The occurrence of velopharyngeal insufficiency in Pierre Robin Sequence patients |
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Authors: | Goudy Steven Ingraham Christopher Canady John |
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Institution: | aDepartment of Otolaryngology, Vanderbilt University, 2200 Children's Way Doctors’ Office Tower, 7th floor, Nashville, TN 37232, United States;bDepartment of Radiology, University of Washington, United States;cDepartment of Surgery/Otolaryngology, University of Iowa, United States |
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Abstract: | ObjectiveChildren born with Pierre-Robin Sequence (PRS) have cleft palate, micrognathia, and macroglossia. After the repair of the cleft palate, velopharyngeal insufficiency (VPI) can occur in a subset of patients. We hypothesize that the need for the surgical correction of VPI in PRS children is no different than cleft palate only (CPO) patients.MethodsA retrospective study of 21 children with non-syndromic PRS who were matched to 42 non-syndromic, CPO controls for age and sex. We reviewed incidence of VPI, the need for secondary speech surgery, and speech outcomes post-operatively.ResultsSecondary surgery to correct VPI was necessary in 3 of 21 (14.29%) PRS patients (2 Pharyngeal Flaps, 1 Z-plasty), vs. 10 of 42 (23.81%) CPO (9 Pharyngeal Flaps, 1 Z-plasty) controls. Mean age for VPI surgery for PRS vs. controls: 5.33 vs. 6.41 years, respectively. For final speech outcomes, 73.68% of PRS vs. 71.88% of controls showed no evidence of hypernasality, 89.47% of PRS patients vs. 93.75% of controls showed no evidence of hyponasality, and 76.47% of PRS patients vs. 78.13% of controls had normal velopharyngeal competence (p > 0.90 for all three measures).ConclusionOur findings suggest that children born with a Pierre-Robin Sequence do not have a higher rate of post-operative VPI after cleft palate repair and are no more likely to require additional surgical intervention. |
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Keywords: | Cleft palate Pierre Robin Sequence VPI Pharyngeal flap Furlow palatoplasty Sphincter pharyngoplasty |
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