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Morphometric Analysis of Soft Palate: Comparison of Need's Ratio with Palatal Variants and Gender Using Digital
Preethy Mary Donald1, Andrew Ng Jian Xing2, Stephanie Lee Phei Wei2
1Department of Oral Medicine and Radiology, Faculty of Dentistry, Manipal University College Malaysia, Bukit Baru, Melaka, Malaysia.
Background:
The soft palate plays a crucial role in swallowing, respiration, and speech. Variations in its morphology and dimensions may contribute to velopharyngeal insufficiency (VPI) and conditions like obstructive sleep apnea syndrome (OSAS). Limited data exist on soft palate morphometrics in the Malaysian population using digital lateral cephalograms and Need's ratio.
Objective:
To investigate the morphology and dimensions of the soft palate in normal individuals using digital lateral cephalograms and determine the distribution of soft palate types in relation to gender and Need's ratio.
Methods:
This retrospective cross-sectional study analyzed 788 digital lateral cephalograms from adults (>18 years) with normal soft palate visibility. Soft palate types were classified into six variants (leaf-shaped, rat-tail, butt-shaped, straight-line, S-shaped, crook-shaped). Measurements included velar length (VL), pharyngeal depth (PD), and Need's ratio (NR = PD/VL). Associations with gender and comparisons across types were assessed using chi-square test, ANOVA, unpaired t-tests, and post-hoc Bonferroni correction (P<0.05 significant).
Results:
The sample comprised 238 males (30.2%) and 550 females (69.8%), with a mean age of 20.9 (SD 2.0) years. Leaf-shaped (Type 1) was the most common variant (398, 50.5%). No significant association was found between soft palate types and gender (P=0.219). Significant differences were observed in VL (P<0.001) and NR (P<0.001) across types, but not in PD (P=0.436). Males had significantly higher VL (31.7 ± 4.5 mm vs. 30.4 ± 3.8 mm, P<0.001) and lower NR (0.77 ± 0.16 vs. 0.80 ± 0.14, P=0.003) compared to females; PD showed no gender difference (P=0.406).
Conclusions:
Leaf-shaped soft palate predominates in this Malaysian cohort. Morphologic variants influence VL and NR, with sexual dimorphism evident. These findings provide reference data for velopharyngeal assessments in clinical contexts like OSAS and cleft palate surgery.
