​​EVALUATING VELOPHARYNGEAL FUNCTION DURING PHONATION IN CHILDREN UTILIZING STATIC MRI

Abstract

Many children born with cleft palate go on to present with velopharyngeal insufficiency (VPI) characterized by speech that is hypernasal and/or has nasal air emissions. Magnetic resonance imaging (MRI) is the only imaging technique that allows for direct visualization of velopharyngeal musculature to plan for surgical correction of VPI. Normative data for MRI are available at rest and these data indicate age, race, and sex are important variables that may need to be considered when determining what is typical for velopharyngeal anatomy. A current limitation of these normative data are that they do not include speech production.

This study used structural MRI at rest, during sustained phonation of /i/, and sustained production of /s/ to investigate differences in velopharyngeal anatomy between speech production and rest in five and six-year-old children who were either Black or White. The study had two aims. Aim I determined if racial differences were present in velar and pharyngeal structures and resulting physiology. Aim II determined if racial differences were present in the LVP muscle (LVP), which is the most important muscle for velopharyngeal closure,

Aim I determined there are significant differences in velar structure size during speech production between Black and White Children, with Black children presenting with thicker velums and longer effective velums. These anatomical differences result in Black children needing less velar stretch than White children to achieve velopharyngeal closure. Aim II determined there are no differences in LVP length and LVP shortening between Black and White children.