Does the pharyngeal flap reduce the occurrence of velopharyngeal dysfunction following maxillary advancement with Le Fort I osteotomy?
DOI:
https://doi.org/10.34119/bjhrv8n2-196Keywords:
cleft lip and palate, velopharyngeal dysfunction, osteotomyAbstract
Velopharyngeal dysfunction (VPD) is a significant speech disorder affecting 10–50% of children with cleft lip and palate due to impaired palatal extension and oropharyngeal dysmotility. Pharyngeal flap surgery is the primary treatment for VPD, typically performed around 11 years of age to improve speech by preventing excessive nasal airflow. Patients with cleft lip and palate commonly experience maxillary growth restriction, and approximately 40% require orthognathic surgery to correct skeletal discrepancies. This systematic review aimed to assess whether the presence of a pharyngeal flap reduces postoperative VPD following Le Fort I osteotomy in cleft patients. A search in PubMed, Embase, and Web of Science retrieved 588 records. Studies evaluating the impact of a pharyngeal flap before orthognathic surgery and its effect on postoperative VPD were included. The review followed PRISMA guidelines and was registered in PROSPERO (CRD42023410128). After screening, two retrospective studies comprising 101 patients (56 males, 45 females; mean age: 20.7 years) were analyzed. The findings showed inconsistency regarding the protective role of pharyngeal flap surgery, suggesting that it does not prevent postoperative VPD and may, in some cases, worsen it. Further controlled clinical trials are needed to clarify this relationship.
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