Sex Differences in Velopharyngeal Anatomy of 9- and 10-Year-Old Children

Perry, Jamie L.; Lee, Myoung Keun; Tahmasebifard, Neda; Gilbert, Imani R.; Snodgrass, Taylor D.; Shaffer, John R.; Schleif, Eshan Pua; Weinberg, Seth M.

doi:10.1044/2023_jslhr-23-00279

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…This is particularly relevant, given that recent studies have noted that small quantitative differences (<1 mm) have been reported to influence velopharyngeal function, and these differences may be correlated with the perception of hypernasality. 56,57 For example, in patients that demonstrate velopharyngeal insufficiency, use of the curvilinear measurement provides more accurate quantitative assessment of the velar morphology and likelihood for postoperative VP function, particularly as it relates to distraction osteogenesis 30 and obstructive sleep apnea. 58 Furthermore, functional differences may also be observed when assessing velar length during phonation due to patient-specific anatomy postpalatoplasty, again highlighting the need to precisely measure this structure using a curvilinear measurement.…”

Section: Table 1 Velopharyngeal Variables Of Interestmentioning

confidence: 99%

Measurement Matters: MRI Analysis of Differing Anatomic Measurement Techniques for Velar Length and the Velopharyngeal Needs Ratio

Mason,

Hanson,

Black

2024

Plastic and Reconstructive Surgery - Global Open

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Background: Advances in imaging tools provide opportunities to enhance how velopharyngeal (VP) variables are quantified to facilitate surgical decisions. The purpose of this study was to use magnetic resonance imaging (MRI) to determine if quantitative differences were present between measures of linear and curvilinear velar length, and subsequently, the VP needs ratio. Methods: Data were prospectively collected from patients presenting with repaired cleft palate and/or congenital palatal insufficiency with or without VPI at a single center tertiary children’s hospital. Quantitative measures of the velopharynx using a novel nonsedated MRI protocol were obtained. Paired samples t tests were conducted to assess if differences were present between the VP needs ratio and measurements of linear and curvilinear velar length at rest and during sustained phonation. Intraclass correlation coefficients were calculated to assess intra/inter-rater reliability. Results: Significant differences were present between measurements of linear and curvilinear velar length at rest (P ≤ 0.001) and during sustained phonation (P ≤ 0.001). Significant differences were also present in the VP needs ratio (P ≤ 0.001). Curvilinear velar length at rest and during sustained phonation was longer than that of linear velar length at rest and during sustained phonation. No significant differences were observed between measures of effective velar length (P = 0.393). Conclusions: Measurement differences influence the VP needs ratio. This may have implications for comparisons to previously reported normative reference values and for those who are anatomically at risk for VPI. MRI provides an enhanced imaging modality to assess normative benchmarks and the anatomic variables used to define VP anatomy for clinical decision-making.

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Section: Table 1 Velopharyngeal Variables Of Interestmentioning

confidence: 99%

Measurement Matters: MRI Analysis of Differing Anatomic Measurement Techniques for Velar Length and the Velopharyngeal Needs Ratio

Mason,

Hanson,

Black

2024

Plastic and Reconstructive Surgery - Global Open

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The Levator Veli Palatini: Are all Segments Created Equal?

Perry,

Snodgrass,

Gilbert

et al. 2024

The Cleft Palate Craniofacial Journal

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Introduction The levator veli palatini (LVP) muscle has two segments with distinct roles in velopharyngeal function. Previous research suggests longer extravelar segments with shorter intravelar segments may lead to a more advantageous mechanism for velopharyngeal closure. The purpose of this study was to examine whether the distribution of the LVP intravelar and extravelar segments differs between children with cleft palate with and without VPI and controls. Methods The study included 97 children: 37 with cleft palate +/- lip with VPI, 37 controls, and 19 with cleft palate with normal resonance. Measures included mean LVP length, mean extravelar LVP length, and intravelar LVP length. Results Overall mean LVP length was similar ( P = .267) between controls and children with cleft palate (with and without VPI). However, there was a significant difference ( P < .001) between group for both intravelar and extravelar LVP lengths: the intravelar segment was significantly longer in those with VPI compared to controls and children with cleft palate and normal resonance; and the extravelar segment was significantly shorter in those with VPI compared to controls and children with cleft palate and normal resonance. Conclusions Results from this study demonstrate a significant difference between the distribution of the functional segments of the LVP among children with VPI, with a more disadvantageous distribution of the muscle segments among those with VPI.

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Sex Differences in Velopharyngeal Anatomy of 9- and 10-Year-Old Children

Cited by 2 publications

References 30 publications

Measurement Matters: MRI Analysis of Differing Anatomic Measurement Techniques for Velar Length and the Velopharyngeal Needs Ratio

Measurement Matters: MRI Analysis of Differing Anatomic Measurement Techniques for Velar Length and the Velopharyngeal Needs Ratio

The Levator Veli Palatini: Are all Segments Created Equal?

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