دورية أكاديمية
Surgical Management of Submucous Cleft Palate by Radical Muscle Dissection Veloplasty: Speech Outcomes in Patients with 22q11.2 Deletion Syndrome.
| العنوان: | Surgical Management of Submucous Cleft Palate by Radical Muscle Dissection Veloplasty: Speech Outcomes in Patients with 22q11.2 Deletion Syndrome. |
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| المؤلفون: | Ghanem AM; Great Ormond Street Hospital, London, UK., Borg TM; Plastic and Reconstructive Surgery, James Cook University Hospital, Middlesborough, UK.; Academic Plastic Surgery Group, Barts and the London School of Medicine, London, UK., Youssef G; Milner Therapeutics Institute, Cambridge University, Cambridge, UK., Ridout D; University College of London, London, UK., Gilleard O; Plastic and Reconstructive Surgery, Barts Health, London, UK., Birch M; Director of Clinical Physics, Barts Health, London, UK., Sell D; Great Ormond Street Hospital for Children, NHS Trust, London, UK., Sommerlad BC; Great Ormond Street Hospital for Children, NHS Trust, London, UK. |
| المصدر: | The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association [Cleft Palate Craniofac J] 2024 Mar; Vol. 61 (3), pp. 498-507. Date of Electronic Publication: 2023 Jan 09. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: SAGE Publications in Association with American Cleft Palate-Craniofacial Association Country of Publication: United States NLM ID: 9102566 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-1569 (Electronic) Linking ISSN: 10556656 NLM ISO Abbreviation: Cleft Palate Craniofac J Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : [Thousand Oaks, CA] : SAGE Publications in Association with American Cleft Palate-Craniofacial Association Original Publication: Pittsburgh, PA : The Association, [1991- |
| مواضيع طبية MeSH: | Cleft Palate*/surgery , Cleft Palate*/complications , DiGeorge Syndrome*/surgery , Velopharyngeal Insufficiency*/surgery , Velopharyngeal Insufficiency*/complications , Nose Diseases*, Humans ; Child ; Speech ; Retrospective Studies ; Muscles ; Treatment Outcome |
| مستخلص: | Objective: To evaluate the benefit of anatomical muscle dissection repair for velopharyngeal insufficiency (VPI) in patients with submucous cleft palate (SMCP) with 22q11.2 deletion syndrome. Design: Retrospective blinded randomised analysis of a surgeon's management over 10 years. Setting: The study was performed at a specialised Paediatric hospital in the United Kingdom. Patients: Children with SMCP and 22q11.2 deletion syndrome. Interventions: All participants underwent radical muscle dissection veloplasty. Outcomes Measured: Pre- and post- operative measurements included severity of anatomical defect, speech samples and lateral images which were digitised, randomised then externally and blindly analysed using validated techniques. Stata software was used to perform statistical analysis. Results: 57 children with 22q11.2 deletion syndrome were included in this analysis. Intra-operatively, the majority of cases were identified as SMCP Grade I anomalies. Post-operatively, a statistically significant improvement in hypernasality, resting palate length, palate length at maximum closure, palate excursion and gap size at maximum closure was observed. Secondary surgery was performed for 59% of patients by ten years. Conclusion: Muscle dissection repair improves hypernasality, palate closure function and the closure gap in patients with 22q11.2 deletion syndrome. Although over 50% of patients may require further surgery, muscle dissection repair should be a first step due to its utility at a younger age, when invasive investigations are impossible, its lower morbidity, speech and language benefits or altering the plans for less obstructive secondary surgery when it lead to reduced velo-pharyngeal gap and improved palate mobility even when adequate velo-pharyngeal closure was not achieved. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| فهرسة مساهمة: | Keywords: 22q11.2 deletion syndrome; hypernasality; management; muscle dissection.; submucous cleft palate; syndromic |
| تواريخ الأحداث: | Date Created: 20230110 Date Completed: 20240226 Latest Revision: 20240226 |
| رمز التحديث: | 20240226 |
| DOI: | 10.1177/10556656221150707 |
| PMID: | 36624582 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1545-1569 |
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| DOI: | 10.1177/10556656221150707 |