<< Back to the abstract archive
Speech Outcomes Do Not Revert Following Posterior Pharyngeal Flap Takedown for Obstructive Sleep Apnea
Katzel, EB; Naran, S; Losee, JE
University of Pittsburgh
Department of Plastic Surgery
2013-02-27
Presenter: Evan Katzel
Affidavit:
100% of this work represents original work by the authors
Director Name: Joseph Losee
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background
Correction of velopharyngeal insufficiency (VPI) using a posterior pharyngeal flap (PPF) has been shown to improve clinical speech symptomatology; however, PPFs can be complicated by obstructive sleep apnea (OSA). The goal of this study was to assess if speech outcomes revert following PPF takedown for the treatment of OSA.
Methods
A Children's Hospital database was retrospectively queried to identify patients diagnosed with VPI who were treated with a PPF & later required takedown. Using the Pittsburgh Weighted Speech Score (PWSS), pre-operative scores were compared to those following surgical takedown/revision. Given that surgical correction of OSA differed, the method of surgical correction (PPF takedown, conversion Furlowplasty, conversion pharyngoplasty) was stratified & cross-compared.
Results
A total of 41 patients were identified. Of these, 18 underwent PPF takedown alone, 21 underwent PPF takedown with conversion to Furlow palatoplasty, & 2 underwent PPF takedown with conversion to pharyngoplasty. Patients averaged 15.17±6.34 (mean±SD) years of age. 54% were male. The mean duration of follow up after surgery was 40.19 ±29.51 months. For PPF takedown alone, the mean pre-operative & post-operative PWSS was 2.33±3.71 & 2.81±3.66, respectively (p=0.71). The mean change in PWSS was 0.25±3.49.
For conversion to Furlowplasty, the mean pre-operative & post-operative PWSS was 6.05±7.18 & 5.30±7.12, respectively (p=0.74). The mean change in PWSS was -1.00±4.30. For all patients, the mean pre-operative PWSS was 4.54±6.03, compared to 4.29±5.80 following takedown (p=0.86).
Conclusions
While there is concern that PPF takedown may degrade speech, this study finds that surgical takedown of PPF in the setting of OSA does not result in a statistically significant change in PWSS.
