Vocal cord dysfunction: Does laryngeal adduction on laryngoscopy predict disease severity and response to laryngeal retraining therapy?

Introduction: Vocal cord dysfunction (VCD) is a complex disorder characterized by episodic adduction of the vocal folds during inspiration and expiration, which can lead to dyspnea, wheezing, cough, and acute-onset respiratory distress. Currently, there is a lack of standardized criteria among treating physicians across multiple disciplines, including otolaryngologists, pulmonologists, allergists, and speech and language pathologists, for diagnosis and treatment of VCD, although laryngeal-respiratory retraining therapy (LRT) has emerged as the preferred treatment modality.

Objective: In the present study, we examined the efficacy of LRT in patients presenting with a clinical diagnosis of VCD in the presence and absence of laryngeal adduction on laryngoscopy.

Risk of Malocclusion Among Patients Undergoing Single-Stage Versus Two-Stage Cleft Palate Repair.

Objective: Evaluate impact of single-stage versus staged palate repair on the risk of developing malocclusion among patients with cleft palate (CP).

Design: Retrospective cohort study 2000-2016.

Setting: Academic, tertiary children's hospital.

The Quest for a DISE Protocol.

Objective: The objective of this quality initiative project was to modify our existing institutional drug-induced sleep endoscopy (DISE) protocol so that the surgeon could consistently determine obstructive breathing patterns while minimizing children's discomfort.

Methods: A quality initiative study utilizing the well-described plan-do-study-act (PDSA) process was conducted at a tertiary hospital for children with polysomnogram-documented obstructive sleep apnea who were undergoing DISE. A 4-point Likert measurement tool was created.

Bone Grafting of Alveolar Clefts.

The goals of alveolar cleft repair include (1) stabilization of the maxilla, (2) permitting tooth eruption, (3) eliminating the oronasal fistula, (4) improving aesthetics, and (5) improving speech. Alveolar cleft repair should be considered one of the steps of a larger comprehensive orthodontic management plan. In conjunction with closure of the oronasal fistula, a variety of grafting materials can be used in the alveolar cleft.

Radiofrequency Ablation vs Electrocautery Blinded Randomized Trial: Impact on Clinically Meaningful Outcomes.

Objective: To analyze patients' return to normal activity, pain scores, narcotic use, and adverse events after undergoing tonsillectomy or adenotonsillectomy with monopolar electrocautery or radiofrequency ablation.

Study Design: Randomized double-blinded clinical trial based on prospective parallel design.

Setting: Academic medical center and tertiary children's hospital between March 2018 and July 2019.

Management of Velopharyngeal Insufficiency in Cleft Patients With and Without Multidisciplinary Team Care.

Objective: To evaluate the effect of an American Cleft Palate-Craniofacial Association (ACPA)-approved multidisciplinary team on velopharyngeal insufficiency (VPI) diagnosis and treatment.

Design: Retrospective cohort setting; tertiary children's hospital patients; children with cleft palate repair identified through procedure codes.

Main Outcome Measures: Velopharyngeal insufficiency diagnosis was assigned based on surgeon or team assessment.

Ecuadorian Spanish translation and validation of the VELO quality of life instrument.

Objectives: Adapt the Spanish translation of VPI Effects on Life Outcome (VELO) instrument into Ecuadorian Spanish; test the resulting instrument for reliability and validity.

Methods: A cross-sectional, prospective design, set at a humanitarian mission within a community hospital. Linguistic validation: native Ecuadorian-Spanish speakers modified the Spanish VELO to Ecuadorian Spanish.

Oronasal Fistula Risk After Palate Repair.

Objective: To assess risk factors for oronasal fistula, including 2-stage palate repair.

Design: Retrospective analysis.

Setting: Tertiary children's hospital.

Association of Allergic Rhinitis With Change in Nasal Congestion in New Continuous Positive Airway Pressure Users.

Importance: Nasal congestion occurring after continuous positive airway pressure (CPAP) treatment initiation impairs CPAP adherence. Allergic rhinitis is associated with worsening nasal congestion in patients who are exposed to nonallergic triggers. Use of CPAP presents potential nonallergic triggers (eg, humidity, temperature, pressure, and airflow).

Family Experience With Pierre Robin Sequence: A Qualitative Study.

Objective: To identify concepts and constructs important to parents of children with Pierre Robin Sequence (PRS).

Design: Qualitative study.

Setting: All children received some care at a tertiary hospital with additional care at outside facilities.

The Case of the Missing Nose: Congenital Arhinia Case Presentation and Management Recommendations.

Objectives: To discuss the presentation and management of infants with arhinia or congenital absence of the nose.

