Preliminary report on the validation of a grammar-based computer system for assessing skeletal maturity with the Tanner-Whitehouse 2 method

A series of hand and wrist radiographs was assessed manually by two individuals and by a fully automated computer system for determining bone age. Assessments were repeated after 1 month to determine variability between and within the methods of bone age assessment. There was slight intra-observer variation, but complete reproducibility when assessments were made by computer. The variation between the human assessors was less than that between human and computer assessments. The difference between overall maturity scores made by the human observer and the computer system was, however, acceptably small, and the majority of assessments were the same. It is concluded this computer system for assessing bone age in normal children is reliable and accurate, but that it needs to be validated against a much larger set of radiographs.     

Operative techniques of uvulopalatopharyngoplasty

Uvulopalatopharyngoplasty is, for the most part, both safe and effective as a surgical treatment for obstructive sleep apnea and severe snoring. Most complications can be avoided with proper surgical technique. Palatal dysfunction can be avoided if the shortening of the soft palate in the midline (uvula) area is minimized. Nasopharyngeal stenosis can be avoided with minimization of the posterior pillar resection and by avoidance of pharyngeal undermining. The effectiveness of surgery can be improved by placing emphasis 1) on opening the nasopharynx widely in the lateral port areas and 2) on tissue removal deep in the inferior tonsillar poles (and hypopharynx) with mucosal advancement and suturing.