Objective: To obtain detailed anatomic and physiologic information on the levator veli palatini muscle from MRI in individuals with repaired cleft palate and to compare the results with those from normal subjects reported by Ettema et al. (2002).
Design: Prospective study.
Setting: University-based hospital.
Participants: Four men (ages 22 to 43 years) with repaired cleft lip and palate.
Main Outcome Measures: Four quantitative measurements of the levator veli palatini muscle from rest position and dynamic speech magnetic resonance images were obtained: the distance between the origins of the muscle, angle of origin of the muscle, muscle length, and muscle thickness.
Results: The length and thickness of the levator veli palatini muscle varied among the subjects and were different from measurements obtained from normal subjects in a previous study. The distance between origin points, length, and thickness of the levator veli palatini muscle were smaller than those of the normal subjects. There were systematic changes of the levator veli palatini muscle, depending upon vowel and consonant types. Levator veli palatini muscle angle of origin and length became progressively smaller from rest, nasal consonants, low vowels, high vowels, and fricative consonants. These changes are consistent with those of the normal subjects.
Conclusions: This study contributes to a better understanding of cleft palate anatomy in comparison with normal anatomy of the levator veli palatini muscle. The use of MRI shows promise as an important tool in the diagnosis and eventual aid to treatment decisions for individuals born with cleft palate.
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http://dx.doi.org/10.1597/06-220.1 | DOI Listing |
Cleft Palate Craniofac J
December 2024
Phoenix Children's Center for Cleft and Craniofacial, Phoenix Children's Hospital a Division of Plastic Surgery, Phoenix, AZ, USA.
Objective: Describe surgical decision making and outcomes in a series of patients with persistent VPI after pharyngeal flap placement that were all treated with revision palatoplasty.
Design: Retrospective, case series.
Participants: Five patients with nonsyndromic cleft palate and persistent hypernasality following a pharyngeal flap.
Cleft Palate Craniofac J
December 2024
Division of Plastic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
Objective: Velopharyngeal insufficiency (VPI) poses challenges for normal speech production, often necessitating surgical intervention. Determining optimal candidates for surgery remains complex and requires a nuanced understanding of underlying anatomic factors contributing to VPI. This study aimed to identify anatomic predictors that drive surgical recommendations for VPI.
View Article and Find Full Text PDFWorld Neurosurg
December 2024
Department of Otolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address:
Objectives: The parapharyngeal space (PPS) and infratemporal fossa (ITF) present significant challenges for endoscopic skull base surgery due to their complex anatomy and lack of clear bony landmarks. This study aims to propose a systematic compartmentalization of the PPS and ITF, based on key anatomical structures, to optimize surgical planning and approaches.
Methods: To retain a precise bony reference framework, the walls of the maxillary sinus and pterygoid bone were preserved.
J Nippon Med Sch
November 2024
Department of Otolaryngology, Head and Neck Surgery, Nippon Medical School.
Background: We aimed to investigate the contribution of the palatopharyngeal muscle (PP) as a speech muscle in adjusting the velar position.
Methods: X-ray kinematic analysis of the position of the palatopharyngeal arch and an electromyographic study of the PP during speech were performed in two healthy volunteers.
Results: X-ray kinematic analysis revealed that the palatopharyngeal arch was positioned lower during the production of the low-back vowel /a/.
J Speech Lang Hear Res
December 2024
Department of Human Services, University of Virginia, Charlottesville.
Purpose: Finite element (FE) models have emerged as a powerful method to study biomechanical complexities of velopharyngeal (VP) function. However, existing models have overlooked the active contributions of the lateral pharyngeal wall (LPW) in VP closure. This study aimed to develop and validate a more comprehensive FE model of VP closure to include the superior pharyngeal constrictor (SPC) muscle within the LPW as an active component of VP closure.
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