Abstract：
OBJECTIVE: To evaluate a method of measuring the change in palatal length and shape following maxillary advancement using synchronous lateral videofluoroscopy and voice recording in order to understand how movement of the maxilla may affect VPI risk in patients with cleft lip and/or palate (CL/P).
METHODS: Retrospective cohort study of children with cleft lip and/or palate.
METHODS: Single center, tertiary children\'s hospital.
METHODS: Patients with cleft lip and/or palate who underwent maxillary advancement between 2016-21 inclusive.
METHODS: Maxillary advancement surgery, including those who underwent concurrent mandibular procedures.
METHODS: The length of the soft palate and the genu angle were measured throughout palatal dynamic range. Pre- and post-operative measurements were compared using a one sided T-test, with subgroup analysis for patients with clinical VPI.
RESULTS: Ten patients were examined. The mean distance of maxillary advancement was 10.5 mm. The average increase in pre-genu soft palate length was 2.8 mm in the resting position and 2.9 mm in the closed position. The genu angle decreased in the closed position by 16.3 degrees.
CONCLUSIONS: The soft palate showed limited ability to lengthen following maxillary advancement and this may explain the risk of VPI. There was partial compensation by the muscle sling of the palate as demonstrated by a more acute post-operative genu angle and this suggests one reason for the variability of VPI reported. Future research is required to investigate how length and shape changes measured using this method can predict VPI risk.
METHODS: Retrospective cohort study of children with cleft lip and/or palate.
METHODS: Single center, tertiary children\'s hospital.
METHODS: Patients with cleft lip and/or palate who underwent maxillary advancement between 2016-21 inclusive.
METHODS: Maxillary advancement surgery, including those who underwent concurrent mandibular procedures.
METHODS: The length of the soft palate and the genu angle were measured throughout palatal dynamic range. Pre- and post-operative measurements were compared using a one sided T-test, with subgroup analysis for patients with clinical VPI.
RESULTS: Ten patients were examined. The mean distance of maxillary advancement was 10.5 mm. The average increase in pre-genu soft palate length was 2.8 mm in the resting position and 2.9 mm in the closed position. The genu angle decreased in the closed position by 16.3 degrees.
CONCLUSIONS: The soft palate showed limited ability to lengthen following maxillary advancement and this may explain the risk of VPI. There was partial compensation by the muscle sling of the palate as demonstrated by a more acute post-operative genu angle and this suggests one reason for the variability of VPI reported. Future research is required to investigate how length and shape changes measured using this method can predict VPI risk.
摘要：
目的：评估一种使用同步侧向透视和语音记录测量上颌前移后腭长度和形状变化的方法，以了解上颌骨的运动如何影响唇裂患者的VPI风险。
方法：唇裂和/或腭裂患儿的回顾性队列研究。
方法：单中心，三级儿童医院。
方法：在2016-21年间接受上颌前移的唇裂和/或腭裂患者。
方法：上颌前移手术，包括那些同时接受下颌手术的人。
方法：在整个腭动态范围内测量软腭的长度和内角。使用单侧T检验比较术前和术后测量值，对临床VPI患者进行亚组分析。
结果：检查了10例患者。上颌前移的平均距离为10.5mm。在静止位置，前软腭长度的平均增加为2.8mm，在闭合位置为2.9mm。在关闭位置,接合角减小16.3度。
结论：上颌前移后，软腭的延长能力有限，这可以解释VPI的风险。上颚的肌肉吊带可以部分补偿，这由更急性的术后膝关节角证明，这表明了VPI变化的一个原因。未来的研究需要调查使用这种方法测量的长度和形状变化如何预测VPI风险。
方法：唇裂和/或腭裂患儿的回顾性队列研究。
方法：单中心，三级儿童医院。
方法：在2016-21年间接受上颌前移的唇裂和/或腭裂患者。
方法：上颌前移手术，包括那些同时接受下颌手术的人。
方法：在整个腭动态范围内测量软腭的长度和内角。使用单侧T检验比较术前和术后测量值，对临床VPI患者进行亚组分析。
结果：检查了10例患者。上颌前移的平均距离为10.5mm。在静止位置，前软腭长度的平均增加为2.8mm，在闭合位置为2.9mm。在关闭位置,接合角减小16.3度。
结论：上颌前移后，软腭的延长能力有限，这可以解释VPI的风险。上颚的肌肉吊带可以部分补偿，这由更急性的术后膝关节角证明，这表明了VPI变化的一个原因。未来的研究需要调查使用这种方法测量的长度和形状变化如何预测VPI风险。
