Title | Increased Risk of Velopharyngeal Insufficiency in Patients Undergoing Staged Palate Repair. |
Publication Type | Journal Article |
Year of Publication | 2020 |
Authors | McCrary H, Pollard SHatch, Torrecillas V, Khong L, Taylor HM, Meier J, Muntz H, Skirko J |
Journal | Cleft Palate Craniofac J |
Volume | 57 |
Issue | 8 |
Pagination | 975-983 |
Date Published | 2020 08 |
ISSN | 1545-1569 |
Keywords | Child, Cleft Palate, Humans, Retrospective Studies, Treatment Outcome, Velopharyngeal Insufficiency |
Abstract | OBJECTIVE: To evaluate the association of 2-stage cleft palate (CP) surgery on velopharyngeal insufficiency (VPI) incidence, speech surgeries, and cleft-related surgical burden. DESIGN: Retrospective cohort with follow-up of 4 to 19 years. SETTING: Academic, tertiary children's hospital. PATIENTS: Patients who underwent CP surgery between 2000 and 2017. Exclusions included submucous CP or age at last contact under 3.9. INTERVENTIONS: Cleft palate surgery, completed in either a single-stage or 2-stage repair. MAIN OUTCOME MEASURE(S): Rates of VPI diagnosis and speech surgery and total cleft surgeries; tests, tests of proportion, and linear and logistic regression were performed. Total cleft-related surgeries were examined in a subset (n = 418) of patients with chart reviews. RESULTS: A total of 1047 patients were included; 59.6% had 2-stage CP repair, 40.4% had single-stage repair. Approximately 32% of children with 2-stage CP repair were diagnosed with VPI, as opposed to 22% of single-stage patients ( < .001). Children with 2-stage CP repair were 1.8 times as likely to be diagnosed with VPI ( < .001). Speech surgery rates were similar across groups. Patients who had 2-stage repair received an average of 2.3 more cleft-related procedures, when excluding prosthesis management procedures. CONCLUSION: Our data show an increased risk of VPI diagnosis and increased surgical burden among patients receiving 2-stage CP repair. |
DOI | 10.1177/1055665620913440 |
Alternate Journal | Cleft Palate Craniofac J |
PubMed ID | 32207321 |
PubMed Central ID | PMC8751621 |
Grant List | UL1 TR002538 / TR / NCATS NIH HHS / United States |
Increased Risk of Velopharyngeal Insufficiency in Patients Undergoing Staged Palate Repair.
Faculty Reference:
Jonathan Skirko, MD, MHPA, MPH