David L. Jones

Bio: David L. Jones is an academic researcher from University of Wyoming. The author has contributed to research in topics: Velopharyngeal insufficiency & Nasality. The author has an hindex of 13, co-authored 23 publications receiving 863 citations. Previous affiliations of David L. Jones include University of Iowa Hospitals and Clinics & University of Utah.

Standardization for the reporting of nasopharyngoscopy and multiview videofluoroscopy: a report from an International Working Group.

Abstract: A multidisciplinary International Working Group of scientists was assembled to address the question of standardizing reporting techniques for multiview videofluoroscopy and nasopharyngoscopy, the generally accepted standards for direct observation of the velopharyngeal valve. This report is a first attempt to propose standards while seeking feedback from the readership in order to further develop a common methodology.

Speech production of preschoolers with cleft palate

Abstract: Objective: The present investigation was conducted to examine the prevalence of preschoolers with cleft palate who require speech therapy, demonstrate significant nasalization of speech, and produce compensatory articulations. The relationship among these three dependent variables and the independent variables of cleft type and age of primary palatal surgery was also examined. Participants: The participants included 212 preschoolers with repaired cleft palate aged 2 years 10 months to 5 years 6 months. Main Outcome Measures: Chi-square analyses were performed to examine the relationship between two independent variables (cleft type and age of surgery) and three dependent variables (percentage of children requiring speech therapy, percentage demonstrating moderate to severe hypernasality and receiving secondary management for velopharyngeal insufficiency, and percentage producing glottal/pharyngeal substitutions). Results: Sixty-eight percent of the children were enrolled in (or had previously rec...

Clinical results of pharyngeal flap surgery: the Iowa experience.

Abstract: Sixty-five patients with cleft palate, with or without cleft lip, who received previous pharyngeal flap surgery for chronic velopharyngeal dysfunction in our department, were examined for velopharyngeal status, speech production patterns, and evidence of nasal airway obstruction. Of the 65 subjects,

Vocal evaluation of thyroplastic surgery in the treatment of unilateral vocal fold paralysis.

Abstract: Vocal function was assessed in 15 patients who received thyroplasty type I for the rehabilitation of unilateral vocal fold paralysis. The function was assessed by perceptual evaluation, voice intensity and frequency range profiles, and questionnaire. Goals of the study were to evaluate the efficacy of thyroplasty in improving the voice, to compare postoperative thyroplasty voices to normal voices, and to correlate objective measurements to the results of the questionnaire regarding satisfaction with the voice. Perceptual evaluations were performed by randomizing normal and thyroplasty voices on a recording tape. The voices on the tape were then rated by independent, blinded, trained listeners. The perceptual qualities of pitch, intonation, and loudness were not statistically different than normals; however, voice qualities of strain, breathiness, hoarseness, harshness, and unsteadiness were different than normals. Mean frequency range and mean intensity range were moderately to severely reduced from normals with a wide variation being present in the results. The correlation between the higher threshold phonation pressures and decreased intensity ranges found in some patients is discussed. Questionnaire results indicated that a high degree of satisfaction with the surgery was present (92%). Extreme or general satisfaction with voice was present in 73%. The most difficult voicing was experienced at work, with 25% needing to adjust their employment to accommodate their voice abilities. These results indicate that thyroplasty type I is effective in partially rehabilitating unilateral voice fold paralysis. Voice function is still not normal, probably in part due to the underlying disease.

Results of multidisciplinary management of bilateral cleft lip and palate at the Iowa Cleft Palate Center.

Abstract: Bilateral cleft of the lip and palate is by many standards the most complex and severe form of the defect. The complexity and severity of the defect require an unusual degree of cooperation among all specialists and especially between the surgeon and the orthodontist. There are no published findings that we know about in which comprehensive data from a number of disciplines are reported for the same group of bilateral cleft patients. Fifty randomly selected patients with bilateral complete clefts were examined by the Iowa team and two orthodontists from other institutions. The evaluations revealed that a large number of patients over the age of 10 have multiple residual problems requiring further treatment. Only 23 percent of the older patients studied were judged to have had treatment completed by the surgeon, speech pathologist, and orthodontist. It is very difficult to state whether the results obtained by our team can be considered satisfactory because there are no comparable studies that have attempted to evaluate the same parameters in multidisciplinary management.

The perforasome theory: vascular anatomy and clinical implications.

Abstract: Background:A clear understanding of the vascular anatomy of an individual perforator relative to its vascular territory and flow characteristics is essential for both flap design and harvest. The authors investigated the three-dimensional and four-dimensional arterial vascular territory of a single

Clinical practice guideline: Hoarseness (Dysphonia)

Abstract: OBJECTIVE: This guideline provides evidence-based recommendations on managing hoarseness (dysphonia), defined as a disorder characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication or reduces voice-related quality of life (QOL). Hoarseness affects nearly one-third of the population at some point in their lives. This guideline applies to all age groups evaluated in a setting where hoarseness would be identified or managed. It is intended for all clinicians who are likely to diagnose and manage patients with hoarseness. PURPOSE: The primary purpose of this guideline is to improve diagnostic accuracy for hoarseness (dysphonia), reduce inappropriate antibiotic use, reduce inappropriate steroid use, reduce inappropriate use of anti-reflux medications, reduce inappropriate use of radiographic imaging, and promote appropriate use of laryngoscopy, voice therapy, and surgery. In creating this guideline the American Academy of Otolaryngology—Head and Neck Surgery Foundation selected a panel representing the fields of neurology, speech-language pathology, professional voice teaching, family medicine, pulmonology, geriatric medicine, nursing, internal medicine, otolaryngology‐ head and neck surgery, pediatrics, and consumers. RESULTS: The panel made strong recommendations that 1) the clinician should not routinely prescribe antibiotics to treat hoarseness and 2) the clinician should advocate voice therapy for patients diagnosed with hoarseness that reduces voice-related QOL. The

The pulmonary surfactant system: biochemical and clinical aspects.

Abstract: This article starts with a brief account of the history of research on pulmonary surfactant. We will then discuss the morphological aspects and composition of the pulmonary surfactant system. We describe the hydrophilic surfactant proteins A and D and the hydrophobic surfactant proteins B and C, with focus on the crucial roles of these proteins in the dynamics, metabolism, and functions of pulmonary surfactant. Next we discuss the major disorders of the surfactant system. The final part of the review will be focused on the potentials and complications of surfactant therapy in the treatment of some of these disorders. It is our belief that increased knowledge of the surfactant system and its functions will lead to a more optimal composition of the exogenous surfactants and, perhaps, widen their applicability to treatment of surfactant disorders other than neonatal respiratory distress syndrome.

Speech and Language Issues in the Cleft Palate Population: The State of the Art

Abstract: Objective: State-of-the-art activity demands a look back, a look around, and, importantly, a look into the new millennium. The area of speech and language has been an integral part of cleft palate care from the very beginning. This article reviews the development and progression of our knowledge base over the last several decades in the areas of speech; language; anatomy and physiology of the velopharynx; assessment of velopharyngeal function; and treatment, both behavioral and physical, for velopharyngeal problems. Method: The clear focus is on the cleft palate condition. However, much of what is reviewed applies to persons with other craniofacial disorders and with other underlying causes of velopharyngeal impairment. A major challenge in the next several years is to sort through speech disorders that have a clear anatomic underpinning, and thus are more amenable to physical management, versus those that may be treated successfully using behavioral approaches. Speech professionals must do a bet...