دورية أكاديمية
Surgical outcomes and revision rates for velopharyngeal insufficiency (VPI) in syndromic and non-syndromic children: A systematic review and meta-analysis.
| العنوان: | Surgical outcomes and revision rates for velopharyngeal insufficiency (VPI) in syndromic and non-syndromic children: A systematic review and meta-analysis. |
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| المؤلفون: | Chernov ES; Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery, 135 Rutledge Avenue, Charleston, SC 29425, USA; SUNY Upstate Medical University, School of Medicine, 766 Irving Ave, Syracuse, NY 13210, USA., Taniguchi AN; Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery, 135 Rutledge Avenue, Charleston, SC 29425, USA; University of Central Florida, School of Medicine, 6850 Lake Nona Blvd, Orlando, FL 32827, USA., Nguyen SA; Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery, 135 Rutledge Avenue, Charleston, SC 29425, USA. Electronic address: nguyensh@musc.edu., Sutton SR; Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery, 135 Rutledge Avenue, Charleston, SC 29425, USA; University of Nevada, Reno, School of Medicine, 1664 N Virginia St, Reno, NV 89557, USA., Pecha PP; Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery, 135 Rutledge Avenue, Charleston, SC 29425, USA., Patel KG; Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery, 135 Rutledge Avenue, Charleston, SC 29425, USA., Montiel M; Medical University of South Carolina, Department of Speech Language Pathology, 135 Rutledge Avenue, Charleston, SC 29425, USA., Carroll WW; Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery, 135 Rutledge Avenue, Charleston, SC 29425, USA. |
| المصدر: | American journal of otolaryngology [Am J Otolaryngol] 2024 Jul-Aug; Vol. 45 (4), pp. 104341. Date of Electronic Publication: 2024 May 01. |
| نوع المنشور: | Journal Article; Systematic Review; Meta-Analysis |
| اللغة: | English |
| بيانات الدورية: | Publisher: Saunders Country of Publication: United States NLM ID: 8000029 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-818X (Electronic) Linking ISSN: 01960709 NLM ISO Abbreviation: Am J Otolaryngol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Cherry Hill, N. J., Saunders. |
| مواضيع طبية MeSH: | Velopharyngeal Insufficiency*/surgery , Reoperation*/statistics & numerical data, Humans ; Child ; Treatment Outcome ; Plastic Surgery Procedures/methods ; Female ; Male ; Child, Preschool ; Syndrome ; Otorhinolaryngologic Surgical Procedures/methods ; Pharynx/surgery |
| مستخلص: | Purpose: To evaluate pre- and post-operative resonance, surgical technique, revision rate, and revision indication among syndromic and non-syndromic children with velopharyngeal insufficiency (VPI). Materials and Methods: A systematic review was conducted through July 2022. Children surgically treated for VPI were included. A meta-analysis of single means, proportions, comparison of proportions, and mean differences with 95 % confidence interval [CI] was conducted. Results: Twenty-three articles (n = 1437) were included in the analysis. The most common surgery was Sphincter Pharyngoplasty (SP), 62.6 % [31.3-88.9] for syndromic and 76.3 % [37.5-98.9] for non-syndromic children. Among all surgical techniques, for syndromic and non-syndromic children, 54.8 % [30.9-77.5] and 73.9 % [61.3-84.6] obtained normal resonance post-operatively, respectively. Syndromic patients obtained normal resonance post-operatively in 83.3 % [57.7-96.6] of Combined Furlow Palatoplasty and Sphincter Pharyngoplasty (CPSP), 72.6 % [54.5-87.5] of Pharyngeal Flap (PF), and 45.1 % [13.2-79.8] of Sphincter Pharyngoplasty (SP) surgeries. Non-syndromic patients obtained normal resonance post-operatively in 79.2 % [66.4-88.8] of PF and 75.2 % [61.8-86.5] of SP surgeries. The revision rate for syndromic and non-syndromic patients was 19.9 % [15.0-25.6] and 11.3 % [5.8-18.3], respectively. The difference was statistically significant, 8.6 % [2.9-15.0, p = 0.003]. Syndromic patients who underwent PF were least likely to undergo revision surgery as compared to SP and CPSP, 7.7 % [2.3-17.9] vs. 23.7 % [15.5-33.1] and 15.3 % [2.8-40.7], respectively. Conclusions: Syndromic children had higher revision rates and were significantly less likely to obtain normal resonance following primary surgery than non-syndromic patients. Among syndromic children, PF and CPSP have been shown to improve resonance and reduce revision rates more so than SP alone. Competing Interests: Declaration of competing interest The authors have no conflict of interest to disclose. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Non-syndromic; Pediatric; Resonance; Surgery; Syndromic; Velopharyngeal insufficiency |
| تواريخ الأحداث: | Date Created: 20240516 Date Completed: 20240612 Latest Revision: 20240612 |
| رمز التحديث: | 20240613 |
| DOI: | 10.1016/j.amjoto.2024.104341 |
| PMID: | 38754293 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1532-818X |
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| DOI: | 10.1016/j.amjoto.2024.104341 |