Effect of maxillary advancement on velopharyngeal function in cleft lip and palate: 20 years of experience.

This retrospective study aimed to investigate the impact of orthognathic surgery with maxillary advancement (MA) on the velopharyngeal function (VF) in individuals with cleft lip and palate (CLP). The study included 651 patients with repaired CLP, both sexes, aged over 18 years who underwent MA alone or in combination with nasal procedures and/or mandibular osteotomy, operated between 2000 and 2019. The main outcome measures were nasalance (nasal text-NT and oral text-OT) and velopharyngeal orifice area measurement (VA), determined by nasometry and pressure-flow technique, respectively.

Effects of 3D Airway Geometry on the Airflow of Adults with Cleft Lip and Palate and Obstructive Sleep Apnea: A Functional Imaging Study.

 Individuals with cleft lip and palate (CLP) are at a high risk of developing obstructive sleep apnea (OSA). Hypothetically, the severity of OSA might be associated with the morphology of the upper airway (UAW) and the characteristics of the airflow. Thus, the present study aimed to assess and compare, in adults with CLP and skeletal class-III discrepancy, with or without OSA, simulations of airflow resistance and pressure according to the geometrical characteristics of the UAW and cephalometric parameters.

Timing of Primary Surgery for Cleft Palate.

Background: Among infants with isolated cleft palate, whether primary surgery at 6 months of age is more beneficial than surgery at 12 months of age with respect to speech outcomes, hearing outcomes, dentofacial development, and safety is unknown.

Methods: We randomly assigned infants with nonsyndromic isolated cleft palate, in a 1:1 ratio, to undergo standardized primary surgery at 6 months of age (6-month group) or at 12 months of age (12-month group) for closure of the cleft. Standardized assessments of quality-checked video and audio recordings at 1, 3, and 5 years of age were performed independently by speech and language therapists who were unaware of the trial-group assignments.

Models for Predicting Velopharyngeal Competence Based on Speech and Resonance Errors and Velopharyngeal Area Estimation.

Objective: To develop tools for predicting velopharyngeal competence (VPC) based on auditory-perceptual assessment and its correlation with objective measures of velopharyngeal orifice area.

Design: Methodological study.

Participants And Methods: Sixty-two patients with repaired cleft palate, aged 6 to 45 years, underwent aerodynamic evaluation by means of the pressure-flow technique and audiovisual recording of speech samples.

Effect of Orthognathic Surgery on Breathing in Patients with Cleft lip and Palate: 20-Year Experience at a Tertiary Hospital in Brazil.

Objective: To verify the effect of orthognathic surgery (OS) on nasal dimensions and its correlation with respiratory symptoms in patients operated on over the past 20 years.

Design: Retrospective study.

Setting: Tertiary level craniofacial hospital.

Respiratory sleep disorders, nasal obstruction and enuresis in children with non-syndromic Pierre Robin sequence.

Introduction: Obstructive sleep apnea is highly prevalent in non-syndromic Pierre Robin sequence patients. Studies have found a probable relationship between obstructive sleep apnea and nasal obstruction and between obstructive sleep apnea and enuresis. Assessment of the relationship between these variables in non-syndromic Pierre Robin sequence patients is scarce.

Internal nasal dimensions of children with unilateral cleft lip and palate and maxillary atresia: comparison between acoustic rhinometry technique and cone-beam computed tomography.

Purpose: To compare the nasal cavity geometry of children and teenagers with cleft lip and palate and maxillary atresia by two methods: cone-beam computed tomography, considered the gold standard, and acoustic rhinometry.

Methods: Data on cone-beam computed tomography and acoustic rhinometry examinations of 17 children and teenagers with cleft lip and palate and maxillary atresia, previously obtained for orthodontic planning purposes, were evaluated prospectively. Using Dolphin Imaging 11.

Adults With Unilateral Cleft Lip and Palate Present Reduced Internal Nasal Volumes: Findings of a Three-Dimensional Morphometric Assessment in Cone-Beam Computed Tomography Scans.

The main purpose was to assess and compare nasal cavity (NC) volumes among adults with unilateral (UCLP) and bilateral cleft lip and palate (BCLP) and in noncleft controls (CON), by means of cone-beam computed tomography (CBCT) three-dimensional reconstructions. Forty-five scans of individuals with class III skeletal pattern, matched by age, were gathered in 3 groups: UCLP (n = 15), BCLP (n = 15) and (CON) (n = 15). The NC volume was assessed three-dimensionally, using Dolphin 11.

Are reduced internal nasal dimensions a risk factor for obstructive sleep apnea syndrome?

