Purpose: Limited quantitative data exist regarding growth of the velopharynx within the first 2 years of life. The purpose of this study was to (a) quantify changes in velopharyngeal structures due to growth during the first 2 years of life, (b) examine the impact of sex and race within this age range, and (c) provide normative measures for comparison to individuals with cleft palate. Method/Description: A retrospective chart review was completed of all patients up to 24 months of age that underwent magnetic resonance imaging of the head for medical necessity within the past 18 months using a three-dimensional fluid-attenuated inversion recovery sequence. Measurements of the velopharynx were obtained from 200 scans consistent with previous literature. Participants were divided into five groups based on corrected age for comparison. Variables of interest included adenoid depth, angle of origin, effective velopharyngeal ratio, effective velar length, levator veli palatini length, origin–origin distance, pharyngeal depth, sagittal angle, velopharyngeal ratio, velar insertion distance, velar length, and velar thickness. Results: Velopharyngeal dimensions were significantly different among corrected age groups after controlling for sex and race. Regarding age, analyses revealed significant differences in all variables of interest except effective velopharyngeal ratio. Regarding sex, significant differences were observed for angle of origin, effective velopharyngeal ratio, effective velar length, levator veli palatini muscle length, and velar insertion distance. Regarding race, a significant difference was only observed for angle of origin. Conclusions: Results of this study demonstrate growth of velopharyngeal anatomy in normative infants with race and sex effects apparent in children up to 24 months of age. Variable growth trends were observed among different velopharyngeal measures.

Objective To quantify differences in levator veli palatini (LVP) muscle dimensions based on age, sex, and race and determine the typical range of asymmetry between the left and right sides of the LVP under age 2 Design Retrospective cohort study Setting Children's tertiary care hospital Participants A retrospective chart review of non-cleft patients under 2 who received a volumetric FLAIR MRI sequence within the past 18 months identified 216 patient scans. Exclusion criteria left 200 scans for analysis. Measurements of the LVP were obtained consistent with previous literature. Interventions Corrected age, sex, and race Main Outcome Measure(s) LVP muscle dimensions Results A significant ( P < .0001) difference between corrected age groups based on the overall combination of LVP variables after controlling for sex and race. Significant age differences included average extravelar length ( P < .0001), average intravelar length ( P < .0001), midline thickness ( P < .0001), and average ( P < .0001) and difference ( P = .0413) in insertion thickness. Significant sex differences included average intravelar length ( P = .0412) and average insertion thickness ( P = .0281). Significant race differences included average insertion thickness ( P = .0334) and difference in intravelar length ( P = .0473). Differences between left and right total length ( P = .0491) and angle of origin ( P < .0001) were significant. Conclusions Differences in LVP morphology were observed in individuals under 2 years or age related to age, sex, and race. While asymmetry was significant in some dimensions, it varied by age range.