Objective To evaluate the impact of orthognathic surgery on acoustic nasalance of subjects with cleft and investigate the causes of possible changes by analyzing velopharyngeal function and nasal patency. Design/Patients Nasalance was measured in 29 subjects with operated cleft palate ± lip before (PRE) and 45 days (POST1) and 9 months (POST2) after surgery, on average. In 19 of the patients, the minimum velopharyngeal (VP) and nasal cross-sectional (N) areas were also determined. Interventions Le Fort I osteotomy with maxillary advancement in combination with procedures involving the nose, maxilla, mandible or all three. Main Outcome Measures Nasalance, VP area, N area. Results We observed: (1) a significant (p < .05) increase in mean nasalance at POST1 and POST2, compared with PRE during the reading of oral sentences and nasal sentences; at POST2, high nasalance on the oral sentences was observed in 45% of the patients with normal nasalance at PRE, and 57% of patients with low nasalance on the nasal sentences at PRE no longer presented abnormal nasalance; (2) a significant increase in mean VP area at POST1; two borderline patients demonstrated deterioration of VP closure at POST2, compared with PRE; and (3) a significant increase in mean N area at POST2, with 73% of patients no longer presenting subnormal areas seen at PRE. Conclusions On a long-term basis, orthognathic surgery modifies speech nasalance of some subjects with cleft, perhaps because of an increase in internal nose size. This may also improve nasal patency for breathing.
This paper presents the treatment protocol of maxillofacial surgery in the
rehabilitation process of cleft lip and palate patients adopted at HRAC-USP.
Maxillofacial surgeons are responsible for the accomplishment of two main procedures,
alveolar bone graft surgery and orthognathic surgery. The primary objective of
alveolar bone graft is to provide bone tissue for the cleft site and then allow
orthodontic movements for the establishment of an an adequate occlusion. When
performed before the eruption of the maxillary permanent canine, it presents high
rates of success. Orthognathic surgery aims at correcting maxillomandibular
discrepancies, especially anteroposterior maxillary deficiencies, commonly observed
in cleft lip and palate patients, for the achievement of a functional occlusion
combined with a balanced face.
On a long-term basis, orthognathic surgery modifies speech nasalance of some subjects with cleft, perhaps because of an increase in internal nose size. This may also improve nasal patency for breathing.
Congenital granular cell lesion of the newborn, also known as congenital epulis, is a rare benign oral cavity tumor presenting at birth. Usually, it appears as a solitary mass arising in the mouth and originates from the anterior alveolar ridge. The objective of the present article is to report a case of congenital granular cell lesion in an 8-day-old female newborn. The patient presented four intraoral pedunculated lesions. Diagnosis, treatment, microscopic and immunohistochemical characteristics are also discussed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.