Utilization of 3D MRI for the Evaluation of Sphincter Pharyngoplasty Insertion Site in Patients With Velopharyngeal Dysfunction.

Autor:	Mason KN; Human Services Department, School of Education, 2358University of Virginia, Charlottesville, VA, USA., Riski JE; Speech Pathology Lab, Center for Craniofacial Disorders, 160364Children's Healthcare of Atlanta, Atlanta, GA, USA., Williams JK; Speech Pathology Lab, Center for Craniofacial Disorders, 160364Children's Healthcare of Atlanta, Atlanta, GA, USA., Jones RA; Department of Radiology, Children's Healthcare of Atlanta, Atlanta, GA, USA., Perry JL; Department of Communication Sciences & Disorders, 3627East Carolina University, Greenville, NC, USA.
Jazyk:	angličtina
Zdroj:	The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association [Cleft Palate Craniofac J] 2022 Dec; Vol. 59 (12), pp. 1469-1476. Date of Electronic Publication: 2021 Sep 27.
DOI:	10.1177/10556656211044656
Abstrakt:	Sphincter pharyngoplasty is a surgical method to treat velopharyngeal dysfunction. However, surgical failure is often noted and postoperative assessment frequently reveals low-set pharyngoplasties. Past studies have not quantified pharyngoplasty tissue changes that occur postoperatively and gaps remain related to the patient-specific variables that influence postoperative change. The purpose of this study was to utilize advanced three-dimensional imaging and volumetric magnetic resonance imaging (MRI) data to visualize and quantify pharyngoplasty insertion site and postsurgical tissue changes over time. A prospective, repeated measures design was used for the assessment of craniometric and velopharyngeal variables postsurgically. Imaging was completed across two postoperative time points. Tissue migration, pharyngoplasty dimensions, and predictors of change were analyzed across imaging time points. Significant differences were present between the initial location of pharyngoplasty tissue and the pharyngoplasty location 2 to 4 months postoperatively. The average postoperative inferior movement of pharyngoplasty tissue was 6.82 mm, although notable variability was present across participants. The pharyngoplasty volume decreased by 30%, on average. Inferior migration of the pharyngoplasty tissue was present in all patients. Gravity, scar contracture, and patient-specific variables likely interact, impacting final postoperative pharyngoplasty location. The use of advanced imaging modalities, such as 3D MRI, allows for the quantification and visualization of tissue change. There is a need for continued identification of patient-specific factors that may impact the amount of inferior tissue migration and scar contracture postoperatively.
Databáze:	MEDLINE
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