Immediate and Long-term Changes in the Pharyngeal Airway Passage following Maxillary Advancement with Distraction Osteogenesis in Adult Patients with Cleft Lip and Palate

Abstract

Objective: To evaluate the immediate and long-term effects of maxillary distraction osteogenesis on the pharyngeal airway passage and soft palate adaptation in adult patients with cleft lip and palate. Design: A total of 12 North Indian adult patients in the age range of 17 to 34 years with cleft lip and palate underwent advancement of maxilla by distraction osteogenesis. Lateral cephalograms recorded prior to distraction, at the end of distraction, 6 months after distraction and at least 24 months (mean 25.5 ± 1.94 months) after distraction osteogenesis were used for the evaluation of immediate and long-term effects of maxillary distraction on the pharyngeal airway passage and adaptation of soft palate. Descriptive statistics, ANOVA and post-hoc test were used, and probability value (p-value) 0.05 was considered as statistically significant level. Results: Maxillary distraction improved the depth of nasopharynx. The depth of oropharynx was increased significantly (p < 0.05) after immediate maxillary advancement; but at the end of 6 months and after 2 years of follow-up, the improvements were not significant. The length of soft palate was increased after immediate and long-term follow-up of maxillary distraction. The inclination of the soft palate was increased significantly (p < 0.01) after immediate advancement of maxilla and was remained stable till the end of 2 years postdistraction. Conclusion: The advancement of the maxilla by distraction osteogenesis improved the pharyngeal airway passage in adult subjects of cleft lip and palate.