Diagnosis of 22q11.2 Deletion Syndrome is not Independently Associated with Complications Following Speech Surgery: A National Surgical Quality Improvement Program Pediatric Study.

Document Type

Article

Publication Date

7-2026

Identifier

DOI: 10.1177/10556656251348979

Abstract

Objective Children with 22q11.2 deletion syndrome (22qDS) often experience velopharyngeal insufficiency. We aimed to understand outcomes following speech surgeries in children with 22qDS compared to those without.

Design, Patients, and Outcomes The National Surgical Quality Improvement Program (NSQIP)-Pediatric database from 2013 to 2020 identified patients ≥3 years old who underwent speech surgery. Outcomes included postoperative length of stay (LOS) >2 days and 30-day complications. Descriptive statistics and multivariable logistic regression were performed.

Results Among 3227 patients who underwent speech surgery, 273 (8.5%) had 22qDS. They were more often premature (14.7% vs 10.1%, p =.03) with worse American Society of Anesthesiologists (ASA) classification (class I: 3.3%; class II 48.3%; class III + 48.3% compared to those without 22qDS (24.0%, 62.7%, and 13.3%, respectively) (p < .0001)), with more airway abnormalities (26.7% vs 14.2%, p < .0001), and more cardiac risk factors (56.4% vs 8.5%, p < .0001). On regression analysis, 22qDS diagnosis conferred higher odds of prolonged postoperative LOS (adjusted odds ratio [aOR]: 2.02, 95% confidence interval [CI]: 1.43-2.86). Complications were associated with chronic lung disease (aOR 4.01, 95% CI: 1.46-11.06), surgeon specialty (pediatric otolaryngology vs plastics aOR0.74, 95% CI: 0.46-1.19; other specialty vs plastics aOR 0.43, 95% CI: 0.22-0.85), and ASA classification (class II vs class I aOR 1.11, 95% CI: 0.62-2.01; class III + vs class I aOR 2.30, 95% CI: 1.18-4.50); however, diagnosis of 22qDS was not associated with complications.

Conclusions Children with 22qDS undergoing speech surgery have prolonged postoperative LOS without higher odds of complications. Investigation of contributing factors including protocolization of this patient population is warranted.

Journal Title

The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association

Volume

63

Issue

7

First Page

1847

Last Page

1853

MeSH Keywords

Humans; Female; DiGeorge Syndrome; Child; Postoperative Complications; Male; Quality Improvement; Child, Preschool; Velopharyngeal Insufficiency; Length of Stay; Retrospective Studies; United States; Risk Factors; Databases, Factual

PubMed ID

40509647

Keywords

DiGeorge syndrome; posterior pharyngeal flap; sphincter pharyngoplasty; velocardiofacial syndrome; velopharyngeal dysfunction

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