title: Impact of 22q deletion syndrome on speech outcomes following primary surgery for submucous cleft palate.
abstract: BACKGROUND
  Patients with 22q deletion syndrome are at increased risk of submucous cleft palate and velopharyngeal insufficiency. The authors' aim is to evaluate speech outcomes following primary Furlow palatoplasty or pharyngeal flap for correction of velopharyngeal insufficiency in submucous cleft palate patients with and without 22q deletion syndrome.
  
  
  METHODS
  Records of submucous cleft palate patients who underwent primary surgery between 2001 and 2010 were reviewed. Data included 22q deletion syndrome diagnosis, age at surgery, procedure, preoperative nasopharyngoscopy and nasometry, speech outcomes, complications, and secondary surgery rates.
  
  
  RESULTS
  Seventy-eight submucous cleft palate patients were identified. Twenty-three patients had 22q deletion syndrome. Fewer 22q deletion syndrome patients obtained normal resonance on perceptual assessment compared with nonsyndromic patients (74 percent versus 88 percent). A similar difference existed based on postoperative nasometric scores. Among 22q deletion syndrome patients, similar success rates were achieved with Furlow palatoplasty and pharyngeal flap. No difference in the proportion improved postoperatively was noted between 22q deletion syndrome and nonsyndromic groups. One complication was experienced per group. More revision operations were indicated in the 22q deletion syndrome group (17 percent) compared with the nonsyndromic group (4 percent). Median times to normal resonance for 22q deletion syndrome and nonsyndromic patients were 150 weeks and 34 weeks, respectively. Adjusting for multiple variables, 22q deletion syndrome patients were 3.6 times less likely to develop normal resonance.
  
  
  CONCLUSIONS
  Careful selection of Furlow palatoplasty or pharyngeal flap for primary repair of submucous cleft palate is highly effective in 22q deletion syndrome patients and yields results approaching those of nonsyndromic patients.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Halifax, Nova Scotia, and Toronto, Ontario, Canada From the IWK Health Center, Division of Plastic and Reconstructive Surgery, Dalhousie University; the Department of Speech Language Pathology, The Hospital for Sick Children; and the Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, University of Toronto.
authors.forename: Michael
authors.initials: M
authors.lastname: Bezuhly
authors.forename: Simone
authors.initials: S
authors.lastname: Fischbach
authors.forename: Paula
authors.initials: P
authors.lastname: Klaiman
authors.forename: David M
authors.initials: DM
authors.lastname: Fisher
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002872:Chromosome Deletion; D002892:Chromosomes, Human, Pair 22 / Q000235:genetics*; D002972:Cleft Palate / Q000235:genetics* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009061:Mouth Mucosa; D012189:Retrospective Studies; D013060:Speech; D013577:Syndrome; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000235:genetics* / Q000601:surgery*