BACKGROUND AND PURPOSE: The effects of maxillary advancement (MA) on velopharyngeal anatomy have been previously studied by means of cephalometric analysis.1 The purpose of this study is to compare the pre- and postoperative velopharyngeal port configuration modifications as measured on computerized tomographic scans. Changes in velopharyngeal function (VPF) as evaluated by perceptual speech assessments are also discussed.
METHODS: This was a retrospective cohort study of 44 patients with and without cleft lip and palate who were treated with MA for midface hypoplasia and secondary malocclusion at skeletal maturity. Pre- and postoperative computerized tomographic images were compared with respect to pre-established landmarks by 2 independent evaluators. Perceptual speech assessments were completed pre- and postoperatively.
RESULTS: Of the linear distances computed, the differences in the pre- and postoperative measures of the narrowest part of the nasopharynx, the narrowest part of the retropalatal airway space, and the retropalatal anteroposterior distance were statistically significant (P < 0.05). The retropalatal cross-sectional areas (pre: 129.82 ± 102.12 mm2 versus post: 145.65 ± 99.90 mm2), the nasopharyngeal cross-sectional areas (pre: 375.16 ± 120.58 mm2 versus post: 370.38 ± 142.61 mm2), and the volumetric assessment of the nasopharyngeal space (pre: 4.06 ± 2.26 cm3 versus post: 4.34 ± 2.35 cm3) showed no statistically significant difference (P < 0.05). There was no change in VPF following MA as reported by perceptual speech assessment.
CONCLUSION: Our results support the belief that although some structural modifications of the pharyngeal port are inherent to MA in cleft lip and palate patients, its surface area and its volume do not seem to change significantly. These modifications do not seem to impact VPF.
1. Aksu M, Taner T, Sahin-Veske P, et al. Pharyngeal airway changes associated with maxillary distraction osteogenesis in adult cleft lip and palate patients. J Oral Maxillofac Surg. 2012;70:e133–e140.