Velopharyngeal function following maxillary advancement.

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Speech Pathology

Background:

• Patients with craniofacial dysostosis often present with velopharyngeal dysfunction.
• Cleft palate patients are at higher risk for velopharyngeal incompetence after surgery.
• Distinct anatomical features in craniofacial dysostosis may protect the velopharyngeal mechanism.

Purpose of the Study:

• To evaluate the effect of maxillary advancement on velopharyngeal function in patients with craniofacial dysostosis.
• To assess changes in nasopharyngeal volume and velopharyngeal contact post-surgery.
• To identify any resulting speech articulation changes.

Main Methods:

• Cephalometric analysis of 40 patients undergoing maxillary advancement.
• Phonating cephalograms to assess velopharyngeal function.
• Clinical evaluation of speech articulation.

Main Results:

• No instances of velopharyngeal incompetence were observed in the study group.
• Hyponasality resolved in 5 patients with Crouzon's disease.
• Cephalometric studies showed increased nasopharyngeal volume and a wider hard and soft palate angle.
• Phonating cephalograms indicated more physiological velopharyngeal contact post-advancement.
• The primary articulation change noted was in /s/ sound production.

Conclusions:

• Maxillary advancement is a safe procedure regarding velopharyngeal function in craniofacial dysostosis.
• The surgery can improve nasopharyngeal dimensions and speech quality.
• Dentoalveolar changes, particularly affecting /s/ sounds, are the main articulatory sequelae.