Effect of Maxillary Advancement on Velopharyngeal Function

Abstract

The purpose of this study was to examine the effect of maxillary advancement by Le Fort I osteotomy on velopharyngeal function, in patients with cleft lip and palate (CL/CP), and in patients with non-CL/CP. A total of 15 patients (8 CL/CP patients and 7 non-CL/CP patients) were studied according to three headings, as follows, at 6 moths postoperatively.
1. Measurement of the amount of advancement at the standard point on the nasal side of the soft palate (NSP ), by lateral cephalograms at the rest position.
2. The contact pattern of the soft palate and the posterior pharyngeal wall, on lateral cephalograms, at pronunciation of (a: ), (i: ), and (∫: ).
3. Evaluation of velopharyngeal function by a speech therapist.
The results were as follows;
1. The ratio of the advancement of NSP to the maxillary advancement was 31 % in the CL/CP group, and 46% in the non-CL/CP group. There was no significant difference between the two groups.
2. Aggravation was seen in 5 out of 8 patients of the CL/CP group after surgery according to the contact pattern of the soft palate and the posterior pharyngeal wall. However, no change was seen in the patients of the non-cleft group.
3. One out of 8 patiets in the CL/CP group showed aggravation of velopharyngeal function in the evaluation by the speech therapist. However, no patient showed aggravation in the non-CL/CP group.