Congenital Flashcards
What is the male:female ratio for isolated cleft palate?
1:2
What is the male:female ratio for cleft lip, with or without cleft palate?
2:1
What is the incidence of congenital hearing loss?
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What is the incidence of carcinoma arising in a thyroglossal duct cyst?
What percent of these require surgical intervention?
What are the four clinical subtypes ofWaardenburg’s syndrome?
- SNHL (20%), heterochromia irides, pigment anomalies, dystopia canthorum.
- As above, without dystopia canthorum (SNHL in >so%).
- 3• Klein-Waardenburg’s syndrome: microcephaly, mental retardation, limb and skeletal abnormalities, in addition to signs of #1.
- 4•Shah-Waardenburg’s syndrome: #2 + Hirschsprung’s disease
What are the three clinical subtypes of Usher’s syndrome?
- I-Severe-profound hearing loss, absent vestibular function, prepubertal retinitis pigmentosa.
- II-Moderate-severe hearing loss, normal vestibular function, postpubertal retinitis pigmentosa.
- III-Progressive hearing loss.
What percent of congenital hearing loses are hereditary?
>60%.
What is the incidence of cleft lip, with or without cleft palate, in term newborns?
1 In 1000.
What is the incidence of submucous cleft palate in term newborns?
1 In 1200.
What is the incidence of isolated cleft palate in term newborns?
1 In 2000.
What is the incidence of congenital aural atresia?
1:10,000-20,000.
What percent of children with congenital CMV have hearing loss?
10% are born with hearing loss, 10-15% eventually develop hearing loss.
What percent of infants with laryngomalacia require surgical treatment?
10%.
What percent of cases of choanal atresia involve only a mucosal diaphragm or membrane?
10%.
What are the typical inheritance patterns of nonsyndromic hearing loss?
10-20% AD, 75% autosomal recessive (AR), 2-3% X-linked,
What percent of infants have a hemangioma by age 1?
12%.
What percent of gliomas have a fibrous tract connecting to the subarachnoid space?
15%.
What is the incidence of synchronous airway lesions in children with laryngomalacia?
18-20%.
What is the incidence ofWaardenburg’s syndrome?
1in 4,000 births.
Birth trauma accounts for what percent of vocal cord paralysis in children?
20% (associated with forceps use and C-section).
What percent of cases of congenital vocal cord paralysis are bilateral?
20%.
What is the recovery rate for idiopathic vocal cord paralysis in children?
20%.
What percent of Thyroglossal duct cyst contains thyroid tissue?
20%.
What percent of preauricular pits are bilateral?
20%.
What percent of teratomas become malignant?
20%.
What is the incidence of hemangiomas in premature infants weighing less than 1000 g?
23%.
What is the incidence of facial nerve displacement in congenital aural atresia?
25-30%.
What percent of sporadic cases of congenital hearing loss are caused by mutation of the DFNB1 gene on chromosome 13, encoding for Connexin-26?
27%.
What percent of congenital cholesteatomas are bilateral?
3%.
What percent of the hereditary hearing-loss cases are syndromic?
30%.
What percent of these are bilateral?
33%.
Which branchial pouch is the thymus derived from?
3rd.
What is the chance of producing a cleft-lipped child when one parent is affected?
4%.
What is the mean age of presentation for congenital cholesteatoma?
4•5 years.
If one parent and one sibling are deaf, what is the risk of hearing loss for subsequent offspring?
40% risk.
What percent of cases of choanal atresia are bilateral?
40%.
What percent of patients with neurofibromatosis type 1 have acoustic neuromas?
5% and usually unilateral.
What percent of Caucasians carry the gene defect for cystic fibrosis?
5%.
What percent of patients with branchiootorenal syndrome have hearing loss?
50% (50% mixed, 30% conductive, 20% sensorineural).
What percent of patients with a subglottic hemangioma have an associated cutaneous hemangioma?
50%.
What percent of children with choanal atresia have other congenital anomalies?
50%.
What percent of infants with significant congenital hearing loss will not have risk factors?
50%.
What percent of hemangiomas regress by age 7?
70%.
What percent of patients with congenital bilateral vocal fold paralysis require tracheotomy?
80%.
What percent of children with cleft palate do not require tympanostomy tubes?
8-10%.
Between what ages do hemangiomas grow most rapidly?
8-18 months.
What percent of patients with neurofibromatosis type 2 have acoustic neuromas?
