Speech Outcomes After Sphincter Pharyngoplasty for Velopharyngeal Insufficiency

Objectives/Hypothesis To investigate perceptual speech outcomes following sphincter pharyngoplasty (SP) and to identify patient characteristics associated with velopharyngeal insufficiency (VPI) resolution or improvement. Methods Retrospective review of prospectively collected data was performed of...

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Veröffentlicht in:The Laryngoscope 2021-06, Vol.131 (6), p.E2046-E2052
Hauptverfasser: Lam, Austin S., Kirkham, Erin M., Dahl, John P., Kinter, Sara L., Perkins, Jonathan A., Sie, Kathleen C.Y.
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container_end_page E2052
container_issue 6
container_start_page E2046
container_title The Laryngoscope
container_volume 131
creator Lam, Austin S.
Kirkham, Erin M.
Dahl, John P.
Kinter, Sara L.
Perkins, Jonathan A.
Sie, Kathleen C.Y.
description Objectives/Hypothesis To investigate perceptual speech outcomes following sphincter pharyngoplasty (SP) and to identify patient characteristics associated with velopharyngeal insufficiency (VPI) resolution or improvement. Methods Retrospective review of prospectively collected data was performed of consecutive patients that underwent SP for management of VPI between 1994 and 2016 at a single tertiary care pediatric hospital. Demographic data, nasendoscopic findings, and speech characteristics were recorded using a standardized protocol. Pre‐ and post‐operative VPI was graded on a five‐point Likert scale. Frequency of post‐operative VPI resolution and improvement was assessed and associations with patient characteristics were analyzed. The association between odds of VPI resolution or improvement and five patient characteristics identified a priori was performed controlling for confounding factors. Results Two‐hundred ninety‐six subjects were included. All patients had at least minimal VPI pre‐operatively; 72% were graded moderate or severe. Sixty‐four percent experienced resolution and 83% improved at least one point on the VPI‐severity scale. Of the five patient characteristics, only history of cleft palate repair was significantly associated with decreased odds of VPI improvement but not resolution when controlling for other variables. Conclusions Sphincter pharyngoplasty resulted in resolution of VPI in 64% and improvement in 83% of subjects. Children with a history of cleft palate had significantly decreased odds of VPI improvement compared to those without a history of cleft palate. Neither syndrome diagnosis nor 22q11 deletion had a significant association with speech outcomes after sphincter pharyngoplasty. Level of Evidence 4 Laryngoscope, 131:E2046–E2052, 2021
doi_str_mv 10.1002/lary.29189
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Methods Retrospective review of prospectively collected data was performed of consecutive patients that underwent SP for management of VPI between 1994 and 2016 at a single tertiary care pediatric hospital. Demographic data, nasendoscopic findings, and speech characteristics were recorded using a standardized protocol. Pre‐ and post‐operative VPI was graded on a five‐point Likert scale. Frequency of post‐operative VPI resolution and improvement was assessed and associations with patient characteristics were analyzed. The association between odds of VPI resolution or improvement and five patient characteristics identified a priori was performed controlling for confounding factors. Results Two‐hundred ninety‐six subjects were included. All patients had at least minimal VPI pre‐operatively; 72% were graded moderate or severe. Sixty‐four percent experienced resolution and 83% improved at least one point on the VPI‐severity scale. Of the five patient characteristics, only history of cleft palate repair was significantly associated with decreased odds of VPI improvement but not resolution when controlling for other variables. Conclusions Sphincter pharyngoplasty resulted in resolution of VPI in 64% and improvement in 83% of subjects. Children with a history of cleft palate had significantly decreased odds of VPI improvement compared to those without a history of cleft palate. Neither syndrome diagnosis nor 22q11 deletion had a significant association with speech outcomes after sphincter pharyngoplasty. Level of Evidence 4 Laryngoscope, 131:E2046–E2052, 2021</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.29189</identifier><identifier>PMID: 33103775</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley &amp; Sons, Inc</publisher><subject>Birth defects ; cleft palate ; Laryngoscopy ; Larynx ; Life Sciences &amp; Biomedicine ; Medicine, Research &amp; Experimental ; Otolaryngology ; Otorhinolaryngology ; Research &amp; Experimental Medicine ; Science &amp; Technology ; Speech ; Sphincter pharyngoplasty ; velopharyngeal insufficiency</subject><ispartof>The Laryngoscope, 2021-06, Vol.131 (6), p.E2046-E2052</ispartof><rights>2020 American Laryngological, Rhinological and Otological Society Inc, “The Triological Society” and American Laryngological Association (ALA)</rights><rights>2020 American Laryngological, Rhinological and Otological Society Inc, “The Triological Society” and American Laryngological Association (ALA).