The impact of surgical maxillary advancement on speech, breathing and pharyngeal airway dimensions in patients with cleft lip and/or palate: A systematic review and meta-analysis

To outline the effect of a Le Fort 1-type advancement osteotomy or Le Fort 1 level distraction osteogenesis (DO) procedure with anterior repositioning on speech, respiration and dimensions of the pharyngeal airway in patients with cleft lip and/or palate. This systematic review was conducted by foll...

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Bibliographic Details
Published in:	Journal of oral and maxillofacial surgery, medicine, and pathology Vol. 36; no. 6; pp. 779 - 792
Main Authors:	Motamedian, Saeed Reza, Ahmadi, Nima, Haeri Boroojeni, Helia Sadat, Jahanbani, Morteza, Hartoonian, Serlie, Bayati, Elnaz, Yaseri, Mina, Mommaerts, Muarice Y.
Format:	Journal Article
Language:	English
Published:	Elsevier Ltd 01-11-2024
Subjects:	Airway Obstruction Cleft palate Distraction Osteogenesis Le Fort 1 osteotomy Orthognathic surgery Pharyngeal airway Distraction Osteogenesis Pharyngeal airway Orthognathic surgery Cleft palate Le Fort 1 osteotomy Airway Obstruction
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Summary:	To outline the effect of a Le Fort 1-type advancement osteotomy or Le Fort 1 level distraction osteogenesis (DO) procedure with anterior repositioning on speech, respiration and dimensions of the pharyngeal airway in patients with cleft lip and/or palate. This systematic review was conducted by following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). For studies published until October 2023, an electronic search was conducted, and those were included in which the impact of Le Fort 1 maxillary advancement (I) on the speech, breathing, and pharyngeal airway dimensions (O) compared to pre-operative situation (C) in the patients with non -syndromic cleft lip/palate (P) were assessed. A meta-analysis was done to assess the difference in the amount of pharyngeal depth. From 892 studies, 19 studies were included in the analysis. All studies reported an increase of airway dimensions that were evaluated with 3D-imaging, velar length and improvement in breathing after the intervention. Meta-analysis of the six studies revealed the significant increase of the following variables: nasopharyngeal depth (NPD) immediately after the Le Fort 1 osteotomy, NPD and middle pharyngeal depth immediately and 12 months after Le Fort 1 DO. In patients with cleft lip and/or palate, maxillary advancement using Le Fort 1 osteotomy and Le Fort 1 DO can significantly increase the dimensions of the airway in the nasopharynx. However, the changes in speech and breathing parameters were not significant in the scrutinized literature. Impact of Le Fort maxillary advancement on patients’ speech remains controversial.
ISSN:	2212-5558
DOI:	10.1016/j.ajoms.2024.03.008