Is there a contraindication for a flap and would an obturator be helpful for children with 22q.11 who also have cardiac and oxygen needs?
Pharyngeal flaps for surgery continue to be the most commonly done surgery for treatment of VPD in children with 22q. Some centers tend to believe that this has a higher success rate than other surgical options. We do pharyngeal flaps on children with history of cardiac defects all the time. As with any surgery, the physicians have to get clearance from the cardiology providers in order to proceed. Often we will get a sleep study on patients if they have any airway concerns prior to the procedure. In fact many places will actually have tonsils and adenoids removed before pharyngeal flap surgery to help lessen the risk of further airway obstruction. We know with any pharyngeal flap surgery there is always (although small) a risk of obstructive sleep apnea. In terms of speech prostheses - we do not routinely use these but I do think that they are a good treatment option for children who cannot have surgery or where families do not want surgery for their child. I think you need to have them made by a prosthodontist who is extremely patient with challenging pediatric patients. And often it is a palatal lift that is the better fit as opposed to an obturator because many of them do have enough palate tissue it just doesn't move as well.
Adriane Baylis, Ph.D., CCC-SLP, is Speech Scientist and Speech-Language Pathologist for the Section of Plastic and Reconstructive Surgery at Nationwide Children's Hospital (Columbus, OH). Dr. Baylis serves as Co-Director of the 22q Center at Nationwide Children’s Hospital and also provides clinical services to the Cleft Lip and Palate Center.
This course is for the SLP with limited background in head & neck cancer who needs to develop basic clinical management skills. The discussion focuses on medical/surgical treatments; anatomic changes; alterations of respiration, and speech and communication options. Understanding the functional consequences of larynx removal is emphasized.
This course is designed to give attendees the basic understanding of what tracheoesophageal (TE) voice restoration is and the role of the SLP in the rehabilitation process. Other topics to be reviewed are: determining who is a candidate, sizing the TE tract, the various types of TE voice prostheses and how they are placed, considerations for prosthesis selection, and how to initiate voice rehabilitation.
Speech and voice deficits in people with Parkinson’s disease have been well-documented perceptually and with objective measures. This course will discuss interventions that have demonstrated clinical efficacy for improving speech in people with Parkinson’s disease. Discussion of cases will follow with a focus on treatment planning.
This course is designed for clinicians with varying levels of experience working with tracheostomy tubes. Indications for, and methodologies used to perform a tracheotomy, as well as applications for various trach styles, sizes, features, and communication options will be discussed. Best practices in assessment and treatment will be emphasized including documentation, subglottic suction, manometry, and upper airway auscultation. Unique perspectives and tips for practitioners will also be shared by a trach user.
(This is the 1st course in a 4-part series, SSD in Children with Cleft Palate and/or VPD.) This course will review the primary components involved in assessing speech sound disorders in children with cleft palate and/or velopharyngeal dysfunction (VPD). Functional tools/techniques will be highlighted with the goal of determining when speech therapy is beneficial and when further medical referrals are necessary.