Austin S Lam1,2, Erin M Kirkham3, John P Dahl1,2, Sara L Kinter4, Jonathan A Perkins1,2, Kathleen C Y Sie1,2. 1. Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, Washington, U.S.A. 2. Department of Otolaryngology - Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A. 3. Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A. 4. Speech and Language Services, Seattle Children's Hospital, Seattle, Washington, U.S.A.
Abstract
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.
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.
Authors: Craig Miller; Randall Bly; Shelagh Cofer; John P Dahl; Lianne de Serres; Steven Goudy; Larry Hartzell; Noel Jabbour; Deborah Kacmarysnki; Carol Macarthur; Anna Messner; Henry Milczuk; Jeff Rastatter; Laura H Swibel Rosenthal; Andrew Scott; Travis Tollefson; Audie Woolley; Carlton Zdanski; Dave A Zopf; Kathleen Sie Journal: Otolaryngol Head Neck Surg Date: 2019-01-15 Impact factor: 3.497
Authors: Jonathan R Skirko; Edward M Weaver; Jonathan A Perkins; Sara Kinter; Linda Eblen; Julie Martina; Kathleen C Y Sie Journal: Otolaryngol Head Neck Surg Date: 2015-06-29 Impact factor: 3.497
Authors: David D Tieu; Mark E Gerber; Henry A Milczuk; Sanjay R Parikh; Jonathan A Perkins; Patricia J Yoon; Kathleen C Y Sie Journal: Arch Otolaryngol Head Neck Surg Date: 2012-10
Authors: Kathleen C Y Sie; Jacqueline R Starr; David C Bloom; Michael Cunningham; Lianne M de Serres; Amelia F Drake; Ravindhra G Elluru; Joseph Haddad; Christopher Hartnick; Carol Macarthur; Henry A Milczuk; Harlan R Muntz; Jonathan A Perkins; Craig Senders; Marshall E Smith; Travis Tollefson; Jay Paul Willging; Carlton J Zdanski Journal: Arch Otolaryngol Head Neck Surg Date: 2008-07