Introduction: Obstructive sleep apnea syndrome is a high-prevalence disorder found in the population. Studies have shown a possible association between nasal obstruction and obstructive sleep apnea syndrome, but the existence of a association between the degree of nasal obstruction and obstructive sleep apnea syndrome severity has not yet been proven.

Objective: To evaluate the internal nasal dimensions of adults with primary snoring and obstructive sleep apnea syndrome by acoustic rhinometry and to correlate the findings with obstructive sleep apnea severity.

Surgical maxillary advancement and speech resonance: comparison among cleft types.

Purpose This study investigated the influence of the cleft type on the appearance of hypernasality after surgical maxillary advancement (MA). Methods Nasality was determined by measurement of nasalance (acoustic correlate of nasality) by nasometry. The study involved analysis of the nasalance scores of 17 individuals with isolated cleft palate (CP), 118 with unilateral cleft lip and palate (UCLP) and 69 with bilateral cleft lip and palate (BCLP), of both sexes, aged 18 to 28 years, after MA.

Reduced pharyngeal dimensions and obstructive sleep apnea in adults with cleft lip/palate and Class III malocclusion.

: To three-dimensionally evaluate the upper airway of individuals with cleft lip and palate (CLP) and Class III malocclusion and the occurrence of obstructive sleep apnea (OSA).: Twenty-one CLP individuals with Class III malocclusion, 20-29 years of age, who underwent computed tomography for orthognathic surgery planning, were prospectively evaluated. All participants underwent polysomnography, and the apnea-hypopnea index ≥ 5 events/hour was considered indicative of OSA.

Normative nasalance scores in the production of words and syllables for Brazilian Portuguese speakers.

The objective of this study was to determine normative nasalance scores for non-cleft children, adolescents and adults, native speakers of Brazilian Portuguese, during the production of words and syllables, for cross-linguistic comparisons in populations with and without cleft palate. Nasalance was assessed in 62 individuals, aged 6-10 years (n = 20), 11-17 years (n = 20) and 18-35 years (n = 22), using a nasometer II model 6450 (KayPENTAX), during production of one sequence of nine oral words ( and of sequences of isolated syllables (e.g.

Symptoms of Obstructive Sleep Apnea, Nasal Obstruction, and Enuresis in Children With Nonsyndromic Cleft Lip and Palate: A Prevalence Study.

Objective: To estimate the prevalence of symptoms of obstructive sleep apnea (OSA), nasal obstruction, and enuresis in children with nonsyndromic unilateral cleft lip and palate.

Design: Prospective cross-sectional study.

Setting: Referral care center.

Surgical Closure of the Cleft Palate Has a Transient Obstructive Effect on the Upper Airway in Children.

Objective: To prospectively investigate the occurrence of respiratory symptoms related to obstructive sleep apnea (OSA) following primary palatoplasty in children with cleft palate (CP).

Method: Fifty-six nonsyndromic children presenting CP with a previously repaired cleft lip (CL) or without CL were assessed before and after palate repair. Twenty nonsyndromic children with isolated CL were analyzed as controls before and after lip repair.

Nasalance scores of Brazilian Portuguese speakers at 5 years of age.

Purpose: To determine nasalance scores of Brazilian Portuguese speaking children without evident speech disorders, language delay and orofacial deformities, at age 5 years, and analyze differences between types of speech samples and genders.

Methods: Twenty children were analyzed, 11 males, age ranging from 4 years and 10 months to 5 years and 11 months. The Nasometer II 6450 (KayPENTAX) was used for nasalance assessment.

Nasopharyngeal dimensions in normal individuals: normative data.

Objective: To establish normative values of minimum cross-sectional nasopharyngeal area in individuals without craniofacial anomalies at different age ranges.

Material And Method: Ninety-six individuals of both genders, without craniofacial anomalies, and with normal body mass index and neck circumference were evaluated. Participants were divided into 4 age groups: children, aged 6 to 10 years (G1); adolescents, aged 11 to 17 years (G2); young adults, 18 to 39 years (G3), and middle-aged adults, 40 to 59 years (G4).

Tomographic Pharyngeal Dimensions in Individuals With Unilateral Cleft Lip/Palate and Class III Malocclusion Are Reduced When Compared With Controls.

Objective: The objective of this study was to three-dimensionally evaluate the pharyngeal dimensions of individuals with complete nonsyndromic unilateral cleft lip and palate (UCLP) using cone beam computed tomography.

Design: This was a cross-sectional prospective study.

Setting: The study took place at the Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru-SP, Brazil.

Influence of pharyngeal flap surgery on nasality and nasalance scores of nasal sounds production in individuals with cleft lip and palate.

