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Biomedical subjects

H Friede

Publications and source records attributed to H Friede.

At least 55 records · Page 3Linked to original sources
PubMed1990

Cleft lip and palate patients prior to delayed closure of the hard palate: evaluation of maxillary morphology and the effect of early stimulation on pre-school speech.

Speech and maxillary development were analysed in two groups of patients with unilateral cleft lip and palate; both groups had early jaw orthopaedic treatment and a surgical regimen that included two-stage lip surgery (mean ages of 2 and 19 months) and soft palate repair (8 months). Closure of the hard palate was postponed until the children were 8 to 10 years of age. The first group comprised 10 consecutive patients who were analysed at 5 and 7 years of age, and the second group seven patients who were studied at the age of 5. Both groups were thus investigated before the repair of the cleft in the hard palate. In addition to surgical and jaw orthopaedic treatment, the second group of patients received early stimulation of lip and tongue tip movements. Our results indicated that hypernasality was less a problem than was retracted palatal or velar articulation of dental consonants. These deviations tended to be reduced, however, after early stimulation. There seemed to be no clear association between the size of the residual cleft in the hard palate and the extent of speech development. The average size of the residual cleft in our patients was comparatively small, and decreased further during follow up. We conclude that preschool children with unilateral cleft lip and palate may develop good speech, in spite of the residual cleft, if they use an intraoral plate and are given extra lip and tongue tip stimulation, together with early speech therapy if necessary.

Child↗
PubMed1990

[The seasonal appearance of swim bladder inflammation in the course of Sphaerospora renicola infection in carp].

In carp during 1st year the course of dynamics of the 3 known stages of Sphaerospora renicola showed an increase of the kidney infection in winter and spring (with inhibited sporulation). The winter/spring-peak was accompanied by an intensive blood-phase (C-stages). After August of the 1st summer the swimbladder-phase (K-stages) was not observed, although SBI occurred between January and April. Under warm water condition this infection was discharged after September/October, the SBI never occurred after this time. In contrast to the 1st summer, affected kidneys were often found during winter and spring. In the period of the second outbreak of SBI, C-stages often occurred in the capillaries of swimbladder and in the kidney. The declining phases of SBI, observed from August to April, were not connected with the temperature conditions.

Air Sacs↗
PubMed1988

Features of maxillary arch and nasal cavity in infancy and their influence on deciduous occlusion in unilateral cleft lip and palate.

The purpose of this study was to test the statistical relationship between certain preoperative characteristics of the maxilla and nasal cavity and later occlusal development in patients born with complete unilateral cleft lip and palate. The sample consisted of 51 patients and 22 of them had undergone surgical treatment which included vomer flap and pushback palatal repair, while the remaining 29 patients were treated with a routine characterized by delayed closure of the hard palate. Twelve variables related to 4 different maxillary and nasal areas were recorded from maxillary casts and frontal cephalograms obtained in infancy. Crossbite scores and maxillary intercanine width were determined from dental casts taken at 3 years of age. Multiple linear regression analysis showed that the preoperative variables selected as predictors of maxillary development at the age of 3 did not explain more than half of the variation found in our subjects. Also, the predictors were not the same in the two surgical subgroups. To improve our ability to predict, further variables should be tested and, if possible, added to the regression formulae.

Child, Preschool↗
PubMed1987

Accuracy of cephalometric prediction in orthognathic surgery.

The reliability of predicting the results of orthodontic surgical treatment was analysed. The sample consisted of 30 patients treated with one of the following six types of surgery: mandibular anterior alveolar surgery; maxillary anterior alveolar surgery; mandibular setback surgery; mandibular advancement surgery; Le Fort I surgery; and a combination of Le Fort I and mandibular setback surgery. Comparisons of tracings of the initial cephalometric radiographs, the prediction tracing and the six-month follow-up film showed great variation in the results both within and between the surgical subgroups. Generally, it was easier to predict the treatment results of alveolar segmental osteotomies, especially in the mandible, than of operations in which the whole mandible was repositioned. The results from Le Fort I surgery with or without a concomitant mandibular setback showed the greatest difference between the predicted and the actual outcome. The postoperative vertical dimension appeared to be particularly hard to predict. Explanations for these discrepancies are offered and possibilities for improvements suggested. It is concluded that prediction tracings are still of value despite the poor accuracy in some cases.

