Nasopharyngoscopic Analyses through Anterior Maxillary Distraction Osteogenesis for Adolescent Patients With Cleft Palate
| Autor: | Yoshimichi Imai, Akimitsu Satoh, Kazuaki Nishimura, Hiroyuki Kanzaki, Kaoru Igarashi, Tetsu Nakajo, Masahiro Tachi, Takayoshi Daimaruya |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Velopharyngeal Insufficiency Adolescent medicine.medical_treatment Micrognathism Osteogenesis Distraction 03 medical and health sciences Young Adult 0302 clinical medicine Velopharyngeal insufficiency Nasopharynx medicine Maxilla Humans Child Orthodontics medicine.diagnostic_test Hypoplastic maxilla business.industry Endoscopy 030206 dentistry General Medicine medicine.disease Sagittal plane Cleft Palate Radiography medicine.anatomical_structure Treatment Outcome Otorhinolaryngology 030220 oncology & carcinogenesis Coronal plane Distraction osteogenesis Pharynx Surgery Female Palate Soft Cephalogram business |
| Zdroj: | The Journal of craniofacial surgery. 29(2) |
| ISSN: | 1536-3732 |
| Popis: | Anterior maxillary distraction osteogenesis (AMDO) is a novel technique for correcting hypoplastic maxilla by sagittal expansion of the maxilla. Recent reports suggest that AMDO does not have an effect on fragile velopharyngeal function in patients with cleft palate. Furthermore, no studies have evaluated the impact of AMDO on velopharyngeal function.We adopted AMDO to correct severe hypoplastic maxilla in adolescent patients with cleft palate and evaluated its impact on velopharyngeal space and function in 8 patients aged 12 to 21 years who underwent AMDO from 2006 to 2014. All the patients had received treatment for cleft palate; however, they still exhibited marginal velopharyngeal insufficiency. The mean activation of the distractor was 10.9 ± 0.9 mm.We determined changes in velopharyngeal closure ratio and closure pattern via nasopharyngoscopy. Additionally, skeletal changes were evaluated using lateral cephalograms.The mean horizontal advancement in the cephalogram obtained 1 year after the distraction was +6.4 mm. Nasopharyngoscopic examination revealed that no deterioration of velopharyngeal gap had occurred after AMDO in all 8 patients. The velopharyngeal closure pattern changed from coronal to circular in 1 patient.Our results indicate that AMDO achieved correction of hypoplastic maxilla without deterioration in velopharyngeal gap and function. Therefore, AMDO is an effective and optimal approach for correcting hypoplastic maxilla especially in patients with fragile velopharyngeal function, such as those with cleft palate. |
| Databáze: | OpenAIRE |
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