Three-Dimensional Pharyngeal Airway Changes After Anterior Maxillary Distraction and Conventional Maxillary Distraction in Patients With Unilateral Cleft Lip and Palate

Abstract

Objective

To compare pharyngeal airway changes after anterior maxillary distraction and conventional maxillary distraction in patients with unilateral cleft lip and palate (UCLP).

Design

Retrospective study.

Setting

Tertiary care medical center for cleft care.

Patients

A total of 20 patients with UCLP and hypoplastic maxilla were selected.

Intervention

Group 1 (n = 10): Anterior Maxillary Distraction, Group 2 (n = 10): Conventional maxillary distraction.

Outcome Measures

The primary outcomes assessed on pre- and postsurgical cone beam computed tomography were changes in the nasopharyngeal, oropharyngeal, and total pharyngeal airway area and volume, as well as the minimal axial area. These 2 distraction techniques were compared for their impact on upper airway dimensions.

Results

In Group 1, the nasopharyngeal area increased significantly by 43.60 mm², and the oropharyngeal area decreased by 40.80 mm². There were no significant changes in the volume and area of all the other pharyngeal parameters. In Group 2, the nasopharyngeal area and volume increased by 202.70 mm² and 5.0 cm³, respectively, the oropharyngeal area and volume increased by 176.20 mm² and 7.9 cm³, respectively, the total pharyngeal area and volume increased by 380.50 mm² and 14.0 cm³, respectively, and the minimal axial area increased by 133.50 mm².

Conclusion

Anterior maxillary distraction had a negligible impact on the pharyngeal airway compared to conventional distraction. The choice between these 2 interventions should also take into consideration associated comorbidities related to pharyngeal airway and speech.