PROJECT SUMMARY/ABSTRACT
Magnetic resonance imaging (MRI) has gained popularity as an imaging modality for children with a history of
cleft palate and/or velopharyngeal insufficiency (VPI) because it is currently the only instrumental assessment
technique that allows for direct visualization of velopharyngeal muscles and structures. Because MRI allows for
direct visualization of velopharyngeal anatomy, it can be very helpful in surgical planning for children with
velopharyngeal insufficiency; however, there are no data describing typical structure size and movement patterns
of the velopharynx during phonation using the protocol many cleft and craniofacial centers use for MRI. The
protocol many craniofacial clinics use consists of sustained phonation of /i/ (shows maximal contraction of the
velopharynx during production of a vowel) and /s/ (shows maximal contraction of the velopharynx during
production of a consonant). The goal of this study is to establish preliminary data among non-cleft subjects for
sustained phonation of /i/ and /s/, as visualized on MRI. There is a critical need for normative data during
sustained phonation of /i/ and /s/, and these norms should include consideration of an individual's race. Racial
considerations are imperative because race can significantly impact velopharyngeal structure size at rest, and
size of structures at rest impacts physiology for speech. This study will provide preliminary normative data to
define typical anatomy and physiology of the velopharynx during these sustained phonation tasks across three
racial groups: Asian, Black, and White. Such data can be used for comparison to children with a history of cleft
palate and/or velopharyngeal insufficiency, given this same MRI protocol is used by many craniofacial centers.
These normative findings will help researchers and clinicians gain a better understanding of the differences
between typical and atypical velopharyngeal function and how race can impact typical velopharyngeal function
for speech. To establish preliminary normative data in children without a history of cleft palate or velopharyngeal
insufficiency, the current study proposes two aims to 1) define normal velar function during sustained phonation
of /i/ and /s/, 2) examine normal levator veli palatini muscle contraction during sustained phonation of /i/ and
/s/. This is innovative, as it will provide preliminary normative sustained phonation data, controlling for race,
which can be used for direct comparison to the anatomy of patients with VPI. We plan to recruit 42 children
without a history of cleft palate or VPI, all aged five (common age for VPI surgery), to complete the clinical
velopharyngeal MRI protocol, including sustained /i/ and /s/.