Magnetic resonance imaging and computer reconstruction of the velopharyngeal mechanism

Further research is needed to fully understand the mechanics of the levator veli palatini muscle in coordination with surrounding structures in individuals born with a cleft palate. The purpose of this study was to combine magnetic resonance imaging (MRI) and three-dimensional computer modeling and animation to study the velopharyngeal mechanism in infants with and without a cleft palate. Two infants with a normal velopharyngeal anatomy (subjects 1 and 2) and 2 infants with a cleft lip and palate (subjects 3 and 4) were scheduled to receive a whole-head MRI for clinical reasons unrelated to the current study. This study demonstrated a successful method for combining MRI and three-dimensional computer technology to study the velopharyngeal mechanism in infants with and infants without a cleft palate. Subject 1 displayed a levator muscle sling arrangement that was shaped like a narrow U, whereas subject 2 had a wider U-shaped muscle arrangement. Subject 4 exhibited smaller angles of origin in the oblique coronal compared with that of subject 1. Both subjects with a normal anatomy showed steeper muscles compared with those of both subjects with a cleft palate. The current study enhances the body of literature in the area of MRI by acquiring MR images from infants before and after primary palatoplasty and combining the imaging with three-dimensional computer technology. The angles of the levator muscle may prove to be a significant factor in velar elevation for normal speech.