Objective: To study the effect of the Le Fort I Osteotomy on the velopharyngeal configuration of maxillary retrognathia patients. Methods: A total of 42 patients with maxillary retrognathia and/or mandibular prognathia (20 males and 22 females, average age 21.6 years old) which underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy between 2007—2009 were retrospectively reviewed. The X-ray examinations consisted of lateral cephalometric radiographs for each patient were undertaken preoperatively (TI), one week postoperatively (T2), and one year postoperatively (T3), and 6 measure indexes of velopharyngeal configuration were collected and analyzed. Results: The average maxillary advancement distance was (5.21±2.33) mm. PNS-PhW, UL and ∠ANS—PNS—U had all significantly increased, and C—PhW T—PhW and UD had significantly decreased post-surgery compared with pre-surgery. No significant linear correlation was found between maxillary advancement distance and velopharyngeal configuration changes. Conclusion: Correction of maxillary hypoplasia by using Le Fort I osteotomy will increase the velopharyngeal cavity depth, which may impair velopharyngeal competence. The compensatory effects of velopharyngeal soft tissue may be alleviated this impairment at certain extent.%目的:探讨上颌Le Fort Ⅰ型截骨术对上颌后缩患者腭咽部结构的影响.方法:选择2007-2009年行上颌Le Fort Ⅰ型截骨术的上颌后缩伴随下颌前突患者42例(男20例,女22例,平均年龄21.6岁),所有患者在术前、术后1周、术后1年拍摄静止位头颅定位侧位片,然后对腭咽部软组织结构指标进行测量分析.结果:上颌骨最大前移幅度为8 mm,最小为3 mm,平均前移(5.21±2.33)mm,术后1周及1年后鼻棘点与咽后壁的距离、软腭长度及软硬腭夹角较术前明显增大,而软腭鼻腔面最突点距咽后壁距离、腭垂末点距咽后壁距离及软腭厚度减小.术后1年软硬腭夹角较术后1周显著增大.上颌前移幅度与腭咽部结构变化程度间无明显相关关系.结论:上颌骨前移术后,会造成患者腭咽腔深度显著增加,可能会使腭咽闭合功能受损,但腭咽部软组织的代偿性改变会在一定程度上减轻这种损害,从而尽量维持良好的腭咽闭合功能.
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