title: Velopharyngeal changes after maxillary distraction in cleft patients using a rigid external distraction device: A retrospective study.
abstract: OBJECTIVE
  To evaluate early and late velopharyngeal changes in cleft lip and palate (CLP) patients after use of the Rigid External Distractor (RED) device and to correlate these changes to the amount of maxillary advancement.
  
  
  METHODS
  Thirty Class III CLP patients were included in the study. Maxillary advancement was performed using the RED device in combination with titanium miniplates and screws for anchorage. Lateral cephalograms, nasometer, and nasopharyngoscope records were taken before distraction, immediately after distraction, and 1 year after distraction. A paired t-test was used to detect differences at P < .05.
  
  
  RESULTS
  SNA angle and A point and ANS to Y axis were significantly increased after maxillary distraction (P  =  .0001). Statistically significant increases in nasopharyngeal and oropharyngeal depths, velar angle, and need ratio were also found (P  =  .0001). Nasalance scores showed a significant increase (P  =  .008 for nasal text and .044 for oral text). A significant positive correlation was observed between the amount of maxillary advancement and the increase in nasopharyngeal depth and hypernasality (P  =  .012 and .026, respectively).
  
  
  CONCLUSIONS
  Nasopharyngeal function was deteriorated after maxillary advancement in CLP patients. There was a significant positive correlation between the amount of maxillary advancement and the increase in nasopharyngeal depth and hypernasality.
authors.affiliation: Associate Professor, Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
authors.forename: Mahasen
authors.initials: M
authors.lastname: Taha
authors.affiliation: Assistant Professor of Plastic Surgery, Faculty of Medicine, Menuofyia University, Menuofyia, Egypt.
authors.forename: Yasser M
authors.initials: YM
authors.lastname: Elsheikh
mesh_terms: D000293:Adolescent; D002508:Cephalometry; D002971:Cleft Lip / Q000628:therapy*; D002972:Cleft Palate / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla; D019857:Osteogenesis, Distraction; D019340:Osteotomy, Le Fort; D012189:Retrospective Studies; D055815:Young Adult
keywords: Distraction; Hypoplasia; Nasometer; Velopharyngeal