Effect of maxillary distraction osteogenesis on velopharyngeal function: A pilot study

• Published in: Oral surgery, oral medicine, oral pathology, oral radiology and endodontics Vol. 93; no. 5; pp. 538 - 543
• Main Authors: Harada, Kiyoshi, Ishii, Yoshimasa, Ishii, Masatoshi, Imaizumi, Humiko, Mibu, Michiko, Omura, Ken
• Format: Journal Article
• Language: English
• Published: St. Louis, MO Mosby, Inc 01.05.2002; Elsevier
• Subjects: Biological and medical sciences; Cephalometry; Cleft Lip - surgery; Cleft Palate - surgery; Dentistry; Female; Follow-Up Studies; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Infant; Male; Maxilla - pathology; Maxilla - surgery; Maxillofacial surgery. Dental surgery. Orthodontics; Medical sciences; Nasal Bone - pathology; Nasopharynx - pathology; Osteogenesis, Distraction - instrumentation; Osteogenesis, Distraction - methods; Osteotomy, Le Fort - methods; Palate, Soft - pathology; Palate, Soft - physiopathology; Pharynx - pathology; Pharynx - physiopathology; Phonetics; Pilot Projects; Speech - physiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Human; Palatine velum; Motility; Prognosis; Stomatology; Maxillary; Cleft; Congenital disease; Pharynx; Malformation; Efficiency; Distraction; Oral cavity disease; Palate; Child; Osteogenesis
• ISSN: 1079-2104; 1528-395X
• DOI: 10.1067/moe.2002.123827

Objective. The purpose of this study was to examine preoperative and postoperative changes of velopharyngeal function in cleft patients who underwent maxillary distraction osteogenesis using the Rigid External Distraction System. Study Design. Six cleft patients followed for a minimum of 12 months after maxillary distraction were examined. Plain and contrast lateral-cephalograms were obtained preoperatively and postoperatively, and speech evaluation was performed by the same authorized speech therapist at the same time points. Results. The mean distraction amount at the anterior nasal spine was 11.7 mm (range, 7.4 mm - 15.0 mm). Both the nasopharyngeal depth and velar length increased after maxillary distraction, but the need ratio (nasopharyngeal depth/velar length) also increased after distraction. Although scores for velopharyngeal closure dropped a few points after maxillary distraction, the rating for hypernasality remained unchanged in all patients but the patient whose distraction amount was 15.0 mm. Conclusion. These results suggest that maxillary distraction of less than 15 mm may not markedly affect velopharyngeal function in cleft patients. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:538-43)