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Maxillary distraction versus orthognathic surgery in cleft lip and palate patients: effects on speech and velopharyngeal function
Authors:HDP Chua  TL Whitehill  N Samman  LK Cheung
Institution:1. Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;2. Division of Speech and Hearing Sciences, Faculty of Education, The University of Hong Kong, Hong Kong, China;1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey;2. Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria;3. Orthopedics, Privat Hospital Maria Hilf, Klagenfurt, Austria;4. Department of Histology, Faculty of Medicine, Cukurova University, Adana, Turkey;1. Consultant Oral and Maxillofacial Surgeon and Honorary Senior Lecturer, Cardiff University, University Dental Hospital and University Hospital for Wales, Cardiff and Vale University Health Board, Cardiff, Wales, UK;2. Consultant Maxillofacial Prosthetist, Morriston Hospital, ABM University Health Board, Swansea, Wales, UK;3. Research Coordinator, Maxillofacial Unit, Morriston Hospital, ABM University Health Board, Swansea, Wales, UK;4. Consultant and Senior Lecturer in Cleft and Maxillofacial Surgery, Morriston Hospital and Swansea University, ABM University Health Board, Swansea, Wales, UK;1. Associate Lecturer, Department of Oral and Maxillofacial Surgery, Ain Shams University, Cairo, Egypt;2. Associate Professor, Department of Oral and Maxillofacial Surgery, Ain Shams University, Cairo, Egypt;3. Associate Professor, Department of Oral and Maxillofacial Surgery, Ain Shams University, Cairo, Egypt;4. Professor, Department of General Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Abstract:This clinical randomized controlled trial was performed to compare the effects of distraction osteogenesis (DO) and conventional orthognathic surgery (CO) on velopharyngeal function and speech outcomes in cleft lip and palate (CLP) patients. Twenty-one CLP patients who required maxillary advancement ranging from 4 to 10 mm were recruited and randomly assigned to either CO or DO. Evaluation of resonance and nasal emission, nasoendoscopic velopharyngeal assessment and nasometry were performed preoperatively and at a minimum of two postoperative times: 3–8 months (mean 4 months) and 12–29 months (mean 17 months). Results showed no significant differences in speech and velopharyngeal function changes between the two groups. No correlation was found between the amount of advancement and the outcome measures. It was concluded that DO has no advantage over CO for the purpose of preventing velopharyngeal incompetence and speech disturbance in moderate cleft maxillary advancement.
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