Relationship Between Age and Diagnosis on Volumetric and Linear Velopharyngeal Measures in the Cleft and Noncleft Populations (original) (raw)
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Variations in Velopharyngeal Structure in Adults With Repaired Cleft Palate
The Cleft Palate-Craniofacial Journal, 2018
Objective: The purpose of this study was to examine differences in velopharyngeal structures between adults with repaired cleft palate and normal resonance and adults without cleft palate. Design: Thirty-six English-speaking adults, including 6 adults (2 males and 4 females) with repaired cleft palate (M = 32.5 years of age, SD = 17.4 years) and 30 adults (15 males and 15 females) without cleft palate (M = 23.3 years of age, SD = 4.1 years), participated in the study. Fourteen velopharyngeal measures were obtained on magnetic resonance images and compared between groups (cleft and noncleft). Results: After adjusting for body size and sex effects, there was a statistically significant difference between groups for 10 out of the 14 velopharyngeal measures. Compared to those without cleft palate, participants with repaired cleft palate had a significantly shorter hard palate height and length, shorter levator muscle length, shorter intravelar segment, more acute levator angles of origi...
The Cleft Palate-Craniofacial Journal, 2017
Objective:The purpose of this study was to quantify the growth of the various craniofacial and velopharyngeal structures and examine sex and race effects.Methods:Eight-five healthy children (53 white and 32 black) with normal velopharyngeal anatomy between 4 and 9 years of age who met the inclusion criteria and successfully completed the magnetic resonance imaging (MRI) scans were included in the study.Results:Developmental normative mean values for selected craniofacial and velopharyngeal variables by race and sex are reported. Facial skeleton variables (face height, nasion to sella, sella to basion, palate height, palate width) and velopharyngeal variables (levator muscle length, angle of origin, sagittal angle, velar length, velar thickness, velar knee to posterior pharyngeal wall, and posterior nasal spine to levator muscle) demonstrated a trend toward a decrease in angle measures and increase in linear measures as age increased (with the exception of posterior nasal spine to le...
Journal of Speech, Language, and Hearing Research
Purpose: The adenoids, or pharyngeal tonsils, consist of a pad of lymphoid tissue, located on the posterior pharyngeal wall of the nasopharynx. During childhood, the adenoid pad serves as a contact site for the soft palate to assist with velopharyngeal closure during oral speech. During adenoidal involution, most children are able to maintain appropriate velopharyngeal closure necessary for normal speech resonance. The purpose of this study is to determine age-related trends of normal adenoid growth and involution from infancy through adulthood. Method/Description: Lateral view magnetic resonance imaging was used to analyze velopharyngeal variables among 270 participants, between 3 months and 34 years of age. The velopharyngeal measures of interest included velar length, effective velar length, pharyngeal depth, adenoid height, adenoid thickness, adenoid depth, and adenoid area. Participants were divided into four age groups for statistical comparison. Results: There was a statistic...
Palatal Volume Changes in Unilateral Cleft Lip and Palate Paediatric Patients
Proceedings of the 6th International Conference on 3D Body Scanning Technologies, Lugano, Switzerland, 27-28 October 2015, 2015
Cleft lip and/or palate (CL/P) are the most common craniofacial abnormalities. CL/P therapy involves also orthopedic and surgical treatments. In particular, the orthopedic treatment can help to align the cleft segments and facilitate surgery. Traditionally, facial and palatal structures have been analyzed by 2D methods, omitting information of volume bone defects. A pre-surgical volume estimation can be useful to determine the anatomical boundaries of the alveolar bone defect; subsequently, volume assessments can appreciate the outcome of secondary alveolar bone grafting. In the present study, we developed a 3D stereophotogrammetric technique for volume estimation of the dental arches of children with CL/P. The method was employed to assess the 3D changes occurring in the maxillary arch of unilateral CLP (UCLP) patients with the use of plates before the first year of life. We collected 96 palatal casts of 32 neonatal patients with UCLP. Palatal casts were obtained before orthopedic treatment, before cheiloplasty, and after cheiloplasty. Half patients were treated with an active plate, half with a passive one. Casts were marked with a set of landmarks, digitized using a stereophotogrammetric system, and then analyzed. Volumes of the greater and the minor alveolar segments were separately assessed, and compared with a 3-w repeated measures ANOVA. Method accuracy was assessed using objects of known size, while repeatability was evaluated using Student's t test and technical error of measurements. Volume estimates were accurate, without systematic errors; random errors were lower than 5% of the total variance. Significant effects of alveolar segment and time were observed (p<0.0001). Instead, no differences were found for the kind of plate. In conclusion, stereophotogrammetric systems can be a valid instrument to estimate palatal volumes of patients with CL/P during treatment, that can be followed up in a safe, rapid and non-invasive way.
The nasopharynx in infants with cleft lip and palate
International journal of pediatric otorhinolaryngology, 2012
The purpose of this study was to use three-dimensional computed tomography data and computer imaging technology to assess the skeletal components of the naso-pharyngeal area in patients with cleft lip and palate and to quantify anatomical variations. CT scans were obtained from 29 patients of Malay origin with cleft lip and palate aged between 0 and 12 months and 12 noncleft patients in the same age group, using a GE Lightspeed Plus Scanner housed in Hospital Universiti Sains Malaysia. Measurements were obtained using the 'Persona' three-dimensional software package, developed at Australian Craniofacial Unit, Adelaide. The results of the present study show that there is an increased nasopharyngeal space in cleft lip and palate that may lead to compression of the nasopharyngeal structures, including the Eustachian tube. Alterations of the medial pterygoid plate and the hamulus may lead to an alteration in the origin and orientation of the tensor veli palatini muscle leading t...