Adolescent↗
PubMed1987

Facial morphology and occlusion at the stage of early mixed dentition in cleft lip and palate patients treated with delayed closure of the hard palate.

Cephalometric radiographs and dental study casts were analyzed in a group of 23 seven-year-old cleft lip and palate patients, 16 with unilateral and 7 with bilateral cleft. The patients' primary surgical procedures had been completed except for closure of the cleft in the hard palate. For comparison, similar records from another group of patients, 18 with unilateral and 8 with bilateral cleft lip and palate, were studied. In these cases the cleft of the hard palate had been repaired in infancy, using a vomer flap procedure. The results indicated that midfacial growth and dental occlusion of the unilateral cleft sample was significantly better in patients whose closure of the hard palatal cleft had been delayed to the stage of mixed dentition than where repair had been performed with a vomer flap in infancy. No differences were found, however, between similar subgroups with bilateral cleft lip and palate.

Cephalometry↗
PubMed1987

Bone grafting at the stage of mixed dentition in cleft lip and palate patients.

Our results of bone grafting to the alveolar process during the mixed dentition were investigated in 55 consecutively treated patients (66 clefts). The amount of remaining bone and gingival retraction at the tooth mesial to the cleft after 3 and 12 months was measured and correlated with the following anatomical conditions present during surgery: width of the cleft, rotation of the adjacent incisor, stage of eruption of the tooth distal to the cleft. It was also considered if any deciduous lateral incisor or canine was extracted during surgery and if any flap dehiscence took place postoperatively. It was found that flap dehiscence resulted in significantly less bone at 3 months and at 1 year after surgery. Furthermore, extraction of a deciduous tooth was found to be significantly correlated to less bone 1 year after surgery, in which cases there were also persisting gingival retractions. The other factors had no significant influence on the outcome of surgery.

Alveolar Process↗
PubMed1986

Craniofacial growth data for cleft lip patients infancy to 6 years of age: potential applications.

The present work was undertaken to provide craniofacial roentgenocephalometric growth data on a group of patients with cleft lip ranging in age from infancy to 6 years. Included are variables related to the neurocranium and orbit. Mensurational data were derived from cephalograms of 72 patients (44 male and 28 female subjects) with cleft lip only (n = 38) or cleft lip with varying degrees of alveolar cleft (n = 34). The data in this mixed longitudinal sample are reported for ten age groups. On the basis of comparison with reported noncleft roentgenocephalometric values, it is suggested that the data may serve as a reference for early craniofacial growth. Measurements from four persons with different types of craniofacial anomalies are also presented to illustrate the application of the reported data in the assessment of craniofacial growth.

Alveolar Process↗
PubMed1986

Skull morphology after early craniotomy in patients with premature synostosis of the coronal suture.

The degree of normalization of the shape of the skull was studied in 12 craniosynostosis patients who had been treated with different types of craniotomies in infancy. Three diagnoses were represented: isolated bicoronal synostosis; Crouzon's syndrome; and Apert's syndrome; there were four subjects in each group. Selected cranial dimensions were measured on roentgencephalograms taken in infancy and at follow-up examinations at 2 to 3 years of age. The measurements were compared with control values obtained from patients with cleft lip. Cranial dimensions in the synostosis patients seldom corresponded well with the values of the controls, either before or after surgery. Cranial height, in particular, was increased, especially in patients with Crouzon's or Apert's syndrome. This resulted in modulus values above the control mean for 11 of the 12 patients at the follow-up examinations.

