Mock Abstract
The Assessment of Velopharyngeal Insufficiency after Primary Palatoplasty in 10-19 years old Cleft Palate Children : Compare standard assessment
Natthaphon Piyasatukit**, Bowornsilp Chowchuen MD, MBA**, Benjamas Prathanee PhD*
* Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
** Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Cleft Palate and
Craniofacial Center, Khon Kaen, Thailand
Abstract
Background: Cleft palate children 20-30% will experience Velopharyngeal incompetence (VPI). VPI results from a malfunctioning of the muscular valve made up of the soft palate and the lateral and posterior pharyngeal walls. Velopharyngeal dysfunction can usually be diagnosed by the speech/language pathologist based on speed assessment.There multiple modalities are available to confirm the diagnosis and the planning of operations such as nasendoscopy, multiplanar-videofluroscopy, pressure-flow measurements(Aerodynamic) and fMRI, Spectography, Accelerometry for a research. This wide variation of investigative tools is critical importance if a surgeon is utilising to evaluate the pattern of closure deficiency and plan their operative intervention appropriately.
Objective:to evalution the accuracy rate of nasendoscopy and multiplanar-videofluroscopy in the assessment of VPI.
Methods: A Cross-sectional study of …N…consecutive symdromic and non-syndromic cleft palates with/or without cleft lips, born Between ..... , who underwent primary palatoplasty at Srinagarind Hospital, Thailand.
Demographic data that were recorded includes: patients with cleft types, age at palatoplasty, operating surgeons ,surgical palatal repair techniques, Speech assessing and treating articulation disorders by speech/language pathologist, Imaging procedures for assessing VPI, age at evaluation, Palatal fistular, and Neuromuscular disfunction associate genetic anomalies.
Results: XXX consecutive patients. There were dermographic data…. .The rate of VPI was xx.x% (xx out of xx patients) of cleft palates underwent primary palatoplasty at Srinagarind Hospital that diaganosis making form speed assessment ,nasendoscopy and multiplanar-videofluroscopy. The evalution of The acccureacy rate of nasendoscopy( xx.x%) and multiplanar-videofluroscopy(xx.x%) when comparison with speed assessment by speech/language pathologist. (xx%),(xx%)when comparison pressure-flow measurements. (xx%),(xx%)when comparison with fMRI.
Conclusions: The rate of VPI and the accuracy rate of the nasendoscopy and multiplanar-videofluroscopy was comparable to results from other standard tools to confirm the diagnosis and the planning of operations of cleft palate patients who underwent primary palatoplasty during previous rounds of our management protocol.
Key words: Velopharyngeal incompetence; VPI; Assessment;
Table 1. Demographic and clinical characteristics of patients with cleft palate with/without cleft lip who underwent primary palatoplasty
|
Characteristics |
Number
|
|
|
Number of patients Gender Male Female Comorbidity &Associate Syndrome VCD G-6-PD deficiency Amniotic band constriction Club feet Etc. Age at time of evaluation( Mean) Age at palatoplasty (Mean) Age range for palatoplasty <12 months 12-18 months >18 months Cleft types Veau 1 Veau 2 Veau 3 Veau 4 Type of palatoplasty Two-flap palatoplasty Secondary palatal repair Fistula closure Residual fistula at time of evaluation
|
|
Table 2. Data collection
|
Investigation |
Number
|
|
|
Speech assessing and treating articulation disorders by speech/language pathologist (yes/no)
Speech assessing parameter of resonance -1 = Hyponasality 0 = normal +1= mild hypernasality +2 = moderate hypernasality +3 = severe hypernasality
Procedures for assessing Nasendoscopy VP gap size(mean) VPI (yes/no) Sagittal diastasis Transverse intact Videofluroscopy(yes/no) VP gap size(mean) VPI (yes/no) Coronal Sagittal Circular Circular with passaavant ridge
Pressure-flow measurements(Aerodynamic) fMRI Spectography Accelerometry
|
|
Table 4. Data analysis
|
|
Speech assessment |
Pressure-flow measurements(Aerodynamic)
|
fMRI |
total |
|
NE |
|
|
|
|
|
MVF |
|
|
|
|
|
Accuracy different |
|
|
|
|