A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

David M Fisher - Top 30 Publications

Assessing technical performance and determining the learning curve in cleft palate surgery using a high fidelity cleft palate simulator.

Technical skills assessment can provide objective measures of surgical performance. This study assessed technical performance in cleft palate repair using a newly developed assessment tool and high fidelity cleft palate simulator through a longitudinal simulation training exercise.

Teaching Palatoplasty Using a High-Fidelity Cleft Palate Simulator.

Cleft palate repair is a challenging procedure for cleft surgeons to teach. A novel high-fidelity cleft palate simulator has been described for surgeon training. This study evaluates the simulator's effect on surgeon procedural confidence and palatoplasty knowledge among learners.

Objective Assessment of the Unilateral Cleft Lip Nasal Deformity Using Three-Dimensional Stereophotogrammetry: Severity and Outcome.

Optimization of care to correct the unilateral cleft lip nasal deformity is hampered by lack of objective measures to quantify preoperative severity and outcome. The purpose of this study was to develop a consensus standard of nasal appearance using three-dimensional stereophotogrammetry; determine whether anthropometric measurements could be used to quantify severity and outcome; and determine whether preoperative severity predicts postoperative outcome.

Infant Robotic Cleft Palate Surgery: A Feasibility Assessment Using a Realistic Cleft Palate Simulator.

A surgical robot offers enhanced precision, visualization, and access and the potential to improve outcomes in cleft palate surgery. The goal of this study was to investigate the feasibility of using the da Vinci robot for cleft palate repair in infants using a cleft palate simulator test bed.

Reliability of Oronasal Fistula Classification.

Objective Oronasal fistula is an important complication of cleft palate repair that is frequently used to evaluate surgical quality, yet reliability of fistula classification has never been examined. The objective of this study was to determine the reliability of oronasal fistula classification both within individual surgeons and between multiple surgeons. Design Using intraoral photographs of children with repaired cleft palate, surgeons rated the location of palatal fistulae using the Pittsburgh Fistula Classification System. Intrarater and interrater reliability scores were calculated for each region of the palate. Participants Eight cleft surgeons rated photographs obtained from 29 children. Results Within individual surgeons reliability for each region of the Pittsburgh classification ranged from moderate to almost perfect (κ = .60-.96). By contrast, reliability between surgeons was lower, ranging from fair to substantial (κ = .23-.70). Between-surgeon reliability was lowest for the junction of the soft and hard palates (κ = .23). Within-surgeon and between-surgeon reliability were almost perfect for the more general classification of fistula in the secondary palate (κ = .95 and κ = .83, respectively). Conclusions This is the first reliability study of fistula classification. We show that the Pittsburgh Fistula Classification System is reliable when used by an individual surgeon, but less reliable when used among multiple surgeons. Comparisons of fistula occurrence among surgeons may be subject to less bias if they use the more general classification of "presence or absence of fistula of the secondary palate" rather than the Pittsburgh Fistula Classification System.

Evaluation and Implementation of a High-Fidelity Cleft Palate Simulator.

Cleft palate repair is a challenging procedure to learn because of the delicate tissue handling required and the small confines of the infant oral cavity. As a result, cleft palate simulators have previously been described to augment cleft palate repair training. Although valuable, they lack the fidelity for this complex procedure.

Preoperative Cleft Lip Measurements and Maxillary Growth in Patients With Unilateral Cleft Lip and Palate.

Maxillary growth in patients with cleft lip and palate is highly variable. The authors' aim was to investigate associations between preoperative cleft lip measurements and maxillary growth determined cephalometrically in patients with complete unilateral cleft lip and palate (cUCLP).

Measuring recreational visitation at U.S. National Parks with crowd-sourced photographs.

Land managers rely on visitation data to inform policy and management decisions. However, visitation data is often costly and burdensome to obtain, and provides a limited depth of information. In this paper, we assess the validity of using crowd-sourced, online photographs to infer information about the habits and preferences of recreational visitors by comparing empirical data from the National Park Service to photograph data from the online platform Flickr for 38 National Parks in the western United States. Using multiple regression analysis, we find that the number of photos posted monthly in a park can reliably indicate the number of visitors to a park in a given month. Through additional statistical testing we also find that the home locations of photo-takers, provided voluntarily on an online profile, accurately show the home origins of park visitors. Together, these findings validate a new method for measuring recreational visitation, opening an opportunity for land managers worldwide to track and understand visitation by augmenting current data collection methods with crowd-sourced, online data that is easy and inexpensive to obtain. In addition, it enables future research on how visitation rates change with changes in access, management or infrastructure, weather events, or ecosystem health, and facilitates valuation research, such as travel cost studies.

Permanent Tooth Agenesis and Maxillary Hypoplasia in Patients with Unilateral Cleft Lip and Palate.

Maxillary growth in patients with clefts is highly variable. The authors' aim was to investigate whether severity of maxillary hypoplasia is associated with the presence of permanent tooth agenesis in children with complete unilateral cleft lip and palate.

