Immediate and Long-term Changes in the Pharyngeal Airway Passage following Maxillary Advancement JIOS The Journal of Indian Orthodontic Society, October-December 2011;45(4):219-223 219 Immediate and Long-term Changes in the Pharyngeal Airway Passage following Maxillary Advancement with Distraction Osteogenesis in Adult Patients with Cleft Lip and Palate 1 Ashok Kumar Jena, 2 Vidya Rattan, 3 Satinder Pal Singh, 4 Ashok Utreja ORIGINAL ARTICLE Received on: 6/6/11 Accepted after Revision: 12/12/11 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. Keywords: Pharyngeal airway, Distraction osteogenesis, Cleft lip, Cleft palate. How to cite this article: Jena AK, Rattan V, Singh SP, Utreja A. Immediate and Long-term Changes in the Pharyngeal Airway Passage following Maxillary Advancement with Distraction Osteogenesis in Adult Patients with Cleft Lip and Palate. J Ind Orthod Soc 2011;45(4):219-223. 1 Assistant Professor, 2,3 Additional Professor, 4 Professor and Head 1,3,4 Unit of Orthodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India 2 Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre Post Graduate Institute of Medical Education and Research Chandigarh, India Corresponding Author: Ashok Kumar Jena, Assistant Professor Unit of Orthodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India e-mail: ashokkjena@yahoo.co.in INTRODUCTION Maxillary hypoplasia is a common deformity in subjects with repaired cleft lip and palate. Distraction osteogenesis of the maxilla offers a solution for the correction of maxillary hypoplasia in cleft lip and palate subjects. The effects of maxillary distraction on the dimensions of pharyngeal airway passage in cleft lip and palate subjects are controversial. Advancement of the maxilla improves the quality of articulation in the labiodental area but might cause velopharyngeal incompetence. 1 Several investigators have reported no evidence of significant change in the velopharyngeal function, 1-4 while others have reported problems in the velopharyngeal closure following maxillary advancement. 5-8 Although few studies are there in the literature mentioning the effects of maxillary distraction on the pharyngeal airway passage, nasorespiratory function and velopharyngeal functions in young and adult subjects of cleft lip and palate; 9-11 but there is not a single study mentioning the long-term effects of maxillary distraction on the pharyngeal airway passage and adaptation of the soft palate in adult subjects of cleft lip and palate. Thus, the present study was designed to evaluate the immediate and long-term effects of maxillary distraction on pharyngeal airway passage and adaptation of soft palate in adult subjects of cleft lip and palate. MATERIALS AND METHODS The study was conducted on 12 (M = 7, F = 5) North Indian adult subjects in the age range of 17 to 34 years with complete cleft lip and palate who underwent advancement of maxilla by distraction osteogenesis. Among 12 subjects, eight were with unilateral cleft lip and palate and four with bilateral cleft lip and palate. None of the subjects had received alveolar bone grafting. All the subjects had severe anteroposterior maxillary hypoplasia with Class-III malocclusion and reverse overjet. 10.5005/jp-journals-10021-1040