Alterations in velopharyngeal function after maxillary advancement in cleft palate patients

Area of Science:

• Craniofacial Surgery
• Speech Pathology
• Pediatric Otolaryngology

Background:

• Velopharyngeal dysfunction (VPD) is a common concern in cleft palate patients.
• Maxillary advancement is a surgical procedure used to correct midface hypoplasia in these patients.
• The impact of maxillary advancement on velopharyngeal function requires further investigation.

Purpose of the Study:

• To assess the effect of maxillary advancement on velopharyngeal function in cleft palate patients.
• To identify factors associated with changes in velopharyngeal function post-surgery.

Main Methods:

• Aerodynamic assessment of velopharyngeal function was performed before and at least 1 year after surgery.
• 24 cleft palate patients who underwent maxillary advancement were included.
• Patient records were reviewed for surgical details, including pharyngeal flap presence.

Main Results:

• Velopharyngeal function improved in 23% of patients and deteriorated in 23%.
• Improved function was associated with the presence of a pharyngeal flap.
• Deterioration occurred primarily in patients with adequate or borderline adequate pre-operative velopharyngeal function.
• No correlation was found between the extent of maxillary advancement and velopharyngeal function changes.

Conclusions:

• Maxillary advancement can lead to variable changes in velopharyngeal function in cleft palate patients.
• The presence of a pharyngeal flap may be a positive prognostic indicator for velopharyngeal function post-surgery.
• Pre-operative velopharyngeal status is a critical factor in predicting post-operative outcomes.