MRI Analyses of the Velopharyngeal Mechanism among Different Adult Populations

不同成年人群腭咽机制的 MRI 分析

• 批准号: 7631091
• 负责人: Jamie L Perry
• 金额: $ 14.07万
• 依托单位: ILLINOIS STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-05 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7631091
• 关键词: Address; Adult; African American; American; Anatomy; Asians; Breathing; Caucasians; Caucasoid Race; Child; Child Care; Cleaved cell; Cleft Palate; Computer Simulation; Data; Deglutition; Diagnosis; Diagnostic; Dimensions; Enrollment; Ethnic group; European; Face; Female; Gender; Goals; Head and neck structure; Human; Imagery; Incidence; Individual; Investigation; Japanese Population; Lead; Life; Magnetic Resonance Imaging; Measurement; Measures; Morphology; Muscle; Muscle function; Operative Surgical Procedures; Oral; Outcome Measure; Patients; Pattern; Population; Predisposition; Premaxillary palate; Production; Race; Recruitment Activity; Reporting; Research; Rest; Sample Size; Sampling; Secondary Palate; Sex Characteristics; Speech; Speech Development; Speech Sound; Speech Therapy; Speed; Structure; Surgical Management; Testing; Tongue; Variant; base; craniofacial; epidemiology study; improved; information gathering; insight; male; oral cleft; palatal surgery; palate repair; public health relevance; racial and ethnic; racial difference; repaired; sex; skeletal; soft tissue; software systems

DESCRIPTION (provided by applicant): It is likely that there are specific dimensions for the musculature of the velopharynx that are required in order for a child to develop normal sounding speech. If a child has a primary repair of the levator muscle that does not conform to that of normal anatomy, it is likely that they will develop hypernasal speech and would require secondary palate surgery. Data has not demonstrated what constitutes "normal" levator muscle anatomy or how race and sex impact those normative measures. We will elucidate what constitutes normative muscle dimension range based on sex, race, craniometric dimensions, and/or velopharyngeal closure patterns. These results can be directly utilized to guide primary surgery. Such patient specific surgical planning will decrease the incidence of hypernasality during speech development and thus reduce the need for secondary surgical management later in life. The aims of this R03 proposal are to address unresolved issues concerning the interaction of race and sex on the structure and function of the velopharynx. The study will also assess the interaction of craniometric measurements and velopharyngeal closure patterns as it relates to levator dimensions found in different racial/ethnic groups and/or gender groups. Analyses of the relationship of these variables will enable us to identify whether racial differences in oral clefts are a result of morphological differences at the skeleto- muscular level. More applicably, data obtained here will have a direct impact on surgical practices in the treatment of children born with cleft palate. Thus, the long term goal of this study is to improve the diagnostic and surgical planning care for children born with cleft palate. The information gathered from these investigations will lead to improved speech outcome measures as well as a reduced need for subsequent secondary palatal surgeries. The following specific aims are proposed: (a) to identify morphologic differences in the levator muscle at rest and during speech production as a function of race (b) to determine whether sex differences exist in the morphology of the levator muscle at rest or during speech production. A total of 84 subjects will be recruited for participation in the study. Magnetic resonance images will be obtained while the velum is at rest (non-speech) and during speech. MR images will be used to measure craniometric measures and levator muscle morphology. Nasoendoscoy will be performed to determine velopharyngeal closure patterns. The data will be imported into a 3D software system to create a computer model in three dimensions of space for improved measurements and visualization of the internal craniofacial and velopharyngeal structures. PUBLIC HEALTH RELEVANCE: Hardin-Jones and Jones (2005) found 68% of preschoolers with repaired cleft palate were enrolled in speech therapy. More interestingly, 37% had moderate to severe hypernasality or had received secondary surgical management due to an incompetent velopharyngeal mechanism. Primary surgical repair (initial surgery) that is patient specific (based on race, sex, and levator muscle dimensions) would reduce the incidence of aberrant speech found among many children with cleft palate and reduce the need for subsequent surgeries (secondary surgical management).

描述（由申请人提供）：为了让儿童发展正常的发音，腭咽部的肌肉组织可能需要特定的尺寸。如果孩子的提上睑肌初次修复不符合正常解剖结构，他们很可能会出现鼻音过多，需要进行二次腭手术。数据尚未证明什么构成“正常”提肌解剖结构或种族和性别如何影响这些规范措施。我们将根据性别、种族、颅骨测量尺寸和/或腭咽闭合模式阐明标准肌肉尺寸范围的构成。这些结果可直接用于指导初次手术。这种针对患者的手术计划将减少言语发育过程中鼻音过多的发生率，从而减少晚年二次手术治疗的需要。该 R03 提案的目的是解决有关种族和性别对腭咽结构和功能的相互作用的尚未解决的问题。该研究还将评估颅骨测量和腭咽闭合模式的相互作用，因为它与不同种族/族裔群体和/或性别群体中发现的提肌尺寸有关。对这些变量之间关系的分析将使我们能够确定口裂的种族差异是否是骨骼肌肉水平形态差异的结果。更适用的是，这里获得的数据将对治疗先天性腭裂儿童的手术实践产生直接影响。因此，这项研究的长期目标是改善对先天性腭裂儿童的诊断和手术计划护理。从这些调查中收集的信息将改善言语结果测量，并减少后续二次腭手术的需求。提出以下具体目标：（a）确定提上睑肌在休息和言语过程中的形态差异作为种族的函数（b）确定提上睑肌在休息或言语过程中的形态是否存在性别差异生产。总共将招募 84 名受试者参与该研究。磁共振图像将在软腭静止（非言语）和言语期间获得。 MR 图像将用于测量颅骨测量和提上睑肌形态。将进行鼻内窥镜检查以确定腭咽闭合模式。数据将被导入 3D 软件系统，以创建三维空间的计算机模型，以改进内部颅面和腭咽结构的测量和可视化。 公共健康相关性：Hardin-Jones 和 Jones (2005) 发现 68% 的腭裂修复学龄前儿童参加了言语治疗。更有趣的是，37% 的人患有中度至重度鼻窦炎，或者由于腭咽机制不健全而接受了二次手术治疗。针对特定患者（基于种族、性别和上睑提肌尺寸）的初次手术修复（初次手术）将减少许多腭裂儿童中发现的异常言语的发生率，并减少后续手术（二次手术治疗）的需要。