An Exploratory Analysis of Early Care Differences and Risk of Post-Maxillary Advancement VPI in Individuals With Cleft Palate.

Objective: To investigate whether differences in early cleft care increase risk of velopharyngeal insufficiency (VPI) after maxillary advancement.

Design: Retrospective cohort study.

Setting: Large pediatric tertiary care hospital.

Retrospective Cohort Studies in Craniofacial Outcomes Research: An Epidemiologist's Approach to Mitigating Bias.

Retrospective cohort studies, defined as a follow-up study in which outcome occurred prior to study onset, are common in craniofacial outcomes research and will continue to be prevalent given the increasing availability of secondary datasets and inherent prospective study limitations. However, if available data are not adequately measured, or necessary variables are absent, retrospective cohort studies can be particularly prone to bias. This brief communication aims to highlight the primary sources of bias, including measurement error, selection bias, and confounding.

Characterizing Speech Phenotype in Individuals With Craniofacial Microsomia: A Scoping Review.

Introduction: Craniofacial microsomia (CFM) is a complex congenital condition primarily affecting the ear, mandible, facial nerve and muscles, and tongue. Individuals with CFM are at increased risk of hearing loss, obstructive sleep apnea, and feeding/swallowing difficulties. The purpose of this scoping review was to summarize evidence pertaining to speech production in CFM.

Does Notching Along the Nasal Velar Surface During Nasopharyngoscopy Predict Discontinuity of the Underlying Levator Veli Palatini Muscle?

Unlabelled: To determine the sensitivity and specificity of velar notching seen on nasopharyngoscopy for levator veli palatini (LVP) muscle discontinuity and anterior positioning. Nasopharyngoscopy and MRI of the velopharynx were performed on patients with VPI as part of their routine clinical care. Two speech-language pathologists independently evaluated nasopharyngoscopy studies for the presence or absence of velar notching.

Characterising the speech phenotype in individuals with craniofacial microsomia: a scoping review protocol.

Introduction: Asymmetric mandibular hypoplasia, microtia, tongue and laryngeal anomalies, and soft palate and facial nerve dysfunction are clinical features observed in children with craniofacial microsomia (CFM). Despite involvement of all these structures in hearing and speech, there is limited evidence reporting speech outcomes in this population. Systematic reviews of clinical and surgical interventions related to CFM have been published, but no methodological review of speech outcomes exists.

Sphincter Pharyngoplasty for Velopharyngeal Dysfunction: Impact of 22q11.2 Deletion Syndrome.

Objective: Patients with 22q11.2 deletion syndrome (22q11DelS) often present with velopharyngeal dysfunction (VPD). VPD in patients with 22q11DelS is multifactorial beyond velopharyngeal insufficiency (VPI) alone, and differences in surgical outcomes are poorly understood.

Does Distraction Lower Risk of VPI Compared to Conventional Maxillary Advancement? A Retrospective Cohort Study of Adolescents with Cleft Palate.

Objective: To determine whether method of maxillary advancement in adolescents with cleft palate with or without cleft lip (CP ± L) influences post-operative velopharyngeal function.

Design: Retrospective cohort.

Setting: Pediatric Tertiary Care Hospital.

Home Language Environment of Children With Orofacial Clefts as a Target for Intervention.

Objective: To evaluate the home language environment (HLE) in children with orofacial clefts as a potential modifiable target for language and literacy intervention.

Design: Feasibility study examining longitudinal trends in HLE and responses to parent-focused literacy intervention.

Setting: Tertiary care children's hospital.

Cognitive, Motor, and Language Development of Preschool Children With Craniofacial Microsomia.

Objective: To examine neurodevelopment in preschool-aged children with craniofacial microsomia (CFM) relative to unaffected peers.

Design: Multisite, longitudinal cohort study.

Setting: Tertiary care centers in the United States.

Speech Outcomes After Sphincter Pharyngoplasty for Velopharyngeal Insufficiency.

Objectives/hypothesis: To investigate perceptual speech outcomes following sphincter pharyngoplasty (SP) and to identify patient characteristics associated with velopharyngeal insufficiency (VPI) resolution or improvement.

Methods: Retrospective review of prospectively collected data was performed of consecutive patients that underwent SP for management of VPI between 1994 and 2016 at a single tertiary care pediatric hospital. Demographic data, nasendoscopic findings, and speech characteristics were recorded using a standardized protocol.

Crowdsourcing to Assess Speech Quality Associated With Velopharyngeal Dysfunction.

Objective: To assess crowdsourced responses in the evaluation of speech outcomes in children with velopharyngeal dysfunction (VPD).

Design: Fifty deidentified speech samples were compiled. Multiple pairwise comparisons obtained by crowdsourcing were used to produce a rank order of speech quality.

Behavioral Adjustment of Preschool Children With and Without Craniofacial Microsomia.

Objective: The study aim was to assess behavioral adjustment in preschool children with and without craniofacial microsomia (CFM).

Design: Multisite cohort study of preschoolers with CFM ("cases") or without CFM ("controls").

Participants: Mothers (89%), fathers (9%), and other caregivers (2%) of 161 preschoolers.

Speech, Language, and Communication Skills of Adolescents With Craniofacial Microsomia.

Purpose Youth with craniofacial microsomia (CFM) have anomalies and comorbidities that increase their risk for speech, language, and communication deficits. We examined these outcomes in youth with and without CFM and explored differences as a function of CFM phenotype and hearing status. Method Participants included youth ages 11-17 years with CFM ( = 107) and demographically similar controls ( = 306).

Methods and Challenges in a Cohort Study of Infants and Toddlers With Craniofacial Microsomia: The Clock Study.

Objective: The Craniofacial microsomia: Longitudinal Outcomes in Children pre-Kindergarten (CLOCK) study is a longitudinal cohort study of neurobehavioral outcomes in infants and toddlers with craniofacial microsomia (CFM). In this article, we review the data collection and methods used to characterize this complex condition and describe the demographic and clinical characteristics of the cohort.

Setting: Craniofacial and otolaryngology clinics at 5 study sites.

Speech and Surgical Outcomes in Children With Veau Types III and IV Cleft Palate: A Comparison of Internationally Adopted and Nonadopted Children.

Objective: This study compares speech and surgical outcomes in internationally adopted and nonadopted patients undergoing cleft palate repair, and examines the influence of age at initial palatoplasty.

Design: Retrospective cohort study setting: Tertiary Care Children's Hospital.

Patients: 70 international adoptees and 211 nonadoptees with Veau type III and IV clefts (without associated syndrome) repaired at our institution.

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.

Cleft palate repair and velopharyngeal dysfunction.

Learning Objectives: After studying this article, the participant should be able to: (1) Describe the technical details common to all cleft palate repairs that optimize outcomes and minimize complications. (2) Explain the subjective and objective evaluation of speech in children with cleft palate. (3) Practice with an increased awareness of the management of complications associated with cleft palate repair.

Modification and evaluation of a Velopharyngeal Insufficiency Quality-of-Life instrument.

Objectives: To modify the existing 45-item Velopharyngeal Insufficiency (VPI) Quality-of-Life (QOL) instrument (VPIQL), to assess the modified instrument for reliability, and to provide further validation.

Design: Validation convenience sample from a previously conducted pilot study.

Setting: Two academic tertiary referral medical centers.