Materne Grace, Disler Emily R, Scott Andrew R, Marston Alexander P
Otolaryngology - Head and Neck Surgery, Tufts University School of Medicine, Boston, USA.
General Surgery, Lahey Hospital & Medical Center, Burlington, USA.
Cureus. 2024 Sep 11;16(9):e69176. doi: 10.7759/cureus.69176. eCollection 2024 Sep.
Introduction Velopharyngeal insufficiency (VPI) and craniofacial differences can lead to diminished speech and swallowing function resulting in communication and social challenges throughout childhood. To monitor changes in patients' psychosocial health and velopharyngeal function, the Pediatric Symptom Checklist (PSC) and Velopharyngeal Insufficiency Effects on Life Outcomes (VELO) survey tools can be utilized. This study aimed to investigate the relationship between VPI quality-of-life outcomes and psychosocial disturbances through a comparative analysis of PSC and VELO parental surveys among children followed by a craniofacial team. Methods A retrospective chart review was completed using data from a single, multidisciplinary cleft and craniofacial team. Previously completed parental survey responses between 2010 and 2022 were collated and results were analyzed using a Spearman's rank correlation test (r). Results There were 89 subjects who completed both surveys on the same day (n = 148 survey pairs (s)). Patients aged three to five years old (s = 88) had a mean VELO of 17.9 (0-65) and a mean PSC of 7.9 (0-27), while patients aged six to eight years old (s = 60) had a mean VELO of 16.6 (0-74) and a mean PSC of 12.0 (0-37). The strongest correlation observed for both age groups was between the total PSC and VELO Speech Limitations sub-scores (three to five years old: r = 0.537, p < 0.001; six to eight years old: r = 0.330, p = 0.010). Similarly, children in the six- to eight-year-old group with cleft lip and palate showed a correlation between the total PSC and VELO Speech Limitations (r = 0.583, p < 0.001). Conclusion This study suggests a relationship between PSC and VELO scores among children ages three to eight years old with cleft differences and demonstrates that specific domains within the VELO questionnaire should be considered as being associated with a higher risk for psychosocial impairment. Specifically, higher VELO Speech Limitations sub-scores may portend a greater risk for poor psychosocial outcomes supporting the importance of early interventions in this group.
引言 腭咽功能不全（VPI）和颅面差异可导致言语和吞咽功能受损，在整个儿童期造成沟通和社交方面的挑战。为监测患者心理社会健康和腭咽功能的变化，可使用儿童症状清单（PSC）和腭咽功能不全对生活结局的影响（VELO）调查工具。本研究旨在通过对颅面团队随访的儿童中PSC和VELO家长调查问卷进行比较分析，探讨VPI生活质量结局与心理社会障碍之间的关系。
方法 使用来自一个单一的多学科腭裂和颅面团队的数据完成回顾性病历审查。整理2010年至2022年期间之前完成的家长调查问卷回复，并使用Spearman等级相关检验（r）分析结果。
结果 有89名受试者在同一天完成了两项调查（n = 148对调查）。三至五岁的患者（n = 88）的平均VELO为17.9（0 - 65），平均PSC为7.9（0 - 27），而六至八岁的患者（n = 60）的平均VELO为16.6（0 - 74），平均PSC为12.0（0 - 37）。两个年龄组中观察到的最强相关性是在PSC总分与VELO言语限制子分数之间（三至五岁：r = 0.537，p < 0.001；六至八岁：r = 0.330，p = 0.010）。同样，六至八岁唇腭裂组儿童的PSC总分与VELO言语限制之间存在相关性（r = 0.583，p < 0.001）。
结论 本研究表明，三至八岁有腭裂差异的儿童中PSC和VELO分数之间存在关联，并表明VELO问卷中的特定领域应被视为与心理社会损害的较高风险相关。具体而言，较高的VELO言语限制子分数可能预示着心理社会不良结局的更大风险，支持对该组进行早期干预的重要性。
