Association of Sphincter Pharyngoplasty and Long-Term Maxillary Hypoplasia in Patients with Cleft Palate.

IF 3.4 2区医学 Q1 SURGERY

Plastic and reconstructive surgery Pub Date : 2025-10-01 Epub Date: 2025-02-18 DOI:10.1097/PRS.0000000000012040

Nghiem H Nguyen, Madeline G Chin, Kelly X Huang, Kaavian Shariati, Jeremiah M Taylor, Juliana Panchura, Kriya Gishen, Justine C Lee, Libby F Wilson

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引用次数: 0

Abstract

Background: The current literature on orthognathic growth outcomes after velopharyngeal insufficiency surgery is limited by cohort size or short follow-up duration after surgery. This study evaluates the relationship between sphincter pharyngoplasty and long-term maxillomandibular growth.

Methods: All patients with cleft lip and palate (CLP) or isolated cleft palate (iCP) greater than or equal to 15 years of age who underwent sphincter pharyngoplasty from 1992 to 2023 were retrospectively reviewed. An age- and diagnosis-matched control group with CLP/iCP was also identified. Postoperative outcomes include clinical diagnosis of maxillary and mandibular hypoplasia, indication for Le Fort surgery, and sella-nasion-A point and sella-nasion-B point angles.

Results: A total of 200 CLP/iCP patients with a mean age of 20.0 ± 3.2 years were included ( n = 114 with pharyngoplasty and n = 86 controls). Within the surgery cohort, pharyngoplasty occurred at a mean age of 12.0 ± 4.5 years with a follow-up duration 9.2 years (interquartile range, 3.5 to 12.2 years) after surgery. Maxillary hypoplasia was diagnosed twice as frequently in pharyngoplasty patients compared with controls (60.5% versus 33.7%; P < 0.001), corresponding to a higher incidence of Le Fort I surgery (45.6% versus 15.1%; P < 0.001) and smaller sella-nasion-A point angles (75.4 ± 4.5 degrees versus 78.2 ± 5.4 degrees; P = 0.03). There were no differences in mandibular hypoplasia or sella-nasion-B point angles. Multivariable analysis indicated that pharyngoplasty was independently associated with a 3-fold increase in later diagnosis of maxillary hypoplasia (OR, 3.8; 95% CI, 1.9 to 7.5; P < 0.001).

Conclusion: Patients with a history of pharyngoplasty were 3.8 times more likely to be subsequently diagnosed with maxillary hypoplasia, highlighting the need for longitudinal follow-up of patients after velopharyngeal insufficiency surgery, as there may be long-term orthognathic consequences.

Clinical question/level of evidence: Therapeutic, III.

查看原文本刊更多论文

腭裂患者咽括约肌成形术与长期上颌发育不全的关系。

背景：目前关于腭咽功能不全（VPI）手术后正颌生长结局的文献受限于队列大小或术后随访时间短。本研究评估括约肌咽成形术与长期上颌下颌骨生长的关系。方法：回顾性分析1992 ~ 2023年所有年龄≥15岁的唇腭裂（CLP）或孤立性腭裂（iCP）行括约肌咽成形术的患者。还确定了年龄和诊断相匹配的CLP/iCP对照组。术后结果包括上颌和下颌骨发育不全的临床诊断、Lefort手术指征、鞍鼻a点（SNA）和鞍鼻b点（SNB）角度。结果：纳入200例CLP/iCP患者，平均年龄20.0±3.2岁（n=114，对照组n=86）。在手术队列中，咽成形术发生的平均年龄为12.0±4.5岁，术后随访时间为9.2年（IQR为3.5-12.2）。在咽成形术患者中，上颌发育不全的诊断频率是对照组的两倍（60.5% vs. 33.7%）。结论：有咽成形术史的患者随后被诊断为上颌发育不全的可能性是对照组的3.8倍，突出了VPI手术后患者纵向随访的必要性，因为可能存在长期的正颌后果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Plastic and reconstructive surgery 医学-外科

CiteScore

5.00

自引率

13.90%

发文量

1436

审稿时长

1.5 months

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