Adenoid Involvement in Velopharyngeal Closure in Children with Cleft Palate
Bibliographic record
Abstract
OBJECTIVE: To assess the role of the adenoid pad in velopharyngeal (VP) closure. DESIGN: A retrospective review of patients with cleft palate (CP) who underwent nasendoscopy and multiview videofluoroscopy during evaluation for VP insufficiency (VPI) from January 2006 to March 2008. PATIENTS: Thirty-two consecutive patients were identified. None of the patients were lost to follow-up. Five patients were excluded: two for advanced age, two due to mental disabilities and one with a submucous cleft. INTERVENTION: Video nasendoscopy and multiview videofluoroscopy were performed for evaluation of VPI. OUTCOME MEASURES: Adenoid size based on nasendoscopy studies, and adenoid involvement in VP closure based on videofluoroscopy were recorded. RESULTS: The average patient age was 6.6 years (range three to 13 years). Seventy-eight per cent of patients had small adenoid volumes (less than 50% obstruction of the choanae), and six patients (two unilateral cleft lip and palate patients, one bilateral cleft lip and palate patient, two isolated CP patients and one cleft of secondary palate patient) had large adenoid volumes (50% or greater obstruction of the choanae); the adenoid pads of these patients were almost always (five of six patients) involved in their VP closure patterns. Videofluoroscopy showed that 26% (95% CI 9% to 40%) of patients did not significantly use their adenoid pad in VP closure. Forty-three per cent of those not using their adenoids attempted contact with a Passavant's ridge. CONCLUSIONS: In general, the adenoid pad should be maintained in CP patients. However, not all CP patients in the present study used their adenoid pad in attempted VP closure. If adenoidectomy is medically indicated, a percentage of these patents might be considered to be at lower risk for the development of postadenoidectomy VPI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".