Velopharyngeal Structure Changes in Cleft Lip and Palate Patients: Anterior Maxillary Segmental Distraction Osteogenesis Versus Total Maxillary Distraction Osteogenesis

Abstract

Objective

This study aimed to compare velopharyrngeal structure in patients with cleft lip and palate following anterior maxillary segmental distraction osteogenesis (AMSDO) or total maxillary distraction osteogenesis (TMDO).

Design

Retrospective cohort study.

Setting

Affiliated Hospital of College of Stomatology, Guangxi Medical University.

Participants

A total of 18 patients with cleft lip and palate were selected.

Interventions

Anterior maxillary segmental distraction osteogenesis (N = 9) and Total maxillary distraction osteogenesis (N = 9)

Main Outcome Measures

Lateral cephalograms were obtained and the indices of velopharyngeal configuration were measured before distraction (T1) and after distraction (T2).

Results

The distance of maxillary advancement increased significantly after distraction osteogenesis in both groups, but the difference was not statistically significant. Although nasopharyngeal depth, velar length, velar angle and need ratio increased after both surgeries, these measurements were significantly larger only in TMDO group. Nasopharyngeal depth, velar length, velar angle differed between the groups (P < 0.01, P = 0.002, P < 0.01). No significant intergroup differences between other parameters of the velopharyngeal configuration occurred (P > 0.05).

Conclusion

The effect of AMSDO on the structures of the velopharyngeal configurations are minimal, and there is basically no change in the velopharyngeal structure and posterior pharyngeal wall. The postoperative results of TMDO group suggest that it may impair velopharyngeal competence and adaptive compensation of velopharyngeal structure.