Terence Kwan-Wong

Velopharyngeal Insufficiency Outcomes Prediction Study

Cleft palate is the most common craniofacial disorder. Following cleft palate surgery, 10-40% of patients will develop VPI (velopharyngeal insufficiency). VPI impacts a child’s speech intelligibility and acceptability affecting their education, relationships, and self-image. Two main types of surgery exist for VPI (palate re-repair and pharyngoplasty), and both have been reported with various efficacies at resolving speech, and potential risks of patients developing obstructive sleep apnea. This is a North American multicenter prospective observational study comparing the effectiveness of palate re-repair with pharyngoplasty for the treatment of VPI. The knowledge gained from this study will enable surgeons to select the most effective, least harmful surgical procedure for each patient.

Corneal Neurotization for Neurotrophic Keratopathy in Children: Systematic Review and Case Series

Neurotrophic keratopathy (NK) is a rare degenerative eye disease which results from congenital or acquired dysfunction of the nerves which typically provide corneal sensation. Left untreated, NK can result in corneal breakdown and eventual perforation causing vision loss. Traditionally, NK in the pediatric population has been challenging to treat and has had variable success in slowing or reversing corneal changes. Corneal neurotization has been proposed as a novel treatment for patients with NK that is refractory to traditional medical and surgical treatment, and involves direct neurotization of the cornea through a nerve graft from a normally functioning sensory nerve.

The first portion of this study will consist of a systematic review of the literature to elucidate treatment options available to pediatric patients with NK, and the outcomes of these interventions. The second component of the study will be a retrospective case series examining the treatment and outcomes of pediatric patients with NK who have received care at BCCH over the past five years.

At a high level, the goal of the research is to provide an overview of historical, contemporary, and novel treatment options and outcomes for pediatric NK that can be used to help guide evidence-based treatment for this patient population. At a local level, the results of the study will help identify patterns of treatment for pediatric patients with NK in British Columbia, and also potentially identify patients who would benefit from further treatment with novel surgical procedures. This study will be conducted in collaboration with the Department of Pediatric Ophthalmology.

Honours & Awards

University of British Columbia Division of Pediatric Emergency Off-Service Teacher of the Year (2022)

University of Toronto Division of Pediatric Emergency Medicine James Fallis Teaching Award (2021)

SickKids Smile Honouree for Outstanding Clinical Care (2019)