Objective: To verify the influence of pharyngeal flap surgery on the management of velopharyngeal insufficiency on nasality and speech nasalance on nasal sound production in individuals with cleft lip and palate.

Methods: Prospective study in 159 individuals with repaired cleft palate ± lip, of both genders, aged 6 to 57 years old. All the participants presented residual velopharyngeal insufficiency and were submitted to pharyngeal flap surgery.

Comparative analysis of velopharyngeal activity assessed by acoustic rhinometry and rhinomanometry.

Purpose: To analyze the velopharyngeal (VP) activity of subjects with velopharyngeal dysfunction (VPD) by acoustic rhinometry, as compared to rhinomanometry.

Methods: This was a prospective clinical study conducted in 41 adults, both genders, with repaired cleft palate, with or without a previously repaired cleft lip, and residual VPD on clinical assessment, without compensatory articulations for [p], [t], and [k]. The outcome measures were as follows: (1) on acoustic rhinometry, nasopharyngeal volumetric change (ΔV) during [p], [t], and [k], relatively to rest condition (decreases by <3 cm3 considered as absence of VP activity); (2) on modified anterior rhinomanometry, VP orifice area (areas ≥0.

Relationship between velopharyngeal closure, hypernasality, nasal air emission and nasal rustle in subjects with repaired cleft palate.

Purpose: To investigate the correlation among velopharyngeal closure, hypernasality, audible nasal air emission (NAE) and nasal rustle (NR), in individuals with repaired cleft palate.

Methods: One hundred patients with repaired cleft palate and lip, submitted to pressure-flow study for measurement of velopharyngeal orifice area (velopharyngeal area) and speech sample recordings. Velopharyngeal area was estimated during the production of the sound /p/ inserted in a sentence, and the velopharyngeal closure was classified as adequate, borderline or inadequate.

Obstructive Sleep Apnea Following Pharyngeal Flap Surgery for Velopharyngeal Insufficiency: A Prospective Polysomnographic and Aerodynamic Study in Middle-Aged Adults.

Objective: To compare the frequency and severity of obstructive sleep apnea (OSA) in middle-aged adults who underwent pharyngeal flap surgery for velopharyngeal insufficiency (VPI) with matched subjects who did not undergo pharyngeal flap surgery and to verify the relationship between OSA severity and internal pharyngeal dimensions.

Setting: National referral care center for cleft lip and palate.

Method: Prospective study on 42 nonsyndromic subjects with repaired cleft palate with flap (F group, n = 22) and without flap (NF group, n = 20), aged 40 to 58 years.

Rapid Maxillary Expansion Increases Internal Nasal Dimensions of Children With Bilateral Cleft Lip and Palate.

Objective: The transverse maxillary deficiency frequently observed in patients with cleft lip and palate (CLP) is usually treated by rapid maxillary expansion (RME). Considering that RME causes a significant increase of the internal nasal dimensions in children with unilateral CLP (UCLP), this study aimed to characterize the internal nasal geometry of children with bilateral CLP (BCLP) and transverse maxillary deficiency using acoustic rhinometry. The study also aimed to analyze changes caused by RME.

Impact of inter-judge agreement on perceptual judgment of nasality.

Purpose: To investigate the effect of perceptual inter-judge agreement of hypernasality on velopharyngeal (VP) closure prediction.

Methods: Two logistic regression models were developed aiming to verify the possibility of predicting the VP closure using the following characteristics: rating of VP closure (adequate, borderline, inadequate), determined by the pressure-flow technique, degree of hypernasality (absent, mild, moderate, severe), and the presence/absence of nasal air emission and nasal rustle determined perceptually by three experienced speech language pathologists. In the first model, 100 speech samples with a moderate agreement rate of hypernasality (kappa coefficient: 0.

Nasal Airway Dimensions of Children With Repaired Unilateral Cleft Lip and Palate.

Objective: To measure cross-sectional areas of the main nasal constrictions as a function of the distance into the nose in children with repaired unilateral cleft lip and palate, as compared with children without cleft, by acoustic rhinometry.

Design: Prospective analysis.

Setting: Craniofacial anomalies hospital.

Velar activity in individuals with velopharyngeal insufficiency assessed by acoustic rhinometry.

Unlabelled: Acoustic rhinometry is routinely used for the evaluation of nasal patency.

Objective: To investigate whether the technique is able to identify the impairment of velopharyngeal (VP) activity in individuals with clinical diagnosis of velopharyngeal insufficiency (VPI).

Methods: Twenty subjects with repaired cleft palate and inadequate velopharyngeal function (IVF) and 18 non-cleft controls with adequate velopharyngeal function (AVF), adults, of both genders, were evaluated.