Magnetic resonance imaging of the levator Veli Palatini muscle in speakers with repaired cleft palate

Objective: To obtain detailed anatomic and physiologic information on the levator veil palatini muscle from MRI in individuals with repaired cleft palate and to compare the results with those from normal subjects reported by Ettema et al. (2002). Design: Prospective study. Setting: University-based hospital. Participants: Four men (ages 22 to 43 years) with repaired cleft lip and palate. Main Outcome Measures: Four quantitative measurements of the levator veil palatini muscle from rest position and dynamic speech magnetic resonance images were obtained: the distance between the origins of the muscle, angle of origin of the muscle, muscle length, and muscle thickness. Results: The length and thickness of the levator veil palatini muscle varied among the subjects and were different from measurements obtained from normal subjects in a previous study. The distance between origin points, length, and thickness of the levator veil palatini muscle were smaller than those of the normal subjects. There were systematic changes of the levator veil palatini muscle, depending upon vowel and consonant types. Levator veil palatini muscle angle of origin and length became progressively smaller from rest, nasal consonants, low vowels, high vowels, and fricative consonants. These changes are consistent with those of the normal subjects. Conclusions: This study contributes to a better understanding of cleft palate anatomy in comparison with normal anatomy of the levator veil palatini muscle. The use of MRI shows promise as an important tool in the diagnosis and eventual aid to treatment decisions for individuals born with cleft palate.