Factors influencing subjective orthodontic treatment need and culture-related differences among Chinese natives and foreign inhabitants

Aim The aim of this survey was to compare Chinese natives and foreign inhabitants in Chengdu, China, with respect to: (1) attitudes towards dental appearance, (2)subjective orthodontic treatment need, and (3) the main factors influencing orthodontic treatment need.Methodology A total of 522 subjects, including 227 foreign inhabitants and 295 Chinese natives in Chengdu participated in the survey. A simple random sampling method was adopted and a face-to-face interview was conducted at some public sites using a questionnaire. Data was entered by two persons synchronously using Epidata 3.0, and SPSS 13.0 was used to analyze these data.Results 89.0% of foreign inhabitants were satisfied with their teeth compared to only 46.8% of Chinese natives.Females were more dissatisfied with their teeth than males.Chinese natives put improving appearance as the top priority (55.9%) for seeking orthodontic treatment;however, in foreign inhabitants, the main reason for seeking treatment was to improve masticatory function (44.1%), followed by "to be pretty" (35.2%). The importance of well-aligned teeth and self-perception of psychosocial impact of malocclusion were the same two main factors influencing subjective orthodontic treatment need (P<0.05) in foreign inhabitants and Chinese natives. Subjective orthodontic treatment need between the two target groups was significantly different (P<0.05).Conclusion (1) It was very common that Chinese natives were dissatisfied with their dental appearance, and their subjective orthodontic treatment needs were high. (2) There were some differences in orthodontic treatment motives between the two target groups. (3) There were differences in subjective orthodontic treatment needs between foreign inhabitants and Chinese natives. However, the prominent influential factors were almost the same. There may be benefit to understanding subjective orthodontic needs of different races.     

Orbital cavernous haemangioma; profile and outcome of 76 patients managed surgically

Background: Orbital cavernous haemangioma (OCH) is one of the most common primary orbital tumours in adults. They can encroach on intraorbital or adjacent structures and be considered ‘anatomically’ malignant.

Aims: To report a series of patients that were all managed surgically, with possible specificities and propose predictors of treatment outcome.

Methods: We realised a hospital-based retrospective case review including data from 76 patient files.

Results: The mean age was 37.8 years. Unilateral proptosis was observed in all patients. Visual loss was found in 32 patients (42.1%). Findings on eye examination included lagophthalmos (76.3%), blepharoptosis (21.1%), complications of corneal exposure (19.6%), strabismus (13.2%) and fundoscopic abnormalities (60.5%). Abnormal fundoscopy was significantly associated with decreased visual acuity (VA) (p?<?.001). Small tumours were predominant (65.8%) and size was associated with VA (correlation coefficient r?=??0.5, p?<?.001). Surgery was mainly by lateral orbitotomy (94.7%), with early post-operative complications in 18 patients (23.7%). Multivariable analysis showed that tumour size, preoperative VA and abnormal fundoscopy were significantly associated with postoperative VA.

Conclusion: Clinical and radiological profiles are consistent. Tumour size, preoperative VA, and abnormal fundoscopy seem to be important factors that could influence outcome expectations. Surgical management is still predominantly by open approaches. Severe complications remain rare.     

嗓音声学分析与心理听觉评价的相关性研究

目的 :探讨嗓音声学分析参数与声嘶程度心理听觉评价之间的关系。方法 :对 178例受试者进行嗓音声学分析 ,按声嘶程度将 2 4例正常人及 15 4例病理嗓音患者分成四组 ,对各组的嗓音声学分析参数及其与声嘶程度的关系进行统计学处理。结果 :除 0级与 1级组 jitter值差异无显著性外 ,其余各参数在各组间差异均有显著性意义。NNE和 SNR为判别声嘶程度的最有意义的两个参数 ,5个参数 (jitter,shim mer,NNE,SNR,SDF0 )均与声嘶程度有良好的相关关系。结论 :嗓音声学分析参数可以较简便直观地评价声嘶程度 ,为临床诊断提供依据。     