Acrocephalosyndactylia↗
PubMed1985

Cephalometric radiography and computed tomography in infants undergoing craniofacial surgery.

A program for preoperative workup and post-operative follow-up in children with craniofacial anomalies is described. Objective measurements were made with cephalometry and computed axial tomography. Improvement in length of the anterior cranial base and shape of the calvaria after surgery and growth was demonstrated in this manner in serial follow-ups. It was concluded that both cephalometry and computed tomography were essential for the diagnosis, surgical planning and follow-up for this group of patients.

Cephalometry↗
PubMed1985

Craniofacial and mucopolysaccharide abnormalities in Kniest dysplasia.

Serial roentgencephalograms of a male patient with Kniest dysplasia were obtained between 1 7/12 and 11 3/12 years of age and were analyzed and compared to cephalometric normative data. The patient displayed macrocephaly with increased size of the neurocranium in all three dimensions. The cranial base angle was significantly flattened, partly as a result of anterior displacement of the sella turcica. The odontoid process was short and wide. At 11 years of age there was bony fusion between the anterior arch of the atlas and the odontoid process as well as between the posterior arch of the atlas and the cranial base. The facial skeleton, including the nasal bones, infra-orbital rims, maxilla and mandible, was retropositioned relative to the anterior cranial base. The mandibular retrognathia was pronounced at an early age but improved with growth. At age 11 years the patient had a straight facial skeletal profile. Examination of the patient's 24-hour urinary excretion of keratan sulfate revealed values markedly elevated for his age. Three additional patients with Kniest dysplasia demonstrated similarly increased excretion of this glycosaminoglycan. The diagnosis of Kniest dysplasia can usually be made from roentgenograms of the extremities, the spine, and the pelvis. However, the morphologic characteristics of the head, as shown by cephalometric analysis, and the increased urinary excretion of keratan sulfate add confirmatory evidence useful in differential diagnosis.

Cephalometry↗
PubMed1985

Long-term effects of premaxillary setback on facial skeletal profile in complete bilateral cleft lip and palate.

The purpose of this study was to analyze the long-term effects of premaxillary setback in the surgical treatment of complete bilateral cleft lip and palate (C-BCLP). Roentgencephalograms at adolescence or early adulthood were available for 13 of our longitudinal C-BCLP patients who were treated with premaxillary setback and followed up with serial films since infancy. Six individuals had been subjected to early premaxillary setback to facilitate lip repair. Seven of the patients had had their premaxillae setback at a later age to correct a severe midfacial protrusion in the preschool years. Fourteen other C-BCLP patients, followed up and treated similarly except for the premaxillary setback, served as controls. The average long-term outcome of the setback surgery in both the early and late subgroups was retrusion of the midface and a slightly concave facial skeletal profile.

Adolescent↗
PubMed1985

Craniovertebral malformations in hemifacial microsomia.

There is increasing evidence that hemifacial microsomia (HFM), Goldenhar syndrome (GS), and oculoauriculovertebral dysplasia (OAV) are part of a spectrum within a single entity. In support of this thesis are the family studies that have suggested that isolated microtia (M) may represent the mildest form of the condition [Kaye et al, 1979; Rollnick and Kaye, 1983]. Vertebral malformations are pathognomonic of OAV, but they have also been described in HFM and GS. In this investigation we studied the frequency and type of cervical spine malformations in HFM, GS, OAV, and M. Our findings show that the frequency of cervical spine malformations in HFM and M was greater than values for a normal population. This further supports the probable association between HFM, GS, OAV, and M. Fusions were the most prevalent cervical spine malformation encountered. The study also included analysis of the cranial base and craniovertebral junction.

Adolescent↗
PubMed1985

The Beckwith-Wiedemann syndrome: a longitudinal study of the macroglossia and dentofacial complex.

