<< Back to the abstract archive
Assessment of Long-term Speech Outcomes in Children with Pierre Robin Sequence
Casey Zhang BA, Justin Beiriger BSE, Zhazira Irgebay, BA, John Smetona, MD, Matt Ford, MS, Joseph Losee MD, Jesse Goldstein, MD
UPMC
2022-01-13
Presenter: Justin W Beiriger
Affidavit:
The majority of the work for this project represents the original work of the presenting medical student, Justin Beiriger
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction
Robin Sequence (RS) includes microretrognathia, glossoptosis, and upper airway obstruction. Cleft palates in this population are wide and U-shaped, making palatoplasty challenging. Velopharyngeal insufficiency (VPI) can result in aberrant speech development and necessitate secondary speech surgery. This study evaluates long-term Pittsburgh Weighted Speech Scores (PWSS) and secondary speech surgeries in patients with RS after palatoplasty.
Methods
Patients diagnosed with RS who underwent primary cleft palate repair between 2001- 2019 were included. Demographic data, medical case information, and speech-language therapy records were collected. Patient outcomes included Pittsburgh Weighted Speech scores and secondary operation for VPI.
Results
107 patients met inclusion criteria (43% male). 93.3% of patients had Veau-Class II cleft palate. 70.1% of patients underwent cleft repair using the modified Furlow technique. Mean age at surgery was 1.3±0.6 years and average age at long-term speech evaluation of 9.0±3.9 years old. Mean PWSS were 4.2±3.4, and only 6.5% demonstrated competent velopharyngeal mechanism. Borderline velopharyngeal mechanisms with minimal to mild hypernasality were achieved in 79.4% of patients. 38.7% of patients developed VPI requiring secondary speech surgery. There was no difference in PWSS between Furlow and straight-line repair (p=0.154) or association between age at surgery and PWSS (p=0.35, R2=0.01).
Conclusion
Only 6.5% of patients demonstrated completely competent velopharyngeal mechanisms in long-term speech analysis. The majority had borderline VP mechanisms in which speech was not overtly stigmatized. 38.7% underwent secondary speech surgery for persistent VPI and stigmatized speech. Results of this analysis are similar to published outcomes in palatoplasty populations with much longer follow-up.
