A Midsagittal-View Magnetic Resonance Imaging Study of the Growth and Involution of the Adenoid Mass and Related Changes in Selected Velopharyngeal Structures (original) (raw)
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Journal of Craniofacial Surgery, 2016
The purpose of this study was to create a 3D volumetric segmentation from magnetic resonance imaging (MRI) of the nasopharyngeal space and adenoid tissue and to examine the relationship between nasopharyngeal volume (NPV), adenoid volume, and linear measures of the velopharyngeal structures, pharynx, and vocal tract in children with and without cleft palate. A total of 24 participants including 18 typically developing children (4-8 years of age) and 6 children (4-8 years of age) with varying degrees of cleft palate were imaged using MRI. Linear and volumetric variables varied significantly based on age. Overall, NPV demonstrates a modest increase with age. Nasopharyngeal volume was positively correlated with age (P ¼ 0.000), oronasopharyngeal volume (P ¼ 0.000), velar length (P ¼ 0.018), and velar thickness (P ¼ 0.046). These variables tend to increase together. Differences in NPV between groups (bilateral cleft lip and palate, submucous cleft lip and palate, unilateral cleft lip and palate [UCLP], and noncleft) were statistically significant (P ¼ 0.007). Participants with bilateral cleft lip and palate demonstrated greater NPVs than those with UCLP and submucous cleft palate.
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...
Growth Effects on Velopharyngeal Anatomy From Childhood to Adulthood
Journal of Speech, Language, and Hearing Research, 2019
PurposeThe observed sexual dimorphism of velopharyngeal structures among adult populations has not been observed in the young child (4- to 9-year-old) population. The purpose of this study was to examine the age at which sexual dimorphism of velopharyngeal structures become apparent and to examine how growth trends vary between boys and girls.MethodStatic 3-dimensional magnetic resonance imaging velopharyngeal data were collected among 202 participants ranging from 4 to 21 years of age. Participants were divided into 3 groups based on age, including Group 1: 4–10 years of age, Group 2: 11–17 years of age, and Group 3: 18–21 years of age. Nine velopharyngeal measures were obtained and compared between groups.ResultsSignificant sex effects were evident for levator length (p= .011), origin to origin (p= .018), and velopharyngeal ratio (p= .036) for those in Group 2 (11–17 years of age). Sex effects became increasingly apparent with age, with 7 of 9 variables becoming significantly diff...
Clinical Otolaryngology, 2017
To characterise the craniofacial structure by cephalometry, especially the skull base and nasopharyngeal space, in children who underwent adenoidectomy and developed persistent velopharyngeal dysfunction (VPD). Design: Retrospective study. Setting: Speech and swallowing clinic of a single academic hospital. Participants: Thirty-nine children with persistent VPD following adenoidectomy (mean age 8.0AE3.6 years) and a control group of 80 healthy children. Main outcome measures: Cephalometric landmarks were chosen; craniofacial linear and angular dimensions were measured and analysed. Results: The linear dimensions of the nasopharyngeal area were shorter in the VPD group, S-Ba (41.6AE4.2 mm, P<.05) and S-Ptm (42.4AE5.1 mm, P<.05). The anterior skull base, N-S, was similar (68.1 mmAE6.8). The velum length, Ptm-P was significantly shorter in the VPD group (27.8AE4.3 mm, P<.001). The Ba-S-Ptm angle was significantly larger in the VPD group (63.5AE5.6°, P<.001). There was no significant difference in cranial base angle (CBA), Ba-S-N, between the two groups.
Changes in velopharyngeal valving with age
International journal of pediatric otorhinolaryngology, 1986
Variability of velopharyngeal valving between subjects has been a well established fact since the advent of new techniques for the direct viewing of the velopharyngeal sphincter during speech. Multi-view videofluoroscopy and nasopharyngoscopy have shown that there is variable contribution to velopharyngeal closure from the velum, the lateral pharyngeal walls, and posterior pharyngeal wall from person to person. However, to date, there has been no evidence to show if velopharyngeal closure remains unchanged within individuals throughout life. The purpose of this investigation was to observe velopharyngeal closure in normal subjects and subjects with cleft palate from prepubertal to postpubertal life (i.e. pre-adenoid involution to post-adenoid involution). Changes in velopharyngeal closure patterns were observed in 60% of the normals studied and 30% of the cleft subjects.