Analysis of factors affecting postoperative functional outcome in patients with otosclerosis

ObjectiveThis study aimed to analyze the factors affecting postoperative hearing results of patients with otosclerosis.MethodsMedical records of 245 patients with clinical otosclerosis who underwent stapes surgery at our center from January 2009 to December 2018 were reviewed. The retrospectively collected data included patients’ demographics, clinical characteristics, pre- and postoperative audiometric data, size of preoperative air-bone gap (ABG) (small/large). The patients were categorized into two groups according to the postoperative functional outcome: Group 1 consisted of patients with a postoperative ABG of ≤10 dB and Group 2 comprised those with a postoperative ABG of >10 dB. Evaluation of factors affecting functional outcome were performed by logistic regression analysis. Receiver operating characteristics (ROC) curve was generated to obtain the cut-off points for preoperative ABG.ResultsThere were no statistically significant differences between the two groups in terms of age group (p = 0.393), gender (p = 0.670), operated side (p = 0.370), and laterality of disease (p = 0.607). There were 42 patients (31.6%) with a small ABG and 91 patients (68.4%) with a large ABG in group 1, and six (13.6%) and 38 patients (86.4%), respectively in group 2. There was a statistical significant difference between the groups in terms of the size of preoperative ABG (p = 0.020). In group 1, the mean preoperative air conduction (AC) threshold and preoperative ABG were significantly lower than in group 2 (p < 0.001 and p < 0.001, respectively). There was no statistically significant difference between the groups in terms of the preoperative bone conduction (BC) threshold (p = 0.406). Preoperatively, the AC threshold and large ABG were found to be significantly poorer prognostic factors (p < 0.001; 95%CI: 1.031–1.210 and p = 0.037; 95%CI: 1.063–7.023, respectively). Preoperative ABG cut-off threshold for functional success was found to be 34.5 dB. The functional success rate was significantly higher in patients with a preoperative ABG of <34.5 than in patients with a preoperative ABG of ≥34.5 dB (p < 0.001).ConclusionThe preoperative AC threshold and large ABG were poor prognostic factors for postoperative hearing outcome in patients with otosclerosis. The functional outcomes were similar in patients with a preoperative small ABG and those with a preoperative ABG of <34.5 dB. A preoperative ABG cut-off value of <34.5 dB should be possibly considered as a parameter for predicting surgical success in otosclerosis and seems to be useful in clinical practice.     

Hearing-aid outcomes in Chinese adults: Clinical application and psychometric properties of the Chinese version of the Satisfaction with Amplification in Daily Life questionnaire

Objective: To adapt the Satisfaction with Amplification in Daily Life questionnaire into Chinese (the SADL-CH questionnaire) and investigate hearing-aid satisfaction in a group of adult Hong Kong Chinese fitted with free hearing aids. Design: Cross-sectional survey. Study sample: One hundred and twenty-five experienced hearing-aid users. Methods: The subjects completed a history form seeking demographic data and a questionnaire combining the SADL-CH instrument with questions seeking subjects’ subjective ratings of satisfaction with some hearing-aid features and overall satisfaction with their hearing aid. Results: The SADL-CH questionnaire had a good internal consistency reliability estimate (α =?0.79) comparable to that of the original version. SADL-CH scores were observed to have significant correlations with other satisfaction ratings on some hearing-aid features and the overall satisfaction measure. A high degree of test-retest reliability (intraclass correlation coefficient =?0.79) was observed. Confirmatory factor analysis revealed that the SADL-CH questionnaire had a four-factor structure. Interim norms were derived for the SADL-CH questionnaire. The level of hearing-aid satisfaction in Chinese adults was generally lower than that reported in studies conducted among Western populations. Conclusion: The SADL-CH questionnaire is a reliable and valid instrument for measuring hearing-aid satisfaction.     