</rights><rights>2021 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>4</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000583513600001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c4489-a7f6681e0e71647fb83b82027798dd3e8ea5cfdf18eb5f1dbcb4c3e44144af093</citedby><cites>FETCH-LOGICAL-c4489-a7f6681e0e71647fb83b82027798dd3e8ea5cfdf18eb5f1dbcb4c3e44144af093</cites><orcidid>0000-0002-2297-6376 ; 0000-0001-8975-3022 ; 0000-0003-0181-3997 ; 0000-0001-6017-4529</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.29189$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.29189$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,781,785,886,1418,27929,27930,39263,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33103775$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lam, Austin S.</creatorcontrib><creatorcontrib>Kirkham, Erin M.</creatorcontrib><creatorcontrib>Dahl, John P.</creatorcontrib><creatorcontrib>Kinter, Sara L.</creatorcontrib><creatorcontrib>Perkins, Jonathan A.</creatorcontrib><creatorcontrib>Sie, Kathleen C.Y.</creatorcontrib><title>Speech Outcomes After Sphincter Pharyngoplasty for Velopharyngeal Insufficiency</title><title>The Laryngoscope</title><addtitle>LARYNGOSCOPE</addtitle><addtitle>Laryngoscope</addtitle><description>Objectives/Hypothesis To investigate perceptual speech outcomes following sphincter pharyngoplasty (SP) and to identify patient characteristics associated with velopharyngeal insufficiency (VPI) resolution or improvement. Methods Retrospective review of prospectively collected data was performed of consecutive patients that underwent SP for management of VPI between 1994 and 2016 at a single tertiary care pediatric hospital. Demographic data, nasendoscopic findings, and speech characteristics were recorded using a standardized protocol. Pre‐ and post‐operative VPI was graded on a five‐point Likert scale. Frequency of post‐operative VPI resolution and improvement was assessed and associations with patient characteristics were analyzed. The association between odds of VPI resolution or improvement and five patient characteristics identified a priori was performed controlling for confounding factors. Results Two‐hundred ninety‐six subjects were included. All patients had at least minimal VPI pre‐operatively; 72% were graded moderate or severe. Sixty‐four percent experienced resolution and 83% improved at least one point on the VPI‐severity scale. Of the five patient characteristics, only history of cleft palate repair was significantly associated with decreased odds of VPI improvement but not resolution when controlling for other variables. Conclusions Sphincter pharyngoplasty resulted in resolution of VPI in 64% and improvement in 83% of subjects. Children with a history of cleft palate had significantly decreased odds of VPI improvement compared to those without a history of cleft palate. Neither syndrome diagnosis nor 22q11 deletion had a significant association with speech outcomes after sphincter pharyngoplasty. 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Methods Retrospective review of prospectively collected data was performed of consecutive patients that underwent SP for management of VPI between 1994 and 2016 at a single tertiary care pediatric hospital. Demographic data, nasendoscopic findings, and speech characteristics were recorded using a standardized protocol. Pre‐ and post‐operative VPI was graded on a five‐point Likert scale. Frequency of post‐operative VPI resolution and improvement was assessed and associations with patient characteristics were analyzed. The association between odds of VPI resolution or improvement and five patient characteristics identified a priori was performed controlling for confounding factors. Results Two‐hundred ninety‐six subjects were included. All patients had at least minimal VPI pre‐operatively; 72% were graded moderate or severe. Sixty‐four percent experienced resolution and 83% improved at least one point on the VPI‐severity scale. Of the five patient characteristics, only history of cleft palate repair was significantly associated with decreased odds of VPI improvement but not resolution when controlling for other variables. Conclusions Sphincter pharyngoplasty resulted in resolution of VPI in 64% and improvement in 83% of subjects. Children with a history of cleft palate had significantly decreased odds of VPI improvement compared to those without a history of cleft palate. Neither syndrome diagnosis nor 22q11 deletion had a significant association with speech outcomes after sphincter pharyngoplasty. 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subjects Birth defects
cleft palate
Laryngoscopy
Larynx
Life Sciences & Biomedicine
Medicine, Research & Experimental
Otolaryngology
Otorhinolaryngology
Research & Experimental Medicine
Science & Technology
Speech
Sphincter pharyngoplasty
velopharyngeal insufficiency
title Speech Outcomes After Sphincter Pharyngoplasty for Velopharyngeal Insufficiency
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