| Objective:Application of 3.0-T Magnetic Resonance Imaging to observe different age paragraph the anatomy and closure function and between the postoperative patients with cleft palate and the normal person.Methods: A total of 28 patients with unilateral cleft lip and palate were treated with plastic surgery from June 2017 to August 2018 in hospital.In the experimental group,there were 19 cases of males,9 cases of women,age 10~21 years old,average age of 12.71±3.65 years.20 normal subjects were randomly selected as the control group,10 in men and 10 in women,aged 12 ~18 years old,the average age was 14.24±3.54 years.All subjects were subject to routine oral examination and speech examination.On the basis of age into the peripubescent group,postpubescent group and adult group.According to the results of speech examination and sagittal and transverse MRI,it was divided into velopharyngeal incompetence group and velopharyngeal competence group.A analysis method including velopharyngeal incompetence in peripubescent group,velopharyngeal competence in peripubescent group,normal person in peripubescent group;B analysis methods including velopharyngeal competence adults and normal adults.In the method of A and B,the dynamic 3.0T cranial MRI scans of sagittal/a:/,/i:/and/ts/were performed;when the subjects were scanned by static 3.0T cranial MRI and/a:/at transverse position.The palate pharyngeal closure pattern of the subjects in the two analysis methods was observed and the relevant data of the cranial surface,palate pharynx and levator veli palatini muscle were measured,and the comparison was made in the group.Results:(1)Speech evaluation and MRI examination were found 7 patients with velopharyngeal incompetence in peripubescent group,6 adult patients after cleft palate surgery and all normal control groups were velopharyngeal competence(2)Cranial-structure,A method of analysis of the patients with velopharyngeal incompetence in peripubescent group and normal person in peripubescent group only between the cranial base of significant differences(P<0.05),the rest of the measurements between the three groups did not see obvious differences.Analysis method of B,velopharyngeal competence adults and normal adults only the length of nasal root to the sella differences have statistically significant(P < 0.05),the rest also did not see clearly different.(3)In the palate pharyngeal structure,13 cases of circular closure pattern(61.9%)and 8 cases of coronal closure pattern(38.1%)were observed in the transverse position observation group,and 10 cases of circular closure pattern(50%)and 10 cases of coronal closure pattern(50%)were found in the control group.The sagittal A analysis methods can be found in the velopharyngeal incompetence in peripubescent group and normal group of eight measurements there are significant gaps and VPC group and VPI group set of hard palate length significantly different(P<0.05),the VPC group and normal group of the PVU corner moving degrees difference is statistically significant(P<0.05).There was a statistically significant difference between the VPC and normal groups for 10 velopharyngeal measures.Compared to those without cleft palate,participants with repaired cleft palate had a significantly shorter hard palate height and length,thinner velum muscle,poor velum mobility,and greater pharyngeal depth.(4)In the measurement of levator veli palatini muscle structure,the oblique coronal A analysis method showed that there were significant differences between the 5 measured items in the velopharyngeal incompetence in peripubescent group and the normal group,respectively,the length of the two sides of the levator veli palatini muscle and the length of the lateral segment of the dorsal muscle and the starting spacing of the muscle,and other measurement items such as the starting angle.Unlike patients in the peripubescent groups,there were significant differences in the medial segment,the thickness of the muscle,the insertion spacing of the extensor muscle and the starting angle of the muscle in the velopharyngeal competence adults and the normal adults.Conclusion:(1)The application of 3.0-T MRI combined with rapid imaging sequence greatly shortens the inspection time,improves the measurement accuracy,and can observe the structure of palatal pharynx and levator veli palatini muscle and the closed state of palate pharynx.(2)The overall cranial structure was similar in patients with VPC and VPI in peripubescent.(3)There were significant differences in the structure of velopharyngeal and levator veli palatini muscle in peripubescent and normal people,but the difference between peripubescent and adult period was different.(4)The evaluation of early palate pharyngeal difference in patients with VPI and normal people has important guiding significance for the choice of surgical methods in this kind of patients,and should be developed in the direction of palate pharyngeal function in children with low age in the future. |
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