fiberoptic endoscopic evaluation of swallowing (FEES) with water, yogurt, and cracker was performed. In CG, evaluation of swallowing was performed only once, corresponding to T1 of RMEG. RESULTS: Prevalence of OD signs and symptoms based on patient complaints and physical examination of swallowing was low (5%-15%), and nonsignificant differences were observed between CG and RMEG at T1 for these parameters as well as for EAT-10 scores. Total post-swallow pharyngeal residue with yogurt was significantly different between CG and RMEG at T1, with a prevalence of 60% in RMEG (P < .05). There was no significant difference regarding residue with yogurt between T1 and T2 in RMEG (P > .05). CONCLUSION: Patients with a maxillary transverse deficiency were affected by pharyngeal residue as indicated by FEES, but it did not appear to improve in short-term follow-up in patients treated with RME.

How are faces with increased and decreased lower facial height perceived visually?

OBJECTIVE: The aim of this study was to assess how faces with different lower facial height (LFH) were visually perceived by laypersons using eye-tracking technology. MATERIALS AND METHOD: A total of 48 facial images of volunteers with different LFH (normodivergent, hypodivergent, hyperdivergent) were randomly viewed by 50 participants (25 male, 25 female) using Tobii Eye Tracker (Tobii T60, Tobii Technology AB, Sweden). Facial images with normal lower anterior facial height (LAFH) were used as the control group. All images were divided into three areas of interest (AOI): eyes, nose, and lower face. Eye movements of participants were analyzed with Tobii Studio software (version 3.3.1, Tobii Technology). Time to first fixation (TFF), fixation before (FB) (initial attentional capture), fixation duration (FD), and fixation count (FC) (sustained attention) parameters were measured and compared between image groups. Repeated measures ANOVA, independent samples t test, and intraclass correlation coefficient (ICC) were used for statistical analysis. RESULTS: In all image groups, the eyes were the most remarkable area that was looked at most and longest. A significant main effect was revealed for TFF on the lower face area between image groups: F (2.98) = 9.61, P = 0.00, η2 = 0.164. The lower face area of the hyperdivergent images was found to capture initial attention faster than that of the other images. A significant main effect was revealed for FD on the lower face area between image groups: F (2.98) = 22.98, P = 0.00, η2 = 0.319. CONCLUSIONS: Increased and decreased LFH affected visual perception. The difference in LFH did not alter the hierarchy of visual perception.