Abnormal soft palate movements in patients with microtia

Publication date: Available online 25 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): M.N. Kolodzynski, BTJA van Hoorn, M. Kon, C.C. Breugem
IntroductionMicrotia is a congenital malformation of the auricle, ranging in severity. It can be isolated or associated with (craniofacial) anomalies. Most of these anomalies together are described as being part of the oculo-auriculo-vertebral spectrum (OAVS). Velar abnormalities have been described to occur in patients with OAVS, however the incidence in patients with microtia without OAVS is largely unknown. The primary purpose of this study was to examine the prevalence of velar palsy in patients with isolated microtia, and in patients with microtia and signs of OAVS. The secondary purpose was to identify possible risk factors associated with the presence of velar palsy.MethodsAll patients with microtia presented to our department between January 2015 and March 2017 were retrospectively reviewed. Medical images, information of the palate and demographics were subtracted from the patients' medical files.ResultsVelar palsy was present in 18 out of 42 patients with isolated microtia (43%; no signs of OAVS), and in 33 out of 41 patients with microtia and signs of OAVS (80%). Patients with signs of OAVS were found to be independently associated with a higher prevalence of velar palsy (OR: 4.8; 95% CI: 1.7 to 13).ConclusionThis study demonstrates a clear relationship of abnormal velar movement and microtia. We believe that isolated microtia should not be seen as a separate entity but as a part of OAVS. Abnormal velar movement can lead to velopharyngeal insufficiency (VPI), which can affect children's speech development. Physicians should exam the palate in all microtia patients, not only those with speech difficulties.