Long-term effect of anterior maxillary distraction using the VINK appliance – Retropalatal and Retroglossal airway change

This longitudinal retrospective study evaluated the effects of anterior maxillary distraction (AMD) using the VINK Maxillary Elongator on retropalatal (RPA) and retroglossal (RGA) airway volumes in 77 cleft lip and palate (CLP) patients. Pre-operative (T0) and eight-month post-operative (T1) lateral cephalograms and CBCT scans were analyzed to assess the correlation between antero-posterior maxillary advancement-measured as Effective Maxillary Length (EML) and airway volume changes. Statistical analyses included paired t-tests and Pearson's correlation tests, with p < 0.001 considered significant. The mean EML increased significantly from 79.12 ± 6.14mm to 88.92 ± 6.49mm (p = 0.001), and the mean airway volume rose from 14.01 ± 6.52mm³ to 16.46 ± 6.70mm³ (p < 0.001). A moderate positive correlation was observed between EML and airway volume change (r = 0.33, p = 0.02). The Epiglottis-Pharynx Line (EPL) increased significantly from 12.66 ± 4.31mm to 14.55 ± 4.07mm (p < 0.001), showing a strong correlation with total airway change (r = 0.62, p = 0.001). Notably, BCLP patients demonstrated greater maxillary elongation (11.52 ± 5.79mm) than UCLP (8.82 ± 4.92mm; p = 0.043), though airway and EPL changes were comparable. These findings suggest that AMD-induced maxillary advancement significantly enhances airway volume by altering tongue posture, irrespective of cleft type.