The Effect Of The Timing Of Cleft Palate Plasty On The Development Of Jaw And Velopharyngeal Function

Objective:To evaluate the development of jaw and velopharyngeal closure in patients after cleft palate surgery,and to explore the effects of different cleft palatal surgery timing on the growth and development of the jaw and the recovery of velopharyngeal closure function.Methods:From 2005 to 2017,42 patients who were diagnosed with?°cleft palate were selected from the patients who underwent cleft palate repair surgery in the Stomatological Hospital of Hebei Medical University from over 14 years old and more than two years after cleft palate,according to the age of the patients undergoing cleft palate surgery,those patients were divided into 3 groups,group A: <4 years old surgical group(n=17)and group B: 4?12 years old surgical group(n=12)and group C: >12 years old surgical group(n=13).The control group was selected from adult patients with other diseases who came to our hospital for a total of 30 cases,including 15 males and 15 females,with an average age of(18.7±1.9)years old.X-ray cephalogram and nasopharynx were performed during the follow-up to evaluate the growth and development of the jaws and the maximum degree of velopharyngeal closure and to statistically test the growth and development of the jaw and the degree of velopharyngeal closure between different age groups.Results:Compared with the normal control group,the three case groups have statistically significant differences in the following indicators(P<0.05).The specific manifestations are: the angle of the mandible angle(?Ar-Go-Gn)is large,and the angle of the skull base(?N-S-Ba)is large,the length of the posterior skull base(S-Ba)is large,the length of the full skull base(N-Ba)is large,the lower height(ANS-Me)is large,and the overall height(N-Me)is large.The length of the maxillary basal bone(A-PMP)is relatively small,indicating that the abnormality of these measurement indicators may be due to the development of the cleft palate itself.The?SNA??SNB??ANB??S-N-ANS?S-N?S-Ba?N-Ba?A-PMP and other measurement indicators were significantly different between groups A and C(P <0.05),indicating the timing of surgery Affect these measurement indexes;the evaluation results of the degree of velopharyngeal closure show that:the degree of velopharyngeal closure is statistically significant between group A and group B(P = 0.05),and there is a significant difference between group A and group C(P? 0.05),there was no statistical difference between group B and group C,indicating that the degree of velopharyngeal insufficiency of patients increased with the age of operation,and the recovery of velopharyngeal closure function was significantly worse in patients over 4 years old who underwent cleft palate repair.Conclusions:Patients with cleft palate have normal growth potential.Surgery is the main reason for inhibiting the growth and development of the maxillary.Cleft palate repair surgery will inhibit the growth and development of the jaw before the peak of growth and development of the jaw is completed.However,postponement of cleft palate repair surgery means that it is difficult for patients to obtain the velopharyngeal closure required for normal pronunciation.