The Effect of Bimaxillary Orthognathic Surgery on Nasalance, Articulation Errors, and Speech Intelligibility in Skeletal Class III Deformity Patients.

Background: We aimed to detect the changes in nasalance, articulation errors, and speech intelligibility after bimaxillary orthognathic surgery in skeletal class III patients.

Methods: This double-blinded before and after quasi-experimental study was conducted in the Department of Maxillofacial Surgery, Qaem Hospital, Mashhad, Iran from Mar 2019 to Apr 2020. The main intervention was maxillary advancement with LeFort I osteotomy and mandibular setback surgery with bilateral sagittal split osteotomy (BSSO). The nasalance score, speech intelligibility, and articulation errors were evaluated one week preoperatively (T), 1 and 6 months (T, T) postoperatively by a speech therapist. The significance level was set at 0.05 using SPSS 21.

Results: Eleven women (55%) and 9 men (45%) with a mean age of 31.95 ± 4.72 yr were enrolled. The mean maxillomandibular discrepancy was 6.15 ± 1.53 mm. The mean scores of nasalance for the oral, nasal, and oral-nasal sentences were significantly improved postoperatively (<0.001). Pre-operative articulation errors of consonants /r/, /z/, /s/ and /sh/ were corrected following the surgery. The percentage of speech intelligibility was significantly increased over time (<0.001).

Conclusion: The patients might show a normal articulation pattern and a modified nasalance feature, following maxillary advancement plus mandibular setback surgery.