ABSTRACT
OBJECTIVE: To demonstrate the feasibility of dynamic MRI with near-real-time temporal resolution for analysing velopharyngeal closure. METHODS: Eleven children and young adults (seven girls, four boys, mean age: 8.4 years) with suspected velopharyngeal insufficiency (VPI), and one healthy volunteer underwent MRI (1.5 Tesla) using T2 fast imaging sequences. Imaging was done without any sedation at rest and during various phonations in the axial and sagittal planes. Images were analysed by two radiologists, a plastic surgeon and a speech therapist. RESULTS: The MRI examinations were well tolerated by even the youngest patient. A qualitative analysis found that the sagittal dynamic sequences during phonation were in relation to the clinical data in all patients. A quantitative analysis enabled calculation of the elevation angle of the soft palate in relation to the hard palate, the velar eminence angle and the percentage of reduction of the antero-posterior diameter of the pharyngeal lumen. CONCLUSION: Dynamic MRI is a non-invasive, rapid and repeatable method. It can be considered a complementary tool to endoscopy and fluoroscopy, particularly in children, for assessing VPI without any sedation or radiation exposure.
Subject(s)
Magnetic Resonance Imaging/methods , Velopharyngeal Insufficiency/diagnosis , Adult , Child , Feasibility Studies , Female , Humans , Male , Phonation , Velopharyngeal Insufficiency/etiologyABSTRACT
The treatment of cleft lip and palate at Saint-Vincent-de-Paul hospital is realized by a multidisciplinary team. The calendar of the primary treatment is adapted according to the eventual antenatal diagnosis: it may be early and in two sessions, or late at 4 months but in one session. The calendar of the secondary treatment is more classical.