Longitudinal Morphological Changes in the Adenoids and Tonsils in Japanese School Children
Journal of Clinical Medicine
The adenoid (Ad) and tonsil (Ts), located in the upper airway, play an important role in immunological protection. These lymphoid tissues grow rapidly, reach a peak of growth at the age of 6–8 years, and decrease in their size thereafter. However, little information is available on the longitudinal growth patterns of Ad and Ts in the general population. This study aimed to evaluate the individual growth of Ad and Ts during childhood using lateral cephalograms taken longitudinally from the same individuals at the ages of 8–12 years. Our results showed that the cross-sectional areas of the Ad, nasopharynx (Np), and oropharynx (Op) significantly increased with age while small changes in the size of Ts were present throughout the study period. In addition, the values of Ad/Np and Ts/Op decreased significantly with age in the elementary school. Furthermore, there was a strong and significant correlation between the Ad/Np ratio and upper airway resistance, indicating the narrowest distanc...
Anatomic development of the oral and pharyngeal portions of the vocal tract: An imaging study
2009
The growth of the vocal tract ͑VT͒ is known to be non-uniform insofar as there are regional differences in anatomic maturation. This study presents quantitative anatomic data on the growth of the oral and pharyngeal portions of the VT from 605 imaging studies for individuals between birth and 19 years. The oral ͑horizontal͒ portion of the VT was segmented into lip-thickness, anterior-cavity-length, oropharyngeal-width, and VT-oral, and the pharyngeal ͑vertical͒ portion of the VT into posterior-cavity-length, and nasopharyngeal-length. The data were analyzed to determine growth trend, growth rate, and growth type ͑neural or somatic͒. Findings indicate differences in the growth trend of segments/variables analyzed, with significant sex differences for all variables except anterior-cavity-length. While the growth trend of some variables displays prepubertal sex differences at specific age ranges, the importance of such localized differences appears to be masked by overall growth rate differences between males and females. Finally, assessment of growth curve type indicates that most VT structures follow a combined/hybrid ͑somatic and neural͒ growth curve with structures in the vertical plane having a predominantly somatic growth pattern. These data on the non-uniform growth of the vocal tract reveal anatomic differences that contribute to documented acoustic differences in prepubertal speech production.
Significance of Adenoid Nasopharyngeal Ratio in the Assessment of Adenoid Hypertrophy in Children
The aims of this study are to find out the significance of adenoid nasopharyngeal ratio obtained from lateral X-Ray of nasopharynx to decide on the option of surgical treatment of adenoid and to correlate the symptoms with the relative size of adenoid in the nasopharynx. This prospective study was done on 100 children who presented with bilateral nasal obstruction from 4-12years of age. Radiological assessment of lateral radiograph of nasopharynx was done. Mean adenoidal depth and mean nasopharyngeal depth were calculated as per Yusuf et al method. Mean ANR was calculated by dividing adenoidal depth by nasopharyngeal depth. There was significant increase in adenoid size during 7-9 years and decrease in 10-12 years, the nasopharyngeal depth increased as age progressed. It was concluded that ANR > 0.7 are the candidates for adenoidectomy.
Age-Related Changes Between the Level of Velopharyngeal Closure and the Cervical Spine
Journal of Craniofacial Surgery, 2016
The primary focus of this study was to assess age related changes in the vertical distance of the estimated level of velopharyngeal closure in relation to a prominent landmark of the cervical spine: the anterior tubercle of cervical vertebrae one (C1). Midsagittal anatomical magnetic resonance images (MRI) were examined across 51 participants with normal head and neck anatomy between 4 and 17 years of age. Results indicate that age is a strong predictor (p = 0.002) of the vertical distance between the level of velopharyngeal closure relative to C1. Specifically, as age increases, the vertical distance between the palatal plane and C1 becomes greater resulting in the level of velopharyngeal closure being located higher above C1 (range 4.88mm to 10.55mm). Results of this study provide insights into the clinical usefulness of using C1 as a surgical landmark for placement of pharyngoplasties in children with repaired cleft palate and persistent hypernasal speech. Clinical implications and future directions are discussed.