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Changes in speech following maxillary distraction osteogenesis.
T W Guyette1, J W Polley, A Figueroa
1Department of Speech Pathology and Audiology, Marquette University, Milwaukee, Wisconsin 53201-1881, USA. guyette@vms.csd.mu.edu
Summary
Maxillary distraction osteogenesis can alter speech, potentially increasing hypernasality in some patients. However, many experience improved nasal resonance and articulation, highlighting the need for speech evaluations post-surgery.
Area of Science:
- Craniofacial surgery
- Speech pathology
- Maxillofacial reconstruction
Background:
- Maxillary distraction osteogenesis (MDO) is a surgical technique to lengthen the maxilla.
- Changes in velopharyngeal function and articulation are potential outcomes of MDO.
Purpose of the Study:
- To describe changes in articulation and velopharyngeal function after MDO.
- To assess the impact of MDO on speech resonance and clarity.
Main Methods:
- A descriptive, post hoc clinical report analyzing pre- and postoperative data from 18 MDO patients.
- Outcome measures included hypernasality, hyponasality, velopharyngeal orifice size (pressure-flow technique), and articulation errors.
Main Results:
- 16.7% of patients showed increased hypernasality at long-term follow-up.
- 75% of patients with preoperative hyponasality improved.
- Articulation improved in 67% of patients by 1 year post-surgery.
Conclusions:
- The risk of velopharyngeal insufficiency after MDO is comparable to Le Fort I advancement, especially in cleft palate patients.
- Pre- and postoperative speech evaluations and counseling are crucial for patients undergoing MDO.