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Pediatric Otolaryngology

(111) Concordance of Patient-Reported Resonance Outcomes with Speech Language Pathologist Evaluation

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
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    Presenting Author(s)

  • Emma H. Neal, PhD

    Medical Student
    Vanderbilt University School of Medicine
    Nashville, Tennessee, United States

    • Co-Author(s)

  • HK

    Hannah Kay, MD

    University of Michigan, USA

  • HC

    Heidi Chen, PhD

    Research Associate Professor
    Vanderbilt University Medical Center
    Brentwood, Tennessee, United States

    • Senior Author(s)

  • James Phillips, MD

    Assistant Professor
    Vanderbilt University Medical Center
    Brentwood, Tennessee, United States

Disclosure(s):
Emma H. Neal, PhD: No relevant relationships to disclose.
Heidi Chen, PhD: No relevant relationships to disclose.
James Phillips, MD: No relevant relationships to disclose.


Introduction: Velopharyngeal dysfunction in pediatric patients with a history of oropharyngeal surgeries has previously been shown to negatively impact patient-reported quality-of-life outcomes. This study examines the concordance between Pediatric Voice-Related Quality-of-Life (PVRQOL) Survey outcomes in pediatric patients with a history of cleft lip and/or palate repairs and same-day speech analyses by speech language pathologists (SLPs) in a tertiary, academic practice during the COVID-19 pandemic.

Methods: PVRQOL surveys were administered to 70 pediatric patients during a total of 78 clinical encounters at a tertiary, academic practice between 6/2020 and 3/2021. Chart review was conducted to confirm history of cleft lip and/or palate repair and the age at which repair occurred, if known. Only those patients evaluated by SLPs on the same day as survey administration were included in further analysis. SLPs’ characterization of vocal resonance quality and presence of co-existing articulation disorders were analyzed for concordance with patient-reported quality-of-life outcomes.

Results: Thirty-three clinical encounters met inclusion criteria for analysis. Patients were 64% male, and the average age at the time of initial cleft palate repair was 16 +/- 18 months. Patients were an average age of 5.3 +/- 3.0 years at the time of survey administration. Twenty (61%) encounters were characterized as having broadly normal resonance by SLPs, and 13 (39%) were characterized as having some degree of resonance change or speech alteration. The average total survey score for patients with broadly normal resonance was 84 +/- 17 and 85 +/- 13 for patients with altered resonance (p = 0.79).

Conclusions: Velopharyngeal dysfunction in patients surveyed was not associated with diminished PVRQOL outcomes. These results are a positive deviation from previous studies and motivate future investigation of the factors underpinning these results, including potential differences in palate reconstruction practices, pandemic-related changes in patient-caregiver behavior, and timing and accessibility of speech therapy services.