Document Detail

Speech outcome after palatal repair in nonsyndromic versus syndromic Robin sequence.
MedLine Citation:
PMID:  23018719     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The authors' purpose was to document speech outcome after cleft palate repair in patients with syndromic versus nonsyndromic Robin sequence. Results of secondary correction of velopharyngeal insufficiency using a superiorly based pharyngeal flap or double-opposing Z-palatoplasty are also reported.
METHODS: Charts of patients with Robin sequence and cleft palate between 1980 and 2007 were reviewed. Data collected included date of birth, sex, syndrome/association, cleft palatal type (Veau I or II), age at palatoplasty, incidence of palatal fistula, postoperative speech assessment, videofluoroscopic results, need for secondary operation for velopharyngeal insufficiency, and type of secondary operation (pharyngeal flap or double-opposing Z-palatoplasty).
RESULTS: The authors identified 140 patients with Robin sequence who had palatal closure. Postoperative speech evaluation was available for 96 patients (69 percent). A syndrome or association was identified in 42 patients (30 percent). Primary palatoplasty was successful in 74 patients (77 percent); speech was characterized as competent and competent to borderline competent. The authors found a significantly higher incidence of velopharyngeal insufficiency following palatal repair for syndromic (38 percent) than nonsyndromic Robin sequence (16 percent). (p = 0.039). In patients with velopharyngeal insufficiency, competent or borderline competent speech was determined after double-opposing Z-palatoplasty (two of five patients) or pharyngeal flap (eight of 10 patients).
CONCLUSIONS: The rate of velopharyngeal insufficiency in syndromic Robin sequence is significantly greater than in nonsyndromic Robin sequence. The authors prefer pharyngeal flap for velopharyngeal insufficiency in patients with Robin sequence, whether syndromic or nonsyndromic, without retrognathism or signs/symptoms of obstructive sleep apnea.
Kamlesh B Patel; Stephen R Sullivan; Ananth S Murthy; Eileen Marrinan; John B Mulliken
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  130     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-28     Completed Date:  2012-12-14     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  577e-584e     Citation Subset:  AIM; IM    
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MeSH Terms
Age Factors
Child, Preschool
Cleft Palate / diagnosis,  surgery*
Cohort Studies
Follow-Up Studies
Palate, Soft / surgery*
Pierre Robin Syndrome / diagnosis,  surgery*
Postoperative Complications / diagnosis,  surgery
Reconstructive Surgical Procedures / adverse effects,  methods*
Reference Values
Reoperation / methods
Retrospective Studies
Risk Assessment
Speech Articulation Tests
Speech Intelligibility
Surgical Flaps / blood supply*
Treatment Outcome
Velopharyngeal Insufficiency / etiology*,  physiopathology,  surgery
Erratum In:
Plast Reconstr Surg. 2014 Jul;134(1):168

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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