Identifying Predictors of Levator Veli Palatini Muscle Contraction During Speech Using Dynamic Magnetic Resonance Imaging

Schleif, Eshan Pua; Pelland, Catherine M.; Ellis, Charles; Fang, Xiangming; Leierer, Stephen J.; Sutton, Bradley P.; Kuehn, David P.; Blemker, Silvia S.; Perry, Jamie L.

doi:10.1044/2020_jslhr-20-00013

Cited by 4 publications

(3 citation statements)

References 32 publications

(86 reference statements)

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“…Targeted recruitment in select CSD studies (e.g., Cycyk & Huerta, 2020;Jasso et al, 2020;Orizaba et al, 2020) appears to have successfully contributed to expanded representation for Hispanic or Latino(a)(x) participants, at least for specific research questions regarding Latino(a)(x) culture and Spanish-English multilingual issues. In contrast, we found just three studies (Caesar & Kerins, 2020;Girolamo et al, 2020;Pua et al, 2020) to recruit according to participant race. Therefore, it seems as though there may be missed opportunities, worth exploring in future studies, for research in CSD to conduct investigations within racial groups for a deeper and more nuanced understanding of characteristics and best practices within various populations.…”

Section: Recruiting For Proportional Versus Targeted Representationmentioning

confidence: 86%

Diversity of Research Participant Gender, Race, and Ethnicity in Communication Sciences and Disorders: A Systematic Review and Quantitative Synthesis of ASHA Publications in 2020

Millager,

Feldman,

Williams

et al. 2023

Preprint

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Purpose: One manifestation of systemic inequities in communication sciences and disorders (CSD) is the chronic underreporting and underrepresentation of sex, gender, race, and ethnicity in research. The present study characterized recent demographic reporting practices and representation of participants across CSD research.Methods: We systematically reviewed and extracted key reporting and participant data from empirical studies conducted in the United States with human participants published in the year 2020 in journals by the American Speech-Language-Hearing Association (ASHA; k = 407 articles). Sex, gender, race, and ethnicity were operationalized per National Institutes of Health guidelines (National Institutes of Health, 2015a, 2015b).Results: Sex or gender was reported in 85.5% of included studies; race was reported in 33.7%; and ethnicity was reported in 13.8%. Sex and gender were clearly differentiated in 3.4% of studies, where relevant. Where reported, median proportions for race and ethnicity were significantly different from the US population, with underrepresentation noted for all non-White racial groups and Hispanic participants. Moreover, 64.7% of studies that reported sex or gender and 67.2% of studies that reported race or ethnicity did not consider these respective variables in analyses or discussion.Conclusion: At present, research published in ASHA journals frequently fails to report key demographic data summarizing the characteristics of participants. Moreover, apparent gaps in representation of minoritized gender, racial, and ethnic groups threaten the external validity of CSD research and broader health care equity endeavors in the United States. Taken together, our findings underscore many shortcomings in CSD research while pointing to several steps that may bring greater accountability, consistency, and diversity to the field.

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Section: Recruiting For Proportional Versus Targeted Representationmentioning

confidence: 86%

Diversity of Research Participant Gender, Race, and Ethnicity in Communication Sciences and Disorders: A Systematic Review and Quantitative Synthesis of ASHA Publications in 2020

Millager,

Feldman,

Williams

et al. 2023

Preprint

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“…Results from the present study indicate that pharyngeal depth may serve as a strong clinical determinant of VPD in children with 22q11.2DS. Dynamic MRI studies in