Background: Maxillary advancement may affect speech in cleft patients. Aims: To evaluate whether the amount of maxillary advancement in Le Fort I osteotomy affects velopharyngeal function (VPF) in cleft patients. Methods: Ninety-three non-syndromic cleft patients (51 females, 42 males) were evaluated retrospectively. All patients had undergone a Le Fort I or bimaxillary (n=24) osteotomy at Helsinki Cleft Palate and Craniofacial Center. Preoperative and postoperative lateral cephalometric radiographs were digitized to measure the amount of maxillary advancement. Pre-and postoperative speech was assessed perceptually and instrumentally by experienced speech therapists. Student´s ttest and Mann-Whitney's U-test were used in the statistical analyses. Kappa statistics were calculated to assess reliability. Results: The mean advancement of A point was 4.0 mm horizontally (range:-2.8-11.3) and 3.9 mm vertically (range-14.2-3.9). Although there was a negative change in VPF, the amount of maxillary horizontal or vertical movement did not significantly influence the VPF. There was no difference between the patients with maxillary and bimaxillary osteotomy. Conclusions: The amount of maxillary advancement does not affect the velopharyngeal function in cleft patients.

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Background: Maxillary advancement may affect speech in cleft patients. Aims: To examine whether the amount of maxillary advancement and preoperativecephalometric skeletal and dentoalveolar relationships are associated with articulation errors of the Finnish alveolar consonants /s/, /l/, and /r/ in cleft patients. Materials and Methods: Fifty-seven nonsyndromic cleft patients who underwent Le Fort I or bimaxillary osteotomies were evaluated retrospectively. Pre-and post-operative lateral cephalometric radiographs and standardized speech video recordings were analyzed. The Aspin-Welch unequal variance t test, Student t test sign test, intraclass correlation and Kappa statistics were used in the statistical analyses. Results: The mean advancement of the maxilla (point A) was 4.65 mm horizontally (range À2.80 to 11.30) and À3.82 mm vertically (range À14.20 to 3.90). The overall articulation (especially the sounds /s/ and /l/) improved significantly postoperatively, but the amount of maxillary advancement did not affect the articulation. The preoperative mean percentages of /s/, /l/, and /r/ errors were 32%, 33%, 46% and the postoperative percentages 23%, 19%, 40%, respectively. Preoperative articulation errors of /s/ were related to palatal inclination of the upper incisors. Conclusions: Orthognathic surgery may improve articulation errors. The amount of maxillary advancement is not related to the improvement.