A modified V-Y chondromucosal composite flap for correction of secondary cleft nasal deformity: photogrammetric analysis of a case-control study.

Re: 'Assessment of long-term donor-site morbidity after harvesting the latissimus dorsi flap for neonatal myelomeningocele repair'.

Presurgical cleft lip anthropometrics and dental arch relationships in patients with complete unilateral cleft lip and palate.

To investigate associations between anthropometric lip measurements and dental arch relationships in patients with complete unilateral cleft lip and palate (CUCLP).

Correction of the cleft nasal deformity: from infancy to maturity.

The cleft nasal deformity remains the most likely stigma of the cleft to remain plainly visible despite vigorous and repeated attempts at correction. This deformity is present at birth, but evolves over time. Certain aspects can be treated early, but some, such as the dorsal and septal deformity continue to develop as facial growth proceeds through adolescence. This article presents a conceptual mechanism and a philosophy of conservative reliable gains starting at the primary operation, with the long-term view of achieving definitive correction at maturity. Cogent planning of longitudinal care of the deformity from infancy leads to solid, predictable results.

Single-stage autologous ear reconstruction for microtia.

The authors have been using the Nagata technique since 2002. In this review of 100 consecutive ear reconstructions, the authors present technique modifications that have evolved over this period that have contributed to improved auricular contour and that now allow for auricular reconstruction in a single stage.

A multilevel cross-cultural examination of role overload and organizational commitment: investigating the interactive effects of context.

Considering the influential nature of context, the current investigation examined whether the relationship between role overload and organizational commitment was affected by various contextual factors. Drawing on the occupational stress literature, structural empowerment and cooperative climate were examined as factors that would mitigate the negative effects of role overload on organizational commitment. In addition, national culture was examined to determine whether empowerment and cooperative climate had consistent moderating effects across cultures. The relationships among these variables were examined using hierarchical linear modeling in a sample of 6,264 employees working at a multinational organization in 337 different work locations across 18 countries. Results suggested that the negative effect of role overload on organizational commitment did not vary as a function of culture in the current sample, but empowerment and cooperative climate had a moderating influence on this relationship. Furthermore, a 3-way interaction was observed between the cultural variable of power distance, empowerment, and role overload in predicting organizational commitment, suggesting that factors that serve to mitigate the negative effects of role overload in one culture may be ineffectual in another. This 3-way interaction was observed regardless of whether Hofstede's (2001) cultural value indices were used or the cultural practice scores from the Global Leadership and Organizational Behavior Effectiveness (GLOBE) project (R. J. House, Hanges, Javidan, Dorfman, & Gupta, 2004).

Presurgical Unilateral Cleft Lip Anthropometrics and the Presence of Dental Anomalies.

To investigate associations between cleft lip anthropometrics and dental anomalies in the permanent dentition in unilateral cleft lip patients.

Distinguishing between taskwork and teamwork planning in teams: relations with coordination and interpersonal processes.

Planning in teams represents a critical process that lays the groundwork for effective team functioning. The current investigation examined whether emergent team planning can be meaningfully characterized in terms of a distinction between planning that focuses on taskwork and planning that focuses on teamwork. In Study 1, items written to reflect commonly identified indicators of team planning were subjected to an exploratory factor analysis. In Study 2, slightly modified items were provided to a separate sample, and a confirmatory factor analysis was conducted. In Study 3, the relationships between the different forms of planning and other team processes (i.e., coordination, interpersonal processes) were examined in order to determine whether there are unique relationships for task-focused and team-focused planning. Results from the first 2 studies provided support for a 2-factor structure of team planning, whereas Study 3 found independent relationships for taskwork and teamwork planning with subsequent team processes. Both forms of planning also exhibited indirect relationships with team performance via the mediating role of subsequent team processes.

Prospective analysis of presurgical risk factors for outcomes in primary palatoplasty.

The authors present a single surgeon's series of primary palatoplasty over a 10-year period in order to determine which presurgical factors might influence postoperative fistula rate and speech outcome.

Cleft lip and palate treatment.

Presurgical unilateral cleft lip anthropometrics: incidence of vermilion height asymmetry.

Facet personality and surface-level diversity as team mental model antecedents: implications for implicit coordination.

Team mental models (TMMs) have received much attention as important drivers of effective team processes and performance. Less is known about the factors that give rise to these shared cognitive structures. We examined potential antecedents of TMMs, with a specific focus on team composition variables, including various facets of personality and surface-level diversity. Further, we examined implicit coordination as an important outcome of TMMs. Results suggest that team composition in terms of the cooperation facet of agreeableness and racial diversity were significantly related to team-focused TMM similarity. TMM similarity was also positively predictive of implicit coordination, which mediated the relationship between TMM similarity and team performance. Post hoc analyses revealed a significant interaction between the trust facet of agreeableness and racial diversity in predicting TMM similarity. Results are discussed in terms of facilitating the emergence of TMMs and corresponding implications for team-related human resource practices.

