Morphological evaluation of changes in velopharyngeal function following maxillary distraction in patients with repaired cleft palate during mixed dentition.
OBJECTIVE
To describe the morphological changes of nasopharyngeal components after maxillary distraction and clarify whether the morphological characteristics are related to velopharyngeal function (VPF).


METHODS
Perceptual judgments of hypernasality and nasendoscopy were performed before and after treatment. Lateral cephalograms were obtained to describe the morphological changes.


METHODS
Department of Oral and Maxillofacial Surgery, Miyazaki Medical College, Miyazaki, Japan.


METHODS
Nine patients with repaired cleft palate in the mixed dentition stage underwent maxillary distraction using a face mask and an intraoral fixed appliance system.


METHODS
The severity of hypernasality, velopharyngeal insufficiency, and measurements such as pharyngeal depth, velar length, and the rotation of the palatal plane were evaluated.


RESULTS
Increase in pharyngeal depth was not always proportional to the amount of advancement. It depended on the posture of the posterior pharyngeal wall and the rotation of palatal plane.


CONCLUSIONS
Cephalometric measurements of the nasopharynx before and after surgery confirmed subsequent changes in VPF. These were suggested to be useful in predicting future VPF. When performing maxillary distraction in patients with cleft palate in the mixed dentition stage, and when velopharyngeal closure is found to occur by velar contact against the hypertrophied adenoid, patients should be counseled about risks of subsequent deterioration in their speech before surgery.
Satoh
Koichi
K
Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kitakyushu, Japan. satoh@kyu-dent.ac.jp
Nagata
Junko
J
Shomura
Kenji
K
Wada
Takeshi
T
Tachimura
Takashi
T
Fukuda
Jinichi
J
Shiba
Ryosuke
R
D000234:Adenoids / Q000473:pathology; D002508:Cephalometry; D002648:Child; D002971:Cleft Lip / Q000150:complications; D002972:Cleft Palate / Q000150:complications; D003818:Dentition, Mixed; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008844:Micrognathism / Q000209:etiology / Q000601:surgery*; D009305:Nasopharynx / Q000473:pathology; D019857:Osteogenesis, Distraction / Q000009:adverse effects*; D019340:Osteotomy, Le Fort / Q000009:adverse effects* / Q000379:methods; D010160:Palate, Soft / Q000473:pathology; D014681:Velopharyngeal Insufficiency / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D014832:Voice Disorders / Q000209:etiology