Methods: This case report describes an infant with arhinia that was diagnosed prenatally. In addition to a discussion of the case, a review of the literature was completed to define appropriate postnatal work-up and management.

Brazilian-Portuguese Linguistic Validation of the Velopharyngeal Insufficiency Effects on Life Outcome Instrument.

Background: The purpose of this study was to conduct a linguistic validation of the velopharyngeal insufficiency (VPI) Effects on Life Outcome (VELO) instrument for use in Brazilian-Portuguese patients with VPI.

Methods: The original English version of the VELO instrument was translated into Brazilian-Portuguese, back-translated, and adapted among the Brazilian patients (n = 21) with VPI and their parents, based on the standardized guidelines for the cross-culture adaption process. Discrepancies in the forward and backward translation steps were computed.

Measuring Patient-Reported Health-Related Quality of Life in Velopharyngeal Insufficiency: Reliability and Validity of the Brazilian Portuguese Version of the VELO Instrument.

Objective: To test the Brazilian Portuguese velopharyngeal insufficiency (VPI) Effects on Life Outcome (VELO) instrument for reliability and validity.

Design: Cross-sectional methodological study.

Setting: Tertiary craniofacial medical center.

Spanish Linguistic Validation of the Velopharyngeal Insufficiency Effects on Life Outcomes: VELO-Spanish.

Background: Quality of life (QOL) assessments are useful tools that measure a patient's health status and monitor patient-reported outcome measures. This study highlights the process of linguistic validation of a QOL assessment to serve Spanish-speaking families and ultimately help decrease language barriers in the treatment of velopharyngeal insufficiency (VPI).

Methods: The standardized linguistic validation process included forward and backward translation, reconciliation, and cognitive interviews with patients and families.

Validation of the Chinese Velopharyngeal Insufficiency Effects on Life Outcomes Instrument.

Objectives/hypothesis: To translate the Velopharyngeal Insufficiency Effects on Life Outcomes (VELO) instrument into Chinese and test its psychometric properties.

Study Design: Quality of life instrument translation and validation.

Methods: The original English version of the VELO instrument was translated into Mandarin, back-translated, and adapted among the Chinese population, based on the standardized guidelines for the cross-culture adaption process.

Unilateral Hearing Loss in Youth: Development of Candidate Items for a Condition-Specific Validated Instrument.

Objective: This study interviewed youth with unilateral hearing, utilizing their responses to generate candidate items for a condition-specific patient-reported instrument.

Study Design: Mixed methods, cross-sectional.

Setting: Tertiary care children's hospital.

Lingual tonsillectomy in children with Down syndrome: Is it safe?

Objective: Evaluate peri-operative course and morbidity in children with Down syndrome (DS) who underwent a lingual tonsillectomy (LT) for residual obstructive sleep apnea (rOSA).

Methods: Retrospective case series for children with DS who underwent LT for rOSA from April 2011 to July 2016. Our primary outcomes were length of stay, readmission and complications.

Association of Velopharyngeal Insufficiency With Quality of Life and Patient-Reported Outcomes After Speech Surgery.

Importance: Patients with cleft palate and other causes of velopharyngeal insufficiency (VPI) suffer adverse effects on social interactions and communication. Measurement of these patient-reported outcomes is needed to help guide surgical and nonsurgical care.

Objectives: To further validate the VPI Effects on Life Outcomes (VELO) instrument, measure the change in quality of life (QOL) after speech surgery, and test the association of change in speech with change in QOL.

Anatomic distribution of cervicofacial lymphatic malformations based on lymph node groups.

Objectives: To evaluate radiographic characteristics and to identify locations of cervicofacial lymphatic malformations in children based on known lymph node groupings.

Methods: Retrospective chart review of pediatric patients with cervicofacial lymphatic malformations who underwent imaging with magnetic resonance imaging (MRI), computed tomography (CT) or ultrasonography (US). Ninety charts were reviewed from November 2005 to June 2015.

Change in Quality of Life with Velopharyngeal Insufficiency Surgery.

Objectives: (1) To define the minimal clinically important difference (MCID) of the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) instrument, and (2) to test for the change in quality of life (QOL) after VPI surgery.

Study Design: Prospective observational cohort.

Setting: VPI clinic at a tertiary pediatric medical center.

Validated patient-reported outcome instruments for velopharyngeal insufficiency.

Velopharyngeal insufficiency (VPI) affects speech, swallowing, and many psychosocial aspects of life in a way best measured by quality-of-life (QOL) instruments. QOL instruments are patient-reported outcome instruments that provide a method of measuring the value that patients place on their health-related experiences. These instruments allow us to quantify patients' QOL during assessment as well as the clinical improvement that we seek with treatment.