Effect of temporomandibular disorder therapy on otologic signs and symptoms: a systematic review

The most common temporomandibular disorders (TMD) signs and symptoms are related to muscle sensitivity through palpation, restricted mouth opening, asymmetric mandibular movements, joint sounds, pain and otologic signs and symptoms. To date, counselling, occlusal splints, exercises, biofeedback and acupuncture are examples of conservative modalities proposed for TMD therapy. The aim of this systematic review was to investigate the effect of these conservative therapies for TMD on otologic signs and symptoms. The authors searched the following electronic databases published up to 1st May 2015: PubMed, LILACS, Scopus, Web of Science and Science Direct with no time or language limitations. Using a two‐phase selection process, the authors identified 08 articles and used them to conduct a qualitative analysis. Methodological quality of each article was performed with the aid of ‘Quality Assessment of a Cohort Study’ and ‘Quality Assessment of a Randomized Clinical Trial’, developed by the Dutch Cochrane Centre, a centre of the Cochrane Collaboration. This systematic review showed in seven of the eight studies included that a total or partial resolution of otologic complains occurred after counselling, exercise therapies and occlusal splint therapy. Upon the limitations of the studies included in this systematic review, the present outcomes suggested that there is insufficient evidence in favour or against the conservative therapies for TMD on changes in otologic signs and symptoms. Thus, further studies with a higher level of evidence and more representative samples should be conducted to better understand the relationship of TMD therapy changes on otologic complains.     

Interventions for caregivers of children who disclose sexual abuse: A review

The importance of interventions for non-offending caregivers following the disclosure of child sexual abuse (CSA) is increasingly recognised in the literature. These interventions are particularly important given what is currently known about the impact of CSA disclosure on non-offending caregivers and the value of caregiver support in assisting their children's recovery. This review provides summary background information on the prevalence and short-term impact of CSA on children, with a particular focus on variables that mediate outcomes including caregiver support. The impact of a child's disclosure on the non-offending caregiver is discussed considering both the emotional effects and changes in their support networks. Furthermore, we examine the associated needs of non-offending caregivers including information, emotional support, support around their own victimisation if relevant, and parenting assistance. Finally, we provide a detailed review of the specific interventions available for caregivers after such a disclosure is made. These interventions include those that just provide information, support groups, psycho-educational groups, support incorporated into the child's intervention, and individual caregiver support. We conclude that interventions for non-offending caregivers are vital in the recovery of the child and their caregiver following CSA and discuss future research considerations.     

The Physiologic Basis of Surgery

Four methods of allograft tendon-to-muscle anastomosis were tested in single cycle distraction to failure using 10 anastomosed ovine calcaneal tendon-biceps brachii units. The tendon-muscle units were compared to intact ovine biceps brachii muscle units. Methods of tendon-to-muscle anastomosis were derived from modifications of existing muscle tendon repair and tenorrhaphy techniques. Load to failure (N), stiffness (N/cm), distraction (cm), and modes of failure were recorded. Of the four methods tested, the side-to-side technique demonstrated the highest load to failure (152.1 N), the greatest stiffness (17.6 N/cm), the least distraction (2.99 cm) before failure, and the least amount of muscle tissue trauma at failure. Results indicate that, of the methods tested, the side-to-side technique offers the greatest initial stability and should therefore allow adequate revascularization and healing of the anastomosis site.