Effect Of Structure On The Palate Pharyngeal Cleft Lip And Palate Patients With Maxillary Research Forward

Purpose::Cleft lip and palate is a familiar deformity.It often occur maxillary hypoplasia.The maxillary Le Fort Ⅰ osteotomy advancement and maxillary protraction are two frequently performed methods used to resolve this abnormalities of jaw. When the entire maxilla is advanced,the hard palate and the attached soft palate are advanced as well,Forward displacement of the hard palate by surgery and maxillary protraction can increase the anteriority diameter of the nasopharynx.This result in an increased distance that soft palate move during velodharyngeal closure activity,Patients may suffered from velopharyngeal incompetence or deterioration of velopharyngeal function,To study the effect on the velopharyngeal structure of maxillary hypoplasia patients of cleft lip and palate after maxillary advancement.Methods:A total of20patients with maxillary hypoplasia (10cleft patients and10non cleft patients) which underwent Le Fort Ⅰ osteotomy for maxillary advancement and maxillary protraction. The X-ray examinations consisted of lateral cephalometric radiographs for each patient were undertaken preoperatively, one month postoperatively, and measure indexes of velopharyngeal structure were collected and analyzed.Results:The average maxillary advancement distance was (5.28±2.32) mm、4.39±2.15mm in the above two groups.Cephalometric analysis in orthognathic group showed:PNS-PPW,PNS-U and∠ANS—U had all significantly increased (P＜0.05), and UD had significantly decreased post-surgery compared with pre-surgery. Cephalometric analysis in maxillary protraction group showed:PNS-PPW,PNS-U and∠ANS—PNS—U had all increased (P>0.05), and UD had decreased post-surgery compared with pre-surgery.Conclusion:Correction of maxillary hypoplasia by maxillary advancement will increase the velopharyngeal cavity depth, which may impair velopharyngeal competence.But the compensatory effects of velopharyngeal soft tissue may alleviate this impairment at certain extent. Maxillary protraction can early correct maxillary hypoplasia in adolescent;Cephalometric analysis showed that velopharyngeal tissue in maxillary protraction group had favourable change to that in orthognathic group.