Impact of 22q deletion syndrome on speech outcomes following primary surgery for submucous cleft palate.

Patients with 22q deletion syndrome are at increased risk of submucous cleft palate and velopharyngeal insufficiency. The authors' aim is to evaluate speech outcomes following primary Furlow palatoplasty or pharyngeal flap for correction of velopharyngeal insufficiency in submucous cleft palate patients with and without 22q deletion syndrome.

Single-stage repair of asymmetrical bilateral cleft lip with contralateral lesser form defects.

Complete or incomplete cleft lip may include a contralateral lesser form of incomplete cleft lip to give rise to an asymmetrical bilateral cleft lip deformity. The principle of simultaneous bilateral cleft repair remains an area of contention with regard to asymmetrical cases, including a lesser form deformity.

Presurgical presentation of columellar features, nostril anatomy, and alveolar alignment in bilateral cleft lip and palate after infant orthopedics with and without nasoalveolar molding.

(1) To evaluate quantitative differences in presurgical presentations of alveolar alignment and nostril anatomy of infants with BCLP treated with nasoalveolar molding (NAM) from those treated with maxillary infant orthopedics only (IO) and (2) to detect interrelationships between presurgical nasoalveolar anatomy, age at lip surgery, age of commencing, and durations of alveolar and nasal molding.

Cleft lip, cleft palate, and velopharyngeal insufficiency.

This article provides an introduction to the anatomical and clinical features of the primary deformities associated with unilateral cleft lip-cleft palate, bilateral cleft lip-cleft palate, and cleft palate. The diagnosis and management of secondary velopharyngeal insufficiency are discussed. The accompanying videos demonstrate the features of the cleft lip nasal deformities and reliable surgical techniques for unilateral cleft lip repair, bilateral cleft lip repair, and radical intravelar veloplasty.

Presurgical unilateral cleft lip anthropometrics: implications for the choice of repair technique.

It has been stated that height of the lateral lip is difficult to obtain with the rotation advancement repair only when the lateral lip is short in both its vertical and horizontal dimensions. The authors studied preoperative cleft lip anthropometry to determine the frequency of the "geometrically unfavorable lateral lip"--short in both vertical and transverse dimensions.

Modified Von Langenbeck cleft palate repair using an anterior triangular flap: decreased incidence of anterior oronasal fistulas.

A complication following cleft palate surgery is the development of oronasal fistulas. Despite recent advances aimed at addressing this concern, rates of postoperative fistulas have remained unchanged and are reported at between 3% and 60%. Oronasal fistulas commonly occur between the hard and soft palate and at the anterior portion of the cleft. These fistulas lead to functional problems with nasal emission, hypernasal speech, and food regurgitation through the nose. For clefts of the secondary palate, we developed a modification of the Von Langenbeck technique in which an anterior triangular flap is used to decrease the incidence of postoperative fistulas.

Objective measurements for grading the primary unilateral cleft lip nasal deformity.

The purpose of this prospective study was to develop and validate an objective means of grading the presurgical unilateral cleft lip nasal deformity. Our hypotheses are that expert cleft surgeons can reliably rank patients according to their subjective assessment of the degree of unilateral cleft lip nasal deformity and that objective anthropometric measurements correlate consistently with this subjective assessment.

Evaluation of elbow flexion as a predictor of outcome in obstetrical brachial plexus palsy.

The purpose of this study was to answer two questions. First, are there obstetrical brachial plexus palsy patients with no elbow flexion at 3 months who go on to recover useful upper extremity function without surgical intervention? Second, are there patients with evidence of elbow flexion at 3 months who do benefit from brachial plexus reconstruction?

The use of Surgisis for abdominal wall reconstruction in the separation of omphalopagus conjoined twins.

Abdominal wall reconstruction in omphalopagus twins poses a difficult reconstructive challenge, as separation often results in a large abdominal wall defect. A number of options are available for closure, including tissue flaps, expanders and patches made of foreign material. Surgisis is a new biodegradable small intestine scaffolding substrate that permits tissue in-growth and results in a permanent durable scar. We describe its use in abdominal wall reconstruction after separation of a set of conjoined twins. A set of omphalopagus conjoined twins shared liver and abdominal wall. After separation at 6 months of age, Twin A's abdomen could be closed primarily, but Twin B could not. A 4-ply Surgisis mesh was used in the upper abdominal closure, and a skin flap was created, to completely cover the patch. Both twins survived the operation. A small portion of the skin flap over the Surgisis broke down, healing by secondary intention. In follow up of over 18 months post procedure, there have been no wound infections and the abdominal wall is intact with no evidence of a hernia. Surgisis can be successfully used for the reconstruction of complex abdominal wall defects in the pediatric patient, including reconstruction after separation of conjoined twins.