Velopharyngeal Function Change after 2-Jaw Orthognathic Surgery in Patients with Cleft: A Study of 162 Consecutive Cases

Chun Lin Su, Betty C.J. Pai, Shu Hui Wang, Claudia Yun, Lun Jou Lo*

*此作品的通信作者

研究成果: 期刊稿件文章同行評審

2 引文 斯高帕斯(Scopus)

摘要

BACKGROUND: Orthognathic surgery (OGS) is a common intervention used to correct midfacial hypoplasia in patients with cleft. Previous studies have reported that Le Fort I maxillary advancement may affect velopharyngeal function, but similar investigations focusing on 2-jaw OGS have not been conducted.

METHODS: A total of 162 consecutive patients with cleft lip and palate who underwent 2-jaw OGS between 2015 and 2020 were enrolled. Clinical data were collected, and preoperative and postoperative skeletal measurements were obtained from cephalometric images. Velopharyngeal function was evaluated using perceptual analysis and nasopharyngoscopy. A logistic regression model was used for risk factors associated with changes in velopharyngeal function.

RESULTS: After 2-jaw OGS, 82.1% of patients showed no change in velopharyngeal function, 3.7% experienced improvement, and 14.2% exhibited worsening of function. Changes in velopharyngeal function were statistically significant compared with velopharyngeal status before OGS. Multivariable logistic regression revealed that the amount of maxillary advancement independently predicted the deterioration of velopharyngeal function after OGS (odds ratio, 1.74; 95% CI, 1.20 - 2.52; P = 0.004). The receiver operating characteristic curve based on maxillary advancement demonstrated good discrimination, with an area under the curve of 0.727 (95% CI, 0.62 - 0.83; P = 0.001). The Youden index was 4.27 mm.

CONCLUSIONS: Despite the risk of velopharyngeal function deterioration in patients with cleft palate undergoing OGS, some individuals experienced improved function after 2-jaw OGS. The extent of maxillary advancement has a negative effect on velopharyngeal function.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

原文英語
頁(從 - 到)813-822
頁數10
期刊Plastic and Reconstructive Surgery
154
發行號4
DOIs
出版狀態已出版 - 01 10 2024

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Copyright © 2023 by the American Society of Plastic Surgeons.

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