Case reports provide insights into fundamental mechanisms and also assist clinicians in treatment of similarly affected patients [Pruzansky, 1976]. The present investigation examines the natural history of the macroglossia associated with a case of Beckwith-Wiedemann syndrome (BWS) and its influence on dentofacial development. Facial skeletal growth and tongue size were assessed by analyzing cephalometric radiographs from age 2 months to 7.5 years. The data were compared with cephalometric norms and new normative data derived from 13 patients with cleft lip. The major influence of the macroglossia was protrusion of dentoalveolar structures, particularly in the lower jaw. This resulted in an anterior cross-bite in the primary dentition. In addition, an abnormally obtuse gonial angle was observed increasing the effective length of the mandible. Tongue size in BWS was generally greater than the norm, but the increase with age paralleled the mean growth curve of the tongue in the control. Over time the base of the tongue became longer and the hyoid bone moved posteriorly and inferiorly, allowing for accommodation of the tongue within the oral cavity. The changes in tongue shape and dentofacial morphology support the position that early partial glossectomy should be delayed or abandoned. In cases where tongue reduction is considered necessary, the new cephalometric normative data on tongue size provided herein can be used to establish objective criteria for such surgery.

Aging↗
PubMed1985

Cardiorespiratory disease associated with Hallermann-Streiff syndrome: analysis of craniofacial morphology by cephalometric roentgenograms.

This paper analyzes the craniofacial morphology in a patient with typical Hallermann-Streiff syndrome (HSS) who developed symptomatic cardiorespiratory deficiency at the age of 48 years. The patient had obstructive sleep apnea (OSA), hypoxia, hypercarbia, pulmonary hypertension, tricuspid insufficiency, and right ventricular failure. Analysis of cephalometric roentgenograms, done 15 years earlier, revealed severe mandibular hypoplasia with marked underdevelopment of the ramus and body. The gonial angle was abnormally obtuse. The condylar and coronoid processes were reduced in size. The anteroposterior dimension of the upper airway was markedly narrowed. Cephalometric roentgenograms of six other HSS patients from our clinic were compared to those of the reference patient. Considerable variation in the features of the syndrome were noted. None of the other patients showed definitive airway obstruction. Comparison was also made with cephalometric roentgenograms of a patient with Treacher Collins syndrome and of a patient with progeria. The former showed airway obstruction associated with a deformed hypoplastic mandible; the latter had an unobstructed airway despite a small mandible because of associated hypoplasia of the maxilla and tongue. The HSS reference patient improved after oxygen therapy, diuretics, antibiotics, and relief of OSA. Patients with HSS, as well as those with Treacher Collins syndrome, appear to be at risk for the development of cardiopulmonary disease if they have obstructed airways. OSA has been shown to have developed in two patients with HSS. The resultant cardiopulmonary insufficiency of such patients may be preventable if airway obstruction can be relieved relatively early in life.

Adolescent↗
PubMed1985

Craniofacial abnormalities in osteopetrosis with precocious manifestations: report of a case with serial cephalometric roentgenograms.

Serial roentgencephalograms were taken (from the age of 2 to 8 years) of a female patient with malignant osteopetrosis. The roentgencephalograms were compared to those of a control patient with cleft lip and to other normative data. The calvaria of the osteopetrosis patient was very thick, increasing with age. The intracranial space was reduced in volume, resulting in compression of the brain. Roentgencephalometric characteristics of the facial skeleton included orbital hypertelorism, defective horizontal and vertical growth of the middle and lower face, and poorly developed dentoalveolar structures. The mandibular body was short in contrast to the wide ramus, both resulting from defective resorption of the anterior ramal border. A cone-shaped structure in the mandible extending from the condylar process into the ramus was noted. This was believed to consist of remnants of unresorbed, heavily calcified secondary cartilage constituting part of the condylar process present since intrauterine life. Recent treatment of malignant osteopetrosis by bone marrow transplantation early in life has resulted in some cases in normalization of bone structure and marrow. Serial roentgencephalometry provides a sensitive method of assessing craniofacial development in cases of osteopetrosis and presumably can be used to evaluate the effects of therapy.

Cephalometry↗