Squamous cell carcinoma of the head and neck in Ontario,Canada, and in southeastern Norway

OBJECTIVES/HYPOTHESIS: Reports comparing case mix, treatments, and outcomes between different countries are uncommon in head and neck oncology. Prospective databases of unselected patients from regional cancer centers in southeastern Ontario, Canada, and southeastern Norway were compared. STUDY DESIGN: Retrospective comparative study of two prospective databases. METHODS: The case mix, treatments, and disease-specific mortality were compared using frequency tables, Kaplan-Meier survival curves, and the log rank test.RESULTSThe case mix, except for differences in oral cavity, oropharynx, and the recorded tumor (T) category, was similar, and the treatments were different. There was no statistical difference in overall survival for all patients, as well as for some sites. CONCLUSIONS: The results of treatments, based on different overall treatment polices, for all patients were similar. The differences in recorded T category with no statistical difference in overall survival suggest a difference in staging assignment and raises a question about the reliability of the TNM staging process.     

Effectiveness of functional orthodontic appliances in obstructive sleep apnea treatment in children: literature review

IntroductionObstructive sleep apnea syndrome is a common condition in childhood and if left untreated can result in many health problems. An accurate diagnosis of the etiology is crucial for obstructive sleep apnea treatment success. Functional orthodontic appliances that stimulate mandibular growth by forward mandibular positioning are an alternative therapeutic option in growing patients.ObjectiveTo perform a literature review about the effects of functional orthodontic appliances used to correct the mandibular deficiency in obstructive sleep apnea treatment.MethodsThe literature search was conducted in June 2020 using Cochrane Library; PubMed, EBSCO (Dentistry & Oral Sciences Source), LILACS Ovid; SciELO Web of Science; EMBASE Bireme and BBO Bireme electronic databases. The search included papers published in English, until June 2020, whose methodology referred to the types and effects of functional orthopedic appliances on obstructive sleep apnea treatment in children.ResultsThe search strategy identified thirteen articles; only four articles were randomized clinical studies. All studies using the oral appliances or functional orthopedic appliances for obstructive sleep apnea in children resulted in improvements in the apnea-hypopnea index score. The cephalometric (2D) and tomographic (3D) evaluations revealed enlargement of the upper airway and increase in the upper airspace, improving the respiratory function in the short term.ConclusionFunctional appliances may be an alternative treatment for obstructive sleep apnea, but it cannot be concluded that they are effective in treating pediatric obstructive sleep apnea. There are significant deficiencies in the existing evidence, mainly due to absence of control groups, small sample sizes, lack of randomization and no long-term results.     

一组汉语普通话单音节表在听力损失人群中的复测信度研究

目的评价一组经过等价性验证的汉语普通话单音节表在听力损失患者中的复测信度。方法使用一组等价的单音节表对18名有听力损失的受试者进行识别率测试,测试强度在纯音平均听阈上30dB,每位受试者以不同表号起始顺序测完所有表,并在间隔1到16天后以相同表序再次进行测试,对两轮结果进行统计学分析。结果两轮测试得分的相关系数为0．931,对两轮测试的识别率得分进行“合理化”反正弦变换后,计算两轮得分差值的标准差,获得该组表在95％置信度下的临界差值为16．3％。结论这组普通话单音节表在评价治疗或助听前后的效果时,只有识别率差值超过16．3％,才能得出“处置有效”的结论。     

孤立性额窦病变的手术治疗和疗效分析

目的：探讨孤立性额窦疾病或以额窦为主体的疾病的手术方式及预后。方法：诊治27例、29侧额窦内病变,包括阻塞性炎症、化脓性炎症、额窦囊肿、额窦霉菌病、良性肿瘤等,其中16例行鼻内径路鼻内镜手术,11例行鼻内镜下鼻内外联合径路手术。患者均随访1年以上。结果：鼻内镜手术16例中术后1年4例复发,复发率为25％,其中2例行二次手术。鼻外、鼻内联合径路11例中术后1年3例复发,复发率为27．3％,差异无显著性（P〈0．01）。结论：额窦手术尤其是鼻内镜下的额窦手术较为困难,须区别病变特性,以行适当的手术和术中处理。     

