Velopharyngeal changes after maxillary distraction in cleft patients using a rigid external distraction device: A...

Area of Science:

• Craniofacial surgery
• Speech pathology
• Orthodontics

Background:

• Cleft lip and palate (CLP) significantly affects facial growth and speech.
• Maxillary hypoplasia is common in Class III CLP patients.
• Surgical correction often involves maxillary advancement.

Purpose of the Study:

• To assess velopharyngeal changes after Rigid External Distractor (RED) device use in CLP patients.
• To correlate these velopharyngeal changes with the extent of maxillary advancement.

Main Methods:

• Thirty Class III CLP patients underwent maxillary advancement with the RED device.
• Lateral cephalograms, nasometry, and nasopharyngoscopy were used for evaluation.
• Data collected pre-distraction, immediately post-distraction, and 1 year later.

Main Results:

• Significant increases in SNA, A point, and ANS to Y axis observed post-advancement.
• Increased nasopharyngeal and oropharyngeal depths, velar angle, and need ratio noted.
• Higher nasalance scores and a positive correlation between advancement and nasopharyngeal depth/hypernasality.

Conclusions:

• Maxillary advancement in CLP patients using the RED device can impair nasopharyngeal function.
• Increased maxillary advancement is associated with greater nasopharyngeal depth and hypernasality.