AnalyzeDirect 
Cleft palate and cleft lip occur when a baby’s palate or lips don’t form properly during early pregnancy. These common birth defects take place if the tissue that makes up the roof of the mouth or the lip does not join completely before birth, leaving an opening. Nowadays, a series of reconstructive surgeries can correct the consequences of this abnormal development.
Among the conditions resulting from cleft palate is velopharyngeal dysfunction, an improper functioning of the velopharyngeal muscles in the soft palate. This defect hinders the mobility of the soft palate and therefore impairs its ability to modulate airflow between the oral and nasal cavities during speech. Because these muscles do not tighten properly, it is impossible for the soft palate to retract and elevate and air escapes through the nose instead of the mouth. Therefore, the child is incapable of properly pronouncing consonants such as “p,” “b,” “g,” “t”, and “d”, causing speech to be perceived as nasal.
The Furlow palatoplasty is a surgical technique commonly chosen for the treatment of velopharyngeal dysfunction. Now a first-line intervention at many institutions, exactly how this surgery modifies palatal anatomy and how these changes relate to clinical outcomes of speech improvement is still not fully understood.
Therefore, scientists from the University of Washington School of Medicine recently investigated the relationship between the anatomical effects of this procedure and clinically relevant results in 29 patients suffering from cleft palate. All patients underwent preoperative and postoperative videofluoroscopy while performing a set of speech tasks. Images of both resting and closed soft palate were captured. Using Analyze software, these paired images were superimposed and adjusted for registration of fixed cranial landmarks. Palatal landmarks were also virtually marked and used to measure relevant angles and distances in Analyze.
After Furlow palatoplasty, the researchers observed significant total palate elongation, tightening and retropositioning of the levator musculature and increased velopharyngeal closure. Postoperative speech improvements were most strongly associated with levator tightening, indicating that this may be the most critical step in the surgical correction of velopharyngeal dysfunction. Further studies will focus on the levator musculature in order to develop alternative strategies for treating this dysfunction in patients with cleft palate.
Tags: Craniofacial, Fetal Development, Pregnancy