鼻中隔偏曲矫正术的主客观评估及相关性分析

目的　探讨鼻中隔偏曲患者行鼻中隔矫正术前、术后的主、客观评估及相关性,评价该手术治疗鼻中隔偏曲的作用。方法　以46例鼻中隔偏曲伴不同程度鼻塞的 患者为研究对象,分别于术前、术后6～8周进行评估,主观方面应用视觉模拟量表（visual analogue scale,VAS）评分,客观方面应用鼻声反射及鼻阻力计,记录双侧鼻腔最小横截面积（nasal minimal cross-sectional area,NMCA）、鼻腔容积（nasal cavity volume,NCV）及鼻阻力（nasal resistance,NR）,应用配对t 检验对各主、客观指标及其之间有无相关性进行统计学分析。结果　术前、术后在VAS、NCV及NR中显示差异均具有统计学意义（P <0.05）,在NMCA中显示差异无统计学意义（P >0.05）。VAS与NMCA,NCV,NR三者之间没有统计学意义上的相关性。结论　鼻中隔偏曲矫正术能有效改善鼻中隔偏曲患者鼻塞症状。鼻腔通气功能的客观检查可以直观并量化的说明手术前、后鼻气道阻力和鼻腔结构的变化,是一种很好的评价参数且不与患者的主观感受一致。     

Factors that influence treatment decision in older patients with resectable head and neck cancer

OBJECTIVES: To find clinical factors related to administration of substandard treatment in older patients with head and neck cancer. STUDY DESIGN: Historic cohort. METHODS: Patients of 70 years of age of older with diagnosis of resectable head and neck cancer were included. Treatment offered to patients was classified as standard or substandard by experienced surgeons. Relation of age, clinical stage, comorbidities, performance status, and treatment with substandard treatment was explored. The effect of substandard treatment on survival was assessed. RESULTS: Three hundred twelve patients were included. Substandard treatment was offered to 19.9% of patients. Associated factors related to selection of substandard treatment were higher age, oro/hypopharynx tumor site, severe comorbidity, advanced clinical stage, and low Karnofsky Index. Patients submitted to substandard treatment had lower overall and cancer-specific survival (45.9% vs. 19.9% and 63.0% vs. 33.1%, respectively). CONCLUSION: Selection of substandard treatment decreases overall and cancer-specific survival. Selecting substandard treatment for reasons such as chronologic age, tumor site, or moderate or mild comorbidities worsen patient prognosis.     

A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques

The proposal of this basic protocol is an attempt to reach better agreement and uniformity concerning the methodology for functional assessment of pathologic voices. The purpose is to allow relevant comparisons with the literature when presenting / publishing the results of voice treatment, e.g. a phonosurgical technique, or a new / improved instrument or procedure for investigating the pathological voice. Meta-analyses of the results of voice treatments are generally limited and may even be impossible owing to the major diversity in the ways functional outcomes are assessed. A multidimensional set of minimal basic measurements suitable for all “common” dysphonias is proposed. It includes five different approaches: perception (grade, roughness, breathiness), videostroboscopy (closure, regularity, mucosal wave and symmetry), acoustics (jitter, shimmer, Fo-range and softest intensity), aerodynamics (phonation quotient), and subjective rating by the patient. The protocol is elaborated on the basis of an exhaustive review of the literature, of the experience of the Committee members, and of plenary discussions within the European Laryngological Society. Instrumentation is kept to a minimum, but it is considered essential for professionals performing phonosurgery. Received: 18 May 2000 / Accepted: 17 October 2000     

