Pharyngeal Airway Dimensional Changes In Cleft Lip And Palate Patients Following Intra-Oral Maxillary Distraction-A Retrospective Cephalometric Study

Research Article
Sowmiya Aravindan., Uma Maheswari., Sanjay Sundararajan and Devaki Vijayalakshmi
DOI: 
http://dx.doi.org/10.24327/ijrsr.2018.0906.2276
Subject: 
science
KeyWords: 
Pharyngeal airway, cleft lip and Palate, Distraction Osteogenesis, Intra-oral distraction, Upper Airway
Abstract: 

Oro-facial clefts(OFC) are amongst the most commonly occurring craniofacial anomalies(CFA). The occurrence of OFC is of two main types, CL/P and CP. The maxillary hypoplasia is the most commonly encountered secondary deformity in patients with CP. The maxillary hypoplasia often results in compromised mastication, speech and nasal pharyngeal airway insufficiency and finally a weak outlook on the life due to a disturbed self-perception. The patients with such syndromic conditions require early functional rehabilitation along with aesthetic enhancements. The treatment of maxillary hypoplasia often involves maxillary surgical advancements or distraction osteogenesis. A major disadvantage of surgical maxillary advancement is a deterioration of velopharyngeal function as soft tissue moves forward. But, in case of distraction osteogenesis involving anterior maxilla there has been very few articles assessing the pharyngeal airway. The aim of the study was therefore to evaluate the impact of AMD using intra-oral distractors on Pharyngeal airway dimensions in Cleft lip and palate patients. The study consists airway and skeletal parameter assessment of cephalogram evaluation of 15 cleft lip and palate patients, with maxillary hypoplasia who had undergone anterior maxillary distraction osteogenesis with tooth borne internal distractors. The results shows an increase in the entire Velo-pharyngeal dimensions in all the five parameters. Post distraction statistically significant changes in the airway parameters are seen only in PPS and SPSS, also certain statistically significant changes seen in skeletal parameters support the increase in pharyngeal airway as a result of distraction. Thus, Anterior maxillary distraction osteogenesis in cleft lip and palate patients with retrognathic maxilla is proved to be a viable treatment option which not only improves the facial profile and esthetics but also enhances the functional characteristics of the airway by increasing its dimension.