Magnetic resonance imaging assessment of velopharyngeal structures in Chinese children after primary palatal repair.
BACKGROUND
Velopharyngeal inadequacy (VPI) after primary palatal repair remains a persistent problem despite advanced surgical techniques. Velopharyngeal inadequacy has significant negative impacts on patients' speech intelligibility and quality. Previous studies have produced conflicting results regarding the causes of VPI, which are likely due to limitations in two-dimensional imaging techniques used as well as failure to include matched groups with repaired cleft palate and differing velopharyngeal outcome. The present study aimed to investigate the characteristics of the velopharyngeal structures, including the levator veli palatini muscles, in children with repaired cleft palate and different speech outcomes.


METHODS
A prescan training was performed to help the child participants to finish scans successfully without general anesthesia. Multiple high-resolution magnetic resonance imaging scans covering the whole head and focusing on the velopharyngeal region, including the levator veli palatini muscles, were acquired in 3 matched groups of young children: children with cleft palate and VPI, children with cleft palate and adequate velopharyngeal closure, and children without cleft palate.


RESULTS
There were few significant differences between the 2 groups with cleft palate, although the functional pharyngeal dimensions were slightly greater in the children with VPI. More significant differences were found between the children with cleft palate and the control subjects.


CONCLUSIONS
Anatomic characteristics of the velopharyngeal structures may be slightly less advantageous for velopharyngeal closure in children with VPI after palatal repair, but these structural differences alone cannot explain VPI.
Tian
Wei
W
Department of Hearing and Speech Sciences, University of Maryland at College Park, College Park, Maryland 20742, USA. wtian@hesp.umd.edu
Yin
Heng
H
Li
Yang
Y
Zhao
Shufan
S
Zheng
Qian
Q
Shi
Bing
B
D001184:Articulation Disorders / Q000503:physiopathology; D016022:Case-Control Studies; D002508:Cephalometry / Q000379:methods; D002648:Child; D002675:Child, Preschool; D002681:China; D002972:Cleft Palate / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009305:Nasopharynx / Q000473:pathology; D009960:Oropharynx / Q000473:pathology; D010156:Palatal Muscles / Q000473:pathology; D021362:Palate, Hard / Q000473:pathology; D010160:Palate, Soft / Q000473:pathology*; D010614:Pharynx / Q000473:pathology*; D013060:Speech / Q000502:physiology; D013064:Speech Disorders / Q000503:physiopathology; D014609:Uvula / Q000473:pathology; D014681:Velopharyngeal Insufficiency / Q000503:physiopathology