Increased Risk of Velopharyngeal Insufficiency in Patients Undergoing Staged Palate Repair.

TitleIncreased Risk of Velopharyngeal Insufficiency in Patients Undergoing Staged Palate Repair.
Publication TypeJournal Article
Year of Publication2020
AuthorsMcCrary H, Pollard SHatch, Torrecillas V, Khong L, Taylor HM, Meier J, Muntz H, Skirko J
JournalCleft Palate Craniofac J
Date Published2020 08
KeywordsChild, Cleft Palate, Humans, Retrospective Studies, Treatment Outcome, Velopharyngeal Insufficiency

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.

Alternate JournalCleft Palate Craniofac J
PubMed ID32207321
PubMed Central IDPMC8751621
Grant ListUL1 TR002538 / TR / NCATS NIH HHS / United States
Faculty Reference: 
Jonathan Skirko, MD, MHPA, MPH