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Assessment of Long-Term Speech Outcomes in Children with Pierre Robin Sequence
Casey Zhang, BA; Nicolás M. Kass, BA; Joseph W. Mocharnuk, BA; Justin Beiriger BSE; Angel Dixon, BA; John Smetona, MD; Matthew Ford, MS; Joseph E. Losee, MD; Jesse A. Goldstein, MD
University of Pittsburgh Medical Center
2024-01-14
Presenter: Casey Zhang
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. I certify that the work is entirely the original work of the resident or medical student.
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction
The purpose of this study was to evaluate long-term Pittsburgh Weighted Speech Scores (PWSS) and the need for secondary speech surgery for velopharyngeal insufficiency (VPI) in patients with Pierre Robin Sequence (PRS) after primary palatoplasty compared to patients without PRS.
Methods
A retrospective cohort study was performed of patients diagnosed with PRS who underwent primary cleft palate repair at a tertiary care children's hospital between 2001-2019. The control group included patients matched on presence Veau Class I or II cleft palate. Outcomes included PWSS and secondary operation for VPI.
Results
106 patients with PRS and 94 control patients met inclusion criteria. Patients with PRS underwent primary palatoplasty at a median age of 1.2 ± 0.8 compared to 1.1 ± 1.1 years in patients without PRS (p=0.11). Patients with PRS underwent most recent speech evaluation at a mean age of 8.7 ± 3.9 years compared to 7.0 ± 2.6 years in the control group (p<.001). Median PWSS among patients with PRS was 4.0 ± 3.4 compared to that of control patients, 4.0 ± 1.9 (p=.58). 37.1 % of patients with PRS had additional secondary palate surgery compared to 19.1% of control patients (p=.005). Similar numbers of patients with and without PRS had VPI (PWSS >7) at most recent evaluation (10.9% vs 4.2%, p=.11).
Conclusion
Long-term speech outcomes are similar among patients with and without PRS. However, patients with PRS required higher rates of secondary palate surgery for persistent VPI, with only 8.4% achieving complete velopharyngeal competence.
