title: Maxillary distraction versus orthognathic surgery in cleft lip and palate patients: effects on speech and velopharyngeal function.
abstract: This clinical randomized controlled trial was performed to compare the effects of distraction osteogenesis (DO) and conventional orthognathic surgery (CO) on velopharyngeal function and speech outcomes in cleft lip and palate (CLP) patients. Twenty-one CLP patients who required maxillary advancement ranging from 4 to 10 mm were recruited and randomly assigned to either CO or DO. Evaluation of resonance and nasal emission, nasoendoscopic velopharyngeal assessment and nasometry were performed preoperatively and at a minimum of two postoperative times: 3-8 months (mean 4 months) and 12-29 months (mean 17 months). Results showed no significant differences in speech and velopharyngeal function changes between the two groups. No correlation was found between the amount of advancement and the outcome measures. It was concluded that DO has no advantage over CO for the purpose of preventing velopharyngeal incompetence and speech disturbance in moderate cleft maxillary advancement.
authors.affiliation: Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China. hdchua@gmail.com
authors.forename: H D P
authors.initials: HD
authors.lastname: Chua
authors.forename: T L
authors.initials: TL
authors.lastname: Whitehill
authors.forename: N
authors.initials: N
authors.lastname: Samman
authors.forename: L K
authors.initials: LK
authors.lastname: Cheung
mesh_terms: D000293:Adolescent; D001860:Bone Plates; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008437:Maxilla / Q000601:surgery*; D009666:Nose / Q000502:physiology; D056948:Orthognathic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods; D013060:Speech / Q000502:physiology*; D013064:Speech Disorders / Q000145:classification; D013065:Speech Intelligibility / Q000502:physiology; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000145:classification; D055158:Velopharyngeal Sphincter / Q000502:physiology*; D014831:Voice / Q000502:physiology; D014833:Voice Quality / Q000502:physiology; D055815:Young Adult