Velopharyngeal Insufficiency Pre- and Post-Surgery Hypernasality Outcomes for Pediatric Patients With Complex Craniofacial Anomalies

Monday, September 30, 2024

10:12 AM – 10:18 AM EDT

Location: MBCC, Art Deco 228AB

Disclosure(s):

JB Eyring, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Wesley P. Allen, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Quinn T. Orb, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Leith O. Bayazid, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Velopharyngeal insufficiency (VPI) often requires surgical intervention for effective speech development. VPI is common in patients with complex craniofacial anomalies, though differences in outcomes remain unclear in these patients compared to others. In a multidisciplinary pediatric craniofacial clinic, we compared complex and non-complex VPI patients' speech improvement following surgery.

Methods: Data were collected on all VPI patients seen in the craniofacial clinic who had VPI-related surgery from October 2017 to June 2023 (N = 250). Speech-language pathologists assessed hypernasality using the Speech Nasality Assessment Protocol (SNAP) and qualitative assessment before surgery and after recovery. Patients were categorized by procedure type and simple versus complex craniofacial anomalies.

Results: Of 250 VPI patients, 65 (26%) had complex craniofacial anomalies, including 30 (46.2%) with 22q11 deletion, 18 (27.7%) with Pierre-Robin sequence, 5 (7.7%) with Trisomy 21, and 12 (18.5%) with rare syndromes. For patients who underwent SNAP testing (N = 127), scores improved with surgery across all subscales (complex: p < 0.01, non-complex: p < 0.0001). Complex patients had comparable speech outcomes to those without complexity. For all patients, the most common types of surgery were sphincter pharyngoplasty (62.7%), pharyngeal flap (20.5%), Furlow palatoplasty (10.3%), or a combination of these (6.5%).

Conclusions: Surgery was an effective treatment for VPI-related hypernasality. Treatment for patients with VPI should be personalized and consider possible underlying syndromes. Further investigations are warranted to better understand the complex interplay between genetic factors and surgical outcomes in VPI patients.

Presenting Author(s)

JB Eyring, BS

Medical Student (MS3)
University of Utah School of Medicine
North Salt Lake, UT, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Brandon M. Hemeyer, BS

Medical Student
University of Utah School of Medicine
Salt Lake City, Utah, United States

Disclosure information not submitted.
Wesley P. Allen, BS

Medical Student
University of Utah School of Medicine
Salt Lake City, Utah, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
QO

Quinn T. Orb, MD

Assistant Professor
Primary Children's Hospital
Salt Lake City, Utah, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
LB

Leith O. Bayazid, MD

Clinical Instructor
Primary Children's Hospital
Hinsdale, IL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

JM

Jeremy D. Meier, MD

Professor
University of Utah Health - Primary Children's Hospital
Holladay, UT, United States

Disclosure information not submitted.