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: 8322922
• 负责人: Jamie L Perry
• 金额: $ 15.33万
• 依托单位: EAST CAROLINA 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 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8322922
• 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; Health; 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; 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）：很可能是有特定的尺寸为肌肉组织的后咽，这是需要为了一个孩子发展正常的发声语言。如果一个孩子有一个初步修复的提上睑肌不符合正常的解剖结构，很可能他们会发展鼻音，并需要二次腭手术。数据还没有证明什么是“正常”的提上睑肌解剖结构或种族和性别如何影响这些规范性措施。我们将根据性别、种族、颅骨测量尺寸和/或咽闭合模式阐明什么构成标准肌肉尺寸范围。这些结果可直接用于指导初次手术。这种患者特定的手术计划将减少在言语发育期间鼻音过浓的发生率，从而减少在以后的生活中对二次手术管理的需要。本R 03提案的目的是解决有关种族和性别对前咽部结构和功能的相互作用的未解决问题。该研究还将评估颅骨测量和咽后壁闭合模式的相互作用，因为它与不同种族/民族和/或性别组中发现的提肌尺寸有关。分析这些变量的关系将使我们能够确定是否种族差异的口裂是一个结果的形态差异在骨骼肌肉水平。更适用的是，这里获得的数据将对腭裂患儿的手术治疗产生直接影响。因此，本研究的长期目标是改善腭裂患儿的诊断和手术计划。从这些调查中收集的信息将导致改善语音结果的措施，以及减少后续的二次腭手术的需要。提出了以下具体目标：（a）确定提上睑肌在休息时和语音产生过程中的形态差异作为种族的函数（B），以确定提上睑肌在休息时或语音产生过程中的形态是否存在性别差异。共招募84例受试者参与研究。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咽闭合模式。这些数据将被导入3D软件系统，以创建三维空间的计算机模型，用于改善颅面和咽内结构的测量和可视化。 公共卫生相关性：Hardin-Jones和Jones（2005）发现，68%的腭裂修复的学龄前儿童参加了语音治疗。更有趣的是，37%的患者有中度至重度的鼻音过重，或者由于咽喉功能不全而接受了二次手术治疗。患者特异性（基于种族，性别和提上睑肌尺寸）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（二次手术管理）的需求。

项目成果

Differences in the Tensor Veli Palatini Muscle and Hearing Status in Children With and Without 22q11.2 Deletion Syndrome.

患有和不患有 22q11.2 缺失综合征的儿童的大腭张肌和听力状态的差异。

• DOI: 10.1177/1055665619869142
• 发表时间: 2020
• 期刊: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
• 作者: Perry,JamieL;Kotlarek,KatelynJ;Spoloric,Kelly;Baylis,Adriane;Kollara,Lakshmi;Grischkan,JonathanM;Kirschner,Richard;Bates,DavidGregory;Smith,Mark;Findlen,Ursula
• 通讯作者: Findlen,Ursula

Morphology of the Musculus Uvulae In Vivo Using MRI and 3D Modeling Among Adults With Normal Anatomy and Preliminary Comparisons to Cleft Palate Anatomy.

使用 MRI 和 3D 建模在具有正常解剖结构的成年人中进行体内悬雍垂肌的形态学分析，并与腭裂解剖结构进行初步比较。

• DOI: 10.1177/1055665619828226
• 发表时间: 2019
• 期刊: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
• 作者: Perry,JamieL;Chen,JoshuaY;Kotlarek,KatelynJ;Haenssler,Abigail;Sutton,BradleyP;Kuehn,DavidP;Sitzman,ThomasJ;Fang,Xiangming
• 通讯作者: Fang,Xiangming

High-resolution dynamic speech imaging with joint low-rank and sparsity constraints.

• DOI: 10.1002/mrm.25302
• 发表时间: 2015-05
• 期刊: MAGNETIC RESONANCE IN MEDICINE
• 影响因子: 3.3
• 作者: Fu, Maojing;Zhao, Bo;Carignan, Christopher;Shosted, Ryan K.;Perry, Jamie L.;Kuehn, David P.;Liang, Zhi-Pei;Sutton, Bradley P.
• 通讯作者: Sutton, Bradley P.

Morphology of the levator veli palatini muscle using magnetic resonance imaging.

• DOI: 10.1597/11-125
• 发表时间: 2013-01
• 期刊: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
• 作者: Perry JL;Kuehn DP;Sutton BP
• 通讯作者: Sutton BP

Identifying Predictors of Levator Veli Palatini Muscle Contraction During Speech Using Dynamic Magnetic Resonance Imaging.

使用动态磁共振成像识别演讲期间提肌 Veli Palatini 肌肉收缩的预测因子。

• DOI: 10.1044/2020_jslhr-20-00013
• 发表时间: 2020
• 期刊: Journal of speech, language, and hearing research : JSLHR
• 作者: PuaSchleif,Eshan;Pelland,CatherineM;Ellis,Charles;Fang,Xiangming;Leierer,StephenJ;Sutton,BradleyP;Kuehn,DavidP;Blemker,SilviaS;Perry,JamieL
• 通讯作者: Perry,JamieL