Speech Outcomes and Rates of Secondary Speech Surgery from Childhood to Skeletal Maturity following Modified Furlow Palatoplasty.

IF 3.2 2区医学 Q1 SURGERY

Plastic and reconstructive surgery Pub Date : 2024-11-01 Epub Date: 2023-09-12 DOI:10.1097/PRS.0000000000011056

Lauren K Salinero, Connor S Wagner, Carlos E Barrero, Zachary D Valenzuela, Susan M McCormack, Cynthia Solot, Marilyn Cohen, Richard E Kirschner, David W Low, Oksana A Jackson

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引用次数: 0

Abstract

Background: This study updates the authors' institutional experience with modified Furlow palatoplasty, evaluating speech outcomes and incidence of secondary speech surgery throughout development and at skeletal maturity.

Methods: Nonsyndromic patients undergoing primary modified Furlow palatoplasty between 1985 and 2005 with postoperative speech evaluations were reviewed retrospectively. Secondary speech surgery and Pittsburgh Weighted Speech Scale (PWSS) scores before secondary speech or orthognathic operations were assessed in the groups aged 5 to 7 years, 8 to 11 years, 12 to 14 years, and older than 15 years and analyzed by Veau cleft type.

Results: A total of 551 patients with 895 total speech assessments were analyzed. Of 364 patients followed up to age 15 years or older, 19.8% underwent secondary speech surgery. Speech assessment of patients aged 15 years or older without prior secondary speech surgery showed competent velopharyngeal mechanisms in 77% of patients. PWSS nasal emission scores were worse in the 5- to 7-year age range ( P = 0.02), whereas resonance scores remained stable throughout development ( P = 0.2). Patients with Veau type I or II clefts had worse overall PWSS classifications in the groups aged 5 to 7 years and 8 to 11 years ( P = 0.01 and P = 0.03), with greater odds of secondary speech surgery relative to those with Veau type III (OR, 2.9; P < 0.001) or IV clefts (OR, 3.6; P = 0.001).

Conclusions: Most patients undergoing primary modified Furlow palatoplasty do not require secondary speech surgery and achieve socially acceptable speech at skeletal maturity. However, Veau type I and II clefts are associated with increased risk for early velopharyngeal dysfunction and secondary speech surgery. The incidence of secondary speech surgery was 19.8%, an increase from our previously reported rate of 8%.

Clinical question/level of evidence: Therapeutic, III.

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改良Furlow腭成形术后从儿童期到骨骼成熟期的言语效果和二次言语手术率。

背景：本研究更新了作者所在机构使用改良Furlow腭成形术的经验：本研究更新了作者所在机构在改良Furlow腭成形术方面的经验，评估了整个发育过程和骨骼成熟期的言语效果和二次言语手术的发生率：方法：对 1985 年至 2005 年间接受改良 Furlow 腭成形术的非合并症患者进行了回顾性研究，并对其术后语言能力进行了评估。对 5 至 7 岁、8 至 11 岁、12 至 14 岁和 15 岁以上年龄组的二次言语手术和二次言语或正颌手术前的匹兹堡加权言语量表 (PWSS) 评分进行评估，并按 Veau 裂缝类型进行分析：结果：共分析了 551 名患者，共进行了 895 次言语评估。在随访至 15 岁或以上的 364 名患者中，19.8% 接受了二次言语手术。对未接受过二次言语手术的 15 岁或以上患者进行的言语评估显示，77% 的患者发音机制正常。5至7岁年龄段的PWSS鼻腔发音评分较差（P = 0.02），而共鸣评分在整个发育过程中保持稳定（P = 0.2）。在5至7岁组和8至11岁组中，Veau I型或II型裂隙患者的整体PWSS分级较差（P = 0.01和P = 0.03），与Veau III型（OR，2.9；P < 0.001）或IV型裂隙（OR，3.6；P = 0.001）患者相比，接受二次言语手术的几率更大：大多数接受初级改良Furlow腭裂成形术的患者不需要二次语言手术，并能在骨骼发育成熟时获得社会可接受的语言能力。然而，Veau I型和II型腭裂与早期咽喉功能障碍和二次语言手术的风险增加有关。二次语言手术的发生率为19.8%，比我们之前报告的8%有所增加：治疗，III 级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Plastic and reconstructive surgery 医学-外科

CiteScore

5.00

自引率

13.90%

发文量

1436

审稿时长

1.5 months

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