咳嗽对良性阵发性位置性眩晕手法复位疗效的影响

目的：分析患良性阵发性位置性眩晕（BPPV）的慢性咳嗽患者经手法复位治疗后的疗效,为BPPV的综合治疗及病因探索提供帮助。方法：分析2009—10—2012—12期间400例BPPV患者的治疗效果,包括观察患者的症状和行体位试验检查。结果：后半规管BPPV的一次治疗成功率为93．4％,水平半规管BPPV治疗成功率为83．0％。在400例BPPV患者中随访到372例,一次治疗成功的复诊患者中,有35例复位治疗好转后又出现阵发性眩晕发作,再次行手法复位仍取得良好效果。追问病史,有29例存在不同程度的咳嗽。控制咳嗽后再行手法复位治疗,眩晕症状消失,随访半年未再发作。结论：BPPV的发生机制可能与咳嗽所致的头部震动有关。     

Multivariate analysis on unilateral cleft lip and palate treatment outcome by EUROCRAN index: A retrospective study

ObjectivesThis study is to evaluate the dental arch relationship and palatal morphology of unilateral cleft lip and palate patients by using EUROCRAN index, and to assess the factors that affect them using multivariate statistical analysis.MethodA total of one hundred and seven patients from age five to twelve years old with non-syndromic unilateral cleft lip and palate were included in the study. These patients have received cheiloplasty and one stage palatoplasty surgery but yet to receive alveolar bone grafting procedure. Five assessors trained in the use of the EUROCRAN index underwent calibration exercise and ranked the dental arch relationships and palatal morphology of the patients' study models. For intra-rater agreement, the examiners scored the models twice, with two weeks interval in between sessions. Variable factors of the patients were collected and they included gender, site, type and, family history of unilateral cleft lip and palate; absence of lateral incisor on cleft side, cheiloplasty and palatoplasty technique used. Associations between various factors and dental arch relationships were assessed using logistic regression analysis.ResultDental arch relationship among unilateral cleft lip and palate in local population had relatively worse scoring than other parts of the world. Crude logistics regression analysis did not demonstrate any significant associations among the various socio-demographic factors, cheiloplasty and palatoplasty techniques used with the dental arch relationship outcome.ConclusionsThis study has limitations that might have affected the results, example: having multiple operators performing the surgeries and the inability to access the influence of underlying genetic predisposed cranio-facial variability. These may have substantial influence on the treatment outcome. The factors that can affect unilateral cleft lip and palate treatment outcome is multifactorial in nature and remained controversial in general.     

Clinical features and outcome of the tall cell variant of papillary thyroid carcinoma

OBJECTIVES: To study the clinical features and outcome of the tall cell variant (TCV) of papillary thyroid carcinoma (PTC). STUDY DESIGN AND METHODS: A single-institution retrospective analysis was performed to review patients with TCV and the usual type of PTC diagnosed from 1960 to 2000. RESULTS: Fourteen of 1,108 patients (median follow-up, 8.9 yr) diagnosed with PTC had TCV. Ten were female, and four were male, with a mean age of 53.7 (33-81) years. All were ethnic Chinese. Compared with the usual PTC cohort, TCV patients presented at an older age (mean, 53.7 vs. 45.2 yr; P = .015). They had a higher rate of extrathyroidal extension (78.6% vs. 43.4%, P = .009), tracheal invasion (28.6% vs. 9%, P = .034), and carotid vessel invasion (14.3% vs. 1.5%, P = .021). TCV patients had more frequent gross (42.9% vs. 17.2%) and microscopic (14.3% vs. 6%) postoperative locoregional residual disease (P = .008). They also had a higher percentage of stage III and IV disease (American Joint Committee on Cancer, 6th ed) (74.3% vs. 31.3%, P = .009). Ten-year local failure-free, regional failure-free, and metastasis-free survival were worse in the TCV group (78.6% vs. 88.8%. P = .017; 53.0% vs. 85.9%, P < .0001; 35.7% vs. 92.1%, P < .0001, respectively). The 10-year cause-specific survival was also lower in TCV patients (48.2% vs. 93.4%, P < .0001). CONCLUSION: TCV presents at a higher stage with more advanced local disease. It has a higher risk of locoregional and distant relapse and a worse overall survival rate. Stratification by stage reveals that TCV has significantly higher mortality compared with PTC for stage IV disease. Aggressive treatment and close follow-up of these patients is necessary.