title: Craniofacial structure variations in patients with palatal anomalies and velopharyngeal dysfunction.
abstract: OBJECTIVE
  Cephalometric evaluation of craniofacial and craniopharyngeal morphology is important for understanding the factors affecting velopharyngeal dysfunction (VPD) in patients with palatal anomalies.
  
  
  METHODS
  In this study, 366 patients with VPD were retrospectively stratified into cleft lip and palate (CLP), cleft palate (CP), submucous cleft palate (SMCP), occult submucous cleft palate (OSMCP), and non-CP groups. Lateral cephalometrics were used to assess craniofacial, craniopharyngeal, and velopharyngeal anatomy.
  
  
  RESULTS
  The average craniofacial morphology in patients with VPD differed significantly according to the type of palatal anomaly. The non-CP and OSMCP groups differed from the CLP, CP, and SMCP groups in nasopharyngeal size and shape as depicted by a larger ANS-Ptm-Ve angle, a smaller S-N-Ba and NBa-PP angles, and a shorter linear value of S-Ar in the non-CP group. The CLP and CP groups had shorter ANS-Ptm, shorter Ptm-P, and smaller SNA and SNB angles.
  
  
  CONCLUSIONS
  VPD patients with overt clefts have different skeletal and nasopharyngeal shapes compared to non-CP and OSMCP. Velopharyngeal function assessment should include the size and shape of the nasopharyngeal space in addition to the size and the activity of the velum and posterior and lateral walls of the nasopharynx. This should enable a more precise understanding of VPD pathology, and lead to improvements in the posterior pharyngeal flap technique in order to obtain better postoperative speech outcomes after surgical management of velopharyngeal dysfunction.
authors.affiliation: The Center for Cleft Palate and Craniofacial Anomalies, Department of Otolaryngology - Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel; Communication Disorders Faculty, Hadassah Academic College, Jerusalem, Israel.
authors.forename: Ariela
authors.initials: A
authors.lastname: Nachmani
authors.affiliation: Orthodontic and Craniofacial Center, Rambam Health Care Campus, and The Technion - Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Dror
authors.initials: D
authors.lastname: Aizenbud
authors.affiliation: The Center for Cleft Palate and Craniofacial Anomalies, Department of Otolaryngology - Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel; Department of Otolaryngology - Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ben
authors.initials: B
authors.lastname: Nageris
authors.affiliation: Department of Oral and Maxillofacial, Rambam Health Care Campus, and The Technion - Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Omri
authors.initials: O
authors.lastname: Emodi
authors.affiliation: The Center for Cleft Palate and Craniofacial Anomalies, Department of Otolaryngology - Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel; Department of Otolaryngology - Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: kassemfiras@gmail.com.
authors.forename: Firas
authors.initials: F
authors.lastname: Kassem
mesh_terms: D000293:Adolescent; D000328:Adult; D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000473:pathology*; D002972:Cleft Palate / Q000473:pathology*; D005147:Facial Bones / Q000002:abnormalities / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D010159:Palate / Q000002:abnormalities / Q000473:pathology; D012189:Retrospective Studies; D013064:Speech Disorders / Q000473:pathology; D014681:Velopharyngeal Insufficiency / Q000473:pathology* / Q000503:physiopathology; D055815:Young Adult
keywords: Cephalometry; Cleft lip and palate; Craniofacial morphology; Occult submucous cleft palate; Velopharyngeal dysfunction