Two-jaw surgery for postoperative cleft palate following anterior maxillary distraction osteogenesis: A case report

Abstract

Maxillary hypoplasia in postoperative cleft palate patients can create post-developmental malocclusion and incongruous dentition. In cases of maxillary recession following cleft palate surgery, there are frequent concerns that surgical maxillary advancement might impair velopharyngeal competence and language faculty. It is, therefore, necessary to minimize the impact on velopharyngeal competence when advancing the upper jaw. We performed corrective maxillomandibular surgery on a woman presenting with slight postoperative velopharyngeal insufficiency, complaining primarily of reversed occlusion and desiring correction, and obtained good results. First, anterior maxillary distraction osteogenesis (AMDO) was performed to preserve velopharyngeal competence and improve structural incongruities in the midface. Subsequently, maxillomandibular repositioning and genioplasty were performed. We attempted to obtain favorable results where the reversed occlusion and incongruous dentition were improved without loss of existing velopharyngeal competence, and the patient was satisfied. As AMDO can be used to improve occlusion and make improvements to dentition without impacting velopharyngeal competence when combined with maxillomandibular repositioning, it may be an effective treatment approach.