Long-Term Effect of Maxillary Distraction Osteogenesis (DO) on Nasal Index in Adult Patients with Cleft Lip and Palate Deformities

An analysis of integrated electromyographic (IEMG) activity of the superior orbicularis oris muscle was undertaken in 15 children with cleft lip and palate who have undergone surgery compared to 10 children without clefts (control group). Bipolar surface electrodes were used for IEMG recordings of resting level activity and during the swallowing of saliva. Similar resting level activity was observed in both groups. During the swallowing of saliva, activity in children with cleft lip and palate was higher than in children without clefts (noncleft children). Moreover, in the cleft lip and palate group, children with abnormal lip seal showed the highest values for IEMG activity during the swallowing of saliva. This fact suggests that with each swallow of saliva, a greater counteracting effect of the superior orbicularis oris muscle could be produced on the growing maxilla. This may result in a significant long-term effect on the growth of the stomatognathic system, since the process of swallowing is a 24-hour function repeated between 600 and 2400 times each day.

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Long-term Follow-up after Maxillary Distraction Osteogenesis in Growing Children with Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/06-104 ◽

2007 ◽

Vol 44 (3) ◽

pp. 274-277 ◽

Cited By ~ 34

Author(s):

Chiung-Shing Huang ◽

Pandurangan Harikrishnan ◽

Yu-Fang Liao ◽

Ellen W. C. Ko ◽

Eric J. W. Liou ◽

...

Keyword(s):

Distraction Osteogenesis ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

University Hospital ◽

Anterior Nasal Spine ◽

Distraction Device ◽

Long Term Follow Up ◽

The University ◽

Maxillary Distraction

Objective: To evaluate the changes in maxillary position after maxillary distraction osteogenesis in six growing children with cleft lip and palate. Design: Retrospective, longitudinal study on maxillary changes at A point, anterior nasal spine, posterior nasal spine, central incisor, and first molar. Setting: The University Hospital Craniofacial Center. Main Outcome Measure: Cephalometric radiographs were used to measure the maxillary position immediately after distraction, at 6 months, and more than 1 year after distraction. Results: After maxillary distraction with a rigid external distraction device, the maxilla (A point) on average moved forward 9.7 mm and downward 3.5 mm immediately after distraction, moved backward 0.9 mm and upward 2.0 mm after 6 months postoperatively, and then moved further backward 2.3 mm and downward 6.8 mm after more than 1 year from the predistraction position. Conclusion: In most cases, maxilla moved forward at distraction and started to move backward until 1 year after distraction, but remained forward, as compared with predistraction position. Maxilla also moved downward during distraction and upward in 6 months, but started descending in 1 year. There also was no further forward growth of the maxilla after distraction in growing children with clefts.

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