Craniometric and Velopharyngeal Assessment of Infants With and Without Cleft Palate

Perry, Jamie L.; Kuehn, David P.; Sutton, Bradley P.; Goldwasser, Michael S.; Jerez, Alex D.

doi:10.1097/scs.0b013e3182087378

Cited by 30 publications

(44 citation statements)

References 6 publications

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“…The LVP of infants is approximately two-thirds of the length of the LVP of adults. 13,20,24,25 This suggests that scaling down the simulated overlap distances for surgeries on infants and children would produce the same mechanical effects on closure force. Estimated overlap amounts for adults and infants based on the overlap percentages from this study are shown in Table 2.…”

Section: Discussionmentioning

confidence: 91%

“…24 One could argue that there should be a wide range of total LVP lengths due to a wide range of cleft severities and anatomies. For example, in a case with a very wide cleft, the LVP may be attached more anteriorly within the mouth, so that the origin and insertion of muscle would be farther apart, making the muscle longer.…”

Section: Discussionmentioning

confidence: 99%

“…24 Therefore, we assume that suturing the LVP halves end-to-end will result in a normal-length LVP sling.…”

Section: Modeling Surgical Overlapmentioning

confidence: 99%

“…Models can integrate the wealth of literature describing the anatomy, physical properties, and in vivo function of the VP mechanism [15][16][17][18][19][20][21][22][23][24][25] and then be used to systematically investigate cause-and-effect relationships that would be either impossible to accomplish in vivo or take decades of clinical trials to uncover. For example, models have the ability to quantify the effect of varying surgical parameters, like the extent of LVP overlap.…”

mentioning

confidence: 99%

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A Computational Model of Velopharyngeal Closure for Simulating Cleft Palate Repair

Inouye¹,

Pelland

Lin³

et al. 2015

Journal of Craniofacial Surgery

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The levator veli palatini (LVP) muscle has long been recognized as the muscle that contributes most to velopharyngeal (VP) closure and is therefore of principal importance for restoring normal speech in patients with a cleft palate. Different surgical reconstructive procedures can utilize varying degrees of LVP overlap, and this study developed a new finite-element model of VP closure designed to understand the biomechanical effects of LVP overlap. A three-dimensional finite-element model was created from adult anatomical dimensions and parameters taken from the literature. Velopharyngeal function was simulated and compared with experimental measurements of VP closure force from a previous study. Varying degrees of overlap and separation of the LVP were simulated, and the corresponding closure force was calculated. The computational model compares favorably with the experimental measurements of closure force from the literature. Furthermore, the model predicts that there is an optimal level of overlap that maximizes the potential for the LVP to generate closure force. The model predicts that achieving optimal overlap can increase closure force up to roughly 100% when compared with too little or too much overlap. The results of using this new model of VP closure suggest that optimizing LVP overlap may produce improved surgical outcomes due to the intrinsic properties of muscle. Future work will compare these model predictions with clinical observations and provide further insights into optimal cleft palate repair and other craniofacial surgeries.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

“…24 Therefore, we assume that suturing the LVP halves end-to-end will result in a normal-length LVP sling.…”

Section: Modeling Surgical Overlapmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

A Computational Model of Velopharyngeal Closure for Simulating Cleft Palate Repair

Inouye¹,

Pelland

Lin³

et al. 2015

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

show abstract

“…The average angle at the origin, between the base of the skull and the course of the muscle bundle during rest, was 64.5° for women and 60.4° for men. Levator muscle thickness has been reported in several studies (Ettema et al, 2002; Ha et al, 2007; Perry et al, 2011; Perry, 2011), although some have questioned the validity of these reports (Ha et al, 2007). This is because studies using magnetic resonance imaging have measured the diameter using a two-dimensional image plane.…”

Section: Introductionmentioning

confidence: 99%

Morphology of the Levator Veli Palatini Muscle Using Magnetic Resonance Imaging

Perry

Kuehn

Sutton

2013

The Cleft Palate Craniofacial Journal

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Background No studies have reported the circumference and diameter of the levator veli palatini muscle at multiple points along its length and from both views (frontal and lateral). The purpose of this study was to provide quantitative data regarding the levator muscle morphology along the length of the muscle using magnetic resonance imaging and advanced three-dimensional computer technology. Methods Ten Caucasian male subjects participated in the study. Subjects were scanned using a Siemens 3 T Trio. Levator muscle measures were obtained using a two-dimensional image plane. A three-dimensional model was used to measure the circumference and muscle diameter (in two directions) at six points along the length of the levator muscle. Results Levator muscle length ranged from 41.67 mm to 52.85 mm across all subjects. Mean extravelar muscle length was 30.55 mm (SD, 2.8 mm) and 30.01 mm (SD, 2.9 mm) for right and left muscles. The mean circumference at the origin was 18.90 mm (SD, 2.6 mm). At the second point, the muscle circumference mean increased slightly (mean, 22.40 mm; SD, 4.9 mm). The means for the remainder of the measures (points 3, 4, 5, and 6) were consistent, showing little to no change. Conclusion Circumference and diameter values were similar to those reported in previous literature. The muscle did diverge at the point where the muscle bundle entered the velum, as it has been previously described. Instead, the muscle diverges near the midline insertion becoming sparser (smaller superior-to-inferior diameter).

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Pathophysiology of the Cleft Palate

Siddiqui

2022

Surgical Atlas of Cleft Palate and Palatal Fistulae

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Craniometric and Velopharyngeal Assessment of Infants With and Without Cleft Palate

Cited by 30 publications

References 6 publications

A Computational Model of Velopharyngeal Closure for Simulating Cleft Palate Repair

A Computational Model of Velopharyngeal Closure for Simulating Cleft Palate Repair

Morphology of the Levator Veli Palatini Muscle Using Magnetic Resonance Imaging

Pathophysiology of the Cleft Palate

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