title: Changes in speech following maxillary distraction osteogenesis.
abstract: OBJECTIVE
  The purpose of this study was to describe changes in articulation and velopharyngeal function following maxillary distraction osteogenesis.
  
  
  METHODS
  This is a descriptive, post hoc clinical report comparing the performance of patients before and after maxillary distraction. The independent variable was maxillary distraction while the dependent variables were resonance, articulation errors, and velopharyngeal function.
  
  
  METHODS
  The data were collected at a tertiary health care center in Chicago.
  
  
  METHODS
  The data from pre- and postoperative evaluations of 18 maxillary distraction patients were used.
  
  
  METHODS
  The outcome measures were severity of hypernasality and hyponasality, velopharyngeal orifice size as estimated using the pressure-flow technique, and number and type of articulation errors.
  
  
  RESULTS
  At the long-term follow-up, 16.7% exhibited a significant increase in hypernasality. Seventy-five percent of patients with preoperative hyponasality experienced improved nasal resonance. Articulation improved in 67% of patients by the 1-year follow-up.
  
  
  CONCLUSIONS
  In a predominately cleft palate population, the risk for velopharyngeal insufficiency following maxillary distraction is similar to the risk observed in Le Fort I maxillary advancement. Patients being considered for maxillary distraction surgery should receive pre- and postoperative speech evaluations and be counseled about risks for changes in their speech.
authors.affiliation: Department of Speech Pathology and Audiology, Marquette University, Milwaukee, Wisconsin 53201-1881, USA. guyette@vms.csd.mu.edu
authors.forename: T W
authors.initials: TW
authors.lastname: Guyette
authors.forename: J W
authors.initials: JW
authors.lastname: Polley
authors.forename: A
authors.initials: A
authors.lastname: Figueroa
authors.forename: B E
authors.initials: BE
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000403:Airway Resistance; D001184:Articulation Disorders / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000150:complications / Q000601:surgery; D002972:Cleft Palate / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D015588:Observer Variation; D019647:Oral Surgical Procedures / Q000009:adverse effects; D019857:Osteogenesis, Distraction / Q000009:adverse effects; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000209:etiology* / Q000473:pathology; D014832:Voice Disorders / Q000209:etiology