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

Autor:	McCrary H; Division of Otolaryngology, University of Utah, Salt Lake City, UT, USA., Pollard SH; Division of Otolaryngology, University of Utah, Salt Lake City, UT, USA., Torrecillas V; Division of Otolaryngology, University of Utah, Salt Lake City, UT, USA., Khong L; School of Medicine, University of Utah, Salt Lake City, UT, USA., Taylor HM; Primary Children's Hospital., Meier J; Division of Otolaryngology, University of Utah, Salt Lake City, UT, USA., Muntz H; Division of Otolaryngology, University of Utah, Salt Lake City, UT, USA., Skirko J; Division of Otolaryngology, University of Utah, Salt Lake City, UT, USA.
Jazyk:	angličtina
Zdroj:	The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association [Cleft Palate Craniofac J] 2020 Aug; Vol. 57 (8), pp. 975-983. Date of Electronic Publication: 2020 Mar 24.
DOI:	10.1177/1055665620913440
Abstrakt:	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; t 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 ( P < .001). Children with 2-stage CP repair were 1.8 times as likely to be diagnosed with VPI ( P < .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.
Databáze:	MEDLINE
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