Anatomia
Clefts of the lip or palate (CLPs) are the most common craniofacial birth defect, with a worldwide incidence of ~1 in 700 live births. The objective of this study is to assess the characteristics of the nasopharyngeal airway in growing vs. non-growing cleft lip/palate subjects and compare them with normal subjects. This retrospective study analyzed eighty-seven scans of three groups from cone beam computed tomography (CBCT). The cone beam computed tomography (CBCT) scans were coded and landmarks were identified using a Dolphin three-dimensional (3D) imaging software server (version 11.7; Patterson Dental Supply, Chatsworth, Calif). All values showed strong measurement reliability (>80), except for the nasopharynx measurement. Regarding gender difference, for the nasopharynx, female subjects (1261.32 ± 713.94) showed the lowest significant values in non-growing unilateral compared to males (6496.8 ± 2987) at p = 0.008. For oropharynx, in the growing bilateral cleft group, male sub...
Objective, Noninvasive Evaluation of Velopharyngeal Function in Cleft and Noncleft Patients
The Cleft Palate-Craniofacial Journal, 1998
The purpose of this study was to investigate a new diagnostic method that provides an approach to noninvasive, objective measurement of velopharyngeal movement by acoustic determination of epipharyngeal volume changes with velopharyngeal muscle function. Design: This was a case control study, using consecutive samples. Setting: This study took place at the Cleft Palate Rehabilitation Center of the University of Mainz, Germany. Patients: Subjects were 29 consecutive cleft lip and palate (CLP) patients and 31 controls (21 patients with dysgnathia and 10 healthy volunteers). Intervention: A series of transnasal acoustic measurements (pressure wave: 55 dB for 2 milliseconds) of epipharyngeal volume were performed with the pharyngeal muscles relaxed in end-expiration and while the velopharyngeal orifice was closed, with the difference in volume representing maximal pharyngeal movement. Results: Cleft palate patients yielded significantly lower values of velopharyngeal movement (6.5 cm 3) than did the control group (8.0 cm 3) (p Ͻ .05; Mann-Whitney U test). Overlapping ranges of values were measured for the C(L)P and control groups. The least mobility (4.75 cm 3) was measured in patients who had undergone pharyngeal flap surgery. Different patterns of restriction were observed in patients with and without a pharyngeal flap. Conclusion: Acoustic pharyngometry may provide access to noninvasive quantitative measurement of velopharyngeal movement and a better understanding of the pattern of movement in C(L)P-patients. We expect it to be a helpful tool in objectively monitoring the progress of logopedic therapy.
Nasopharyngeal Development in Patients with Cleft Lip and Palate: A Retrospective Case-Control Study
The aim of this paper was to evaluate cephalometrically the nasopharyngeal development of patients with complete unilateral cleft lip and palate. Influencing factors were evaluated and cleft to noncleft subjects were compared to each other. Material and Methods. The lateral cephalograms of 66 patients with complete cleft lip and palate were measured and compared retrospectively to the cephalograms of 123 healthy probands. Measurements were derived from a standardized analysis of 56 landmarks. Results. We observed significant differences between cleft and control group: the cleft patients showed amaxillary retroposition and a reduced maxillary length; the inclination of the maxilla was significantly more posterior and cranial; the anterior nasopharyngeal height was reduced; the nasopharyngeal growth followed a vertical tendency with reduced sagittal dimensions concerning hard and soft tissue. The velum length was reduced. In the cleft group, an accumulation of mandibular retrognathia and an anterior position of the hyoid were observed. Skeletal configuration and type of growth were predominantly vertical. Conclusions. Our data provides a fundamental radiological analysis of the nasopharyngeal development in cleft patients. It confirms the lateral cephalogram as a basic diagnostic device in the analysis of nasopharyngeal and skeletal growth in cleft patients.
Three-dimensional assessment of airway volumes in patients with unilateral cleft lip and palate
Progress in Orthodontics, 2021
Background Considering the adverse consequences of respiratory insufficiency in cleft lip and palate (CLP) patients, this study aimed to assess the pharyngeal airway dimensions in 9–12-year-old patients with unilateral CLP. This historical cohort evaluated the cone-beam computed tomography (CBCT) scans of 30 patients with non-syndromic unilateral CLP between 9 and 12 years and 30 age- and sex-matched non-cleft controls. Three-dimensional (3D) images were reconstructed by the Mimics software, and the nasopharyngeal, oropharyngeal, and total airway volumes, as well as the minimal cross-sectional area of the airway (minAx), and posterior airway length (PAL) were all measured in the sagittal plane. Data were analyzed by the Student’s t test. Results The oropharyngeal and the total airway volumes, as well as the minAx and PAL in CLP patients, were significantly smaller than the corresponding values in the control group (P 0.05). Conclusions Nine- to twelve-year-old non-syndromic unilate...