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Year : 2018  |  Volume : 5  |  Issue : 2  |  Page : 97-105

Evaluation of velopharyngeal changes and mechanisms in upper airway following maxillary advancement by LeFort I osteotomy in patients with cleft: A retrospective study

1 Department of Orthodontics, Institute of Dental Sciences, SOA University, Bhubaneswar, Odisha, India
2 Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, SOA University, Bhubaneswar, Odisha, India
3 Orthodontist, Private Practioner Hitech Dental College and Hospital, Bhubaneswar, Odisha, India
4 Department of Orthodontics, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India

Correspondence Address:
Dr. Swati Saraswata Acharya
Department of Orthodontics, Institute of Dental Sciences, SOA University, Bhubaneswar, Odisha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jclpca.jclpca_9_18

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Introduction: Velopharyngeal dysfunction after maxillary advancement in Lefort I osteotomy may be a result of velopharyngeal insufficiency in patients with cleft. Maxillary hypoplasia is often related to a combination of congenital decrease in midfacial growth and surgical scar from cleft palate repair. Aims and Objectives: The aims and objectives of this study are to evaluate and correlate the velopharyngeal changes during and after maxillary advancement in patients with cleft after Lefort I osteotomy. Materials and Methods: Thirty Class III patients were included in this study. Maxillary advancement was done with Lefort I osteotomy. Cephalometric, nasopharyngoscope, and nasometer records were taken before, immediate postoperative and 1 year after advancement. A paired t-test was used to find the differences at P < 0.05. Results: The range of maxillary advancement was almost at mean of 9 mm. Statistical increase in the anteroposterior distance of superior, middle and inferior velopharynx, nasopharyngeal and oropharyngeal dimensions, angle of velar, and need ratio was found (P = 0.0001). There was a significant increase in nasalance scores (P < 0.041). Sagittal maxillary changes were 9.77° postadvancement. Vertical changes in maxilla, ANS, and peripheral nerve stimulation relative to X-axis (P = 0.0001, 0.0001 and 0.018) significantly increased after surgery. A significant positive correlation was seen between the amount of maxillary advancement and increase in depth of nasopharynx (P = 0.0001). Conclusions: The maxilla was advanced forward causing increased nasopharyngeal depth. There was a positive correlation between the amount of maxillary advancement and nasopharyngeal depth.

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