Effect of maxillary distraction osteogenesis on velopharyngeal function: A pilot study

A case of Kabuki syndrome with a large palatal fistula and malocclusion

“…It has been reported that patients with cleft palate developed rhinolalia aperta after maxillary osteotomy [20,21]. On the other hand, it has also been reported that there was no impact on speech in patients with cleft palate after maxillary osteotomy [22][23][24]. This problem, however, remains controversial.…”

Maxillary Anterior Segmental Distraction Osteogenesis with the Dynaform System for Severe Maxillary Retrusion in Cleft Lip and Palate

“…[3][4][5]9 Ko et al 3 have reported that deterioration of hypernasality was related to the amount of forward distraction, especially in cases that required more than a 14-mm advancement. A similar result was reported by Harada et al 4 These results have shown that the procedure has a low possibility of inducing postoperative velopharyngeal incompetence. However, total maxillary distraction osteogenesis always has the possibility of causing morphologic changes in the nasopharynx, although the incidence must be lower than that resulting from simultaneous maxillary advancement.…”

“…1,2 There have been a number of reports recently that describe the advantages of distraction osteogenesis in combination with Le Fort osteotomy for cleft palate patients, with which the patient's maxilla can be advanced with soft tissue in the distraction segment being regenerated. [3][4][5][6][7][8] Some reports also suggest that the incidence of velopharyngeal incompetence is low with the abovementioned procedure except for cases that require excessive advancement. 3,4 It is clear, however, that this procedure may sometimes induce a morphologic change in the pharynx.…”

“…[3][4][5][6][7][8] Some reports also suggest that the incidence of velopharyngeal incompetence is low with the abovementioned procedure except for cases that require excessive advancement. 3,4 It is clear, however, that this procedure may sometimes induce a morphologic change in the pharynx. Also, there is a study showing that the risk of deterioration of hypernasality following maxillary distraction osteogenesis with the Rigid External Distraction system (KLS-Martin, L.P., Tuttlingen, Germany) is as high as that following simultaneous maxillary advancement.…”

Anterior maxillary segmental distraction for correction of maxillary hypoplasia and dental crowding in cleft palate patients: a preliminary report

“…6,16,17,19,23,24 Maxillary distraction following Le Fort I osteotomy has a similar risk of velopharyngeal insufficiency, especially for patients with marginal velopharyngeal incompetence. 5,11,12,16 These procedures typically involve movement of the entire maxilla at Le Fort I level, rather than the anterior maxilla alone, so they inevitably induce some degree of morphologic change in the velopharynx, which may have a detrimental effect on vepharyngeal closure. Anterior maxillary osteotomy is mainly indicated for the correction of maxillary dentoalveolar protrusion.…”