The effects of Le Fort I osteotomy on velopharyngeal function in cleft patients |
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Authors: | Suvi Alaluusua Leena Turunen Anne Saarikko Ahmed Geneid Junnu Leikola Arja Heliövaara |
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Institution: | 1. Cleft Palate and Craniofacial Center, Department of Plastic Surgery, (Head of Department Erkki Tukiainen, Professor, MD, PhD), Helsinki University Hospital, P.O. Box 266, FI-00029, HUS, Finland;2. Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, (Head of Department Antti Aarnisalo, Adjunct Professor, MD, PhD), Helsinki University Hospital, P.O. Box 220, FI-00029, HUS, Finland |
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Abstract: | IntroductionMaxillary advancement may affect speech in cleft patients. The aim of this study was to evaluate whether preoperative velopharyngeal (VP) function and cleft type can predict VP function after a Le Fort I maxillary osteotomy.Materials and methodsOne hundred consecutive nonsyndromic cleft patients (54 females, 64 males) who underwent Le Fort I osteotomies were retrospectively evaluated. Pre- and postoperative VP function was assessed perceptually and instrumentally by a Nasometer. A five-point scale was used to rate velopharyngeal insufficiency symptoms (VPI 0–4). To assess reliability, 30 video recordings were re-evaluated.ResultsPreoperatively, 89% of patients had normal or insignificant VPI (0–1), and only 3% had moderate VPI (3). Postoperatively, 77% of patients had VPI values of 0–1 and 14% had moderate to severe VPI values (VPI 3–4). A positive correlation was found between pre- and postoperative VPI scores, whereas the cleft type did not affect speech results. Patients with a preoperatively normal VPI (0) were not at risk for postoperative velopharyngeal incompetence.ConclusionsThere was an overall significant negative change in speech after a Le Fort I osteotomy. At-risk patients presented with borderline (1) or more severe VPI (2 and 3) preoperatively. |
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Keywords: | Cleft palate Maxillary advancement Velopharyngeal function Osteotomy Speech |
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