Document Detail


Impact of Cleft Width in Clefts of Secondary Palate on the Risk of Velopharyngeal Insufficiency.
MedLine Citation:
PMID:  22508897     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective To investigate the association between velopharyngeal insufficiency (VPI), a common finding after cleft palate repair, and various risk factors, including cleft width.Methods We performed a retrospective cohort study of patients with isolated cleft palates repaired from 2003 to 2008 at a tertiary children's hospital. Patients were observed postoperatively for development of VPI and palatal fistula. The primary risk factor was cleft width. Covariates included cleft length, age at surgery, and presence of associated syndrome. Logistic regression analysis was used to calculate adjusted and unadjusted odds ratios (ORs).Results The cohort comprised 61 patients. Mean (SD) patient age at the time of cleft repair was 13 (3) months. Fistula rate was 3%. Overall rate of postoperative VPI was 32%. We found significant associations between VPI diagnosis and increasing age in months at the time of palate repair (OR, 1.4 [95% CI, 1.2-1.7]) and between VPI and cleft width greater than 10 mm (OR, 5.3 [95% CI, 1.8-15.6]). The association between VPI and cleft width was similar after adjustment for cleft length, patient age, and syndrome presence (OR, 4.5 [95% CI, 1.1-18.7]).Conclusions Our results suggest that increased palatal cleft width is associated with a greater risk of postoperative VPI. Clinicians should consider this when counseling patient families for cleft palate repair.
Authors:
Derek J Lam; Lynn L Chiu; Kathleen C Y Sie; Jonathan A Perkins
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-16
Journal Detail:
Title:  Archives of facial plastic surgery : official publication for the American Academy of Facial Plastic and Reconstructive Surgery, Inc. and the International Federation of Facial Plastic Surgery Societies     Volume:  -     ISSN:  1538-3660     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883500     Medline TA:  Arch Facial Plast Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Cincinnati Children's Hospital Medical Center, Cincinnati Ohio (Dr Lam), University of Washington, Seattle (Drs Lam, Chiu, Sie, and Perkins), and University of California, Irvine (Dr Chiu); Craniofacial Center, Seattle Children's Hospital, Seattle, Washington (Drs Sie and Perkins).
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