Magnetic Resonance Imaging Assessment of Velopharyngeal Structures in Chinese Children After Primary Palatal Repair

Background:Velopharyngeal inadequacy (VPI) after primary palatal repair remains a persistent problem despite advanced surgical techniques. Velopharyngeal inadequacy has significant negative impacts on patients' speech intelligibility and quality. Previous studies have produced conflicting results regarding the causes of VPI, which are likely due to limitations in two-dimensional imaging techniques used as well as failure to include matched groups with repaired cleft palate and differing velopharyngeal outcome. The present study aimed to investigate the characteristics of the velopharyngeal structures, including the levator veli palatini muscles, in children with repaired cleft palate and different speech outcomes. Methods:A prescan training was performed to help the child participants to finish scans successfully without general anesthesia. Multiple high-resolution magnetic resonance imaging scans covering the whole head and focusing on the velopharyngeal region, including the levator veli palatini muscles, were acquired in 3 matched groups of young children: children with cleft palate and VPI, children with cleft palate and adequate velopharyngeal closure, and children without cleft palate. Results:There were few significant differences between the 2 groups with cleft palate, although the functional pharyngeal dimensions were slightly greater in the children with VPI. More significant differences were found between the children with cleft palate and the control subjects. Conclusions:Anatomic characteristics of the velopharyngeal structures may be slightly less advantageous for velopharyngeal closure in children with VPI after palatal repair, but these structural differences alone cannot explain VPI.