95% and usually bilateral.
What is the most common facial cleft?
A cleft uvula.
What is the difference between a complete cleft of the primary palate and that of the secondary palate?
A complete cleft of the primary palate extends into the nose, is always associated with a cleft lip, and does not expose the vomer. A complete cleft of the secondary palate involves both the hard and soft palates, extends into the nose, and exposes the vomer.
What is the role of palatal plates in the treatment of cleft palates?
A palatal plate, when worn for 3 months prior to surgery and adjusted weekly to bring the palate and alveolus into a more normal shape, has been shown to lessen closure tension during surgery.
What is an incomplete cleft?
A varying amount of midline mucosal attachment is preserved with an underlying muscular deficiency.
What is the most common anomaly associated with congenital tracheal stenosis?
Aberrant left pulmonary artery (pulmonary artery sling complex).
What is the basic defect of Crouzon’s disease?
Abnormal fibroblast growth factor receptors.
What is the basic defect causing this syndrome?
Abnormal potassium channels.
What is the ciliary defect in patients with Kartagener’s syndrome?
Absence of dyne in side arms on A-tubules.
Which inner ear aplasia is characterized by high-frequency hearing loss with normal low-frequency hearing?
Alexander.
Why does spontaneous CSF otorrhea present late when caused by arachnoid granulations?
Arachnoid granulations become larger with time; the normal pulsation of CSF pressure can cause bony erosion.
What is the optimal treatment for port wine stains?
Argon laser in darker-skinned adults; flashlamp pulsed tunable dye laser in children and lighter-skinned adults.
What is the most common neurologic condition causing vocal cord paralysis in children?
Arnold-Chiari malformation.
What is the typical course of the tract of right-sided 4th branchial cleft cysts?
As above, except they loop around the subclavian artery instead of the aorta.
What is the typical course of the tract of 3rd branchial cleft cysts?
Ascend lateral to the common carotid artery, pass posterior to the internal carotid artery, superior to XII, and inferior to IX; course medially to pierce the thyrohyoid membrane superior to the internal branch of the superior laryngeal nerve.
Where do most laryngeal webs occur?
At the anterior glottis (75%).
What is the typical inheritance pattern of syndromic hearing loss?
Autosomal dominant (AD).
What is the inheritance pattern of branchiootorenal syndrome?
Autosomal dominant.
What is the inheritance pattern of Treacher-Collins?
Autosomal dominant.
What is the typical course of the tract of left-sided 4th branchial cleft cysts?
Begin at the apex of the pyriform sinus, descend lateral to the recurrent laryngeal nerve into the thorax, loop around the aortic arch, ascend to the neck posterior to the common carotid artery, cross XII, descend to open into the skin at the anterior-inferior aspect of the sternocleidomastoid muscle.
Where are most 2nd branchial cleft cysts located?
Below the angle of the mandible and anterior to the sternocleidomastoid muscle.
Which of these is lethal prenatally?
Blomstrand’s chondrodystrophy.
What syndrome is characterized by hearing loss, renal defects, and cervical fistula?
Branchiootorenal.
What are the clinical features of arteriovenous malformations?
Brightly erythematous lesions of the skin with an associated thrill and bruit.
Persistence of what membrane results in choanal atresia?
Buccopharyngeal.
What does stenosis of the EAC predispose to?
Canal cholesteatoma.
What are the four categories of lymphatic malformations?
Capillary, cavernous, cystic (hygroma), and lymphangiohemangioma.
What are the four main types of vascular malformations?
Capillary, venous, lymphatic, and arteriovenous malformations.
Which type of vascular malformation is a port wine stain?
Capillary.
Which of lymphatic malformations is most commonly found on the tongue or floor of mouth?
Capillary.
What further facial deformities often occur as a child with a cleft palate grows?
Collapse of the alveolar arch, midface retrusion, and malocclusion.
Which sounds are most difficult for patients with cleft palate?
Consonants, as they require full palatal lift.
What disease is characterized by cranial synostosis, exophthalmos, parrot-beaked nose, and hypoplastic mandible?
Crouzon’s disease.
What is a Thornwaldt’s cyst?
Cyst in the nasopharyngeal bursa secondary to persistent embryonic communication between the anterior tip of the notochord and the nasopharyngeal epithelium.
Which of lymphatic malformations is associated with location in the posterior triangle of the neck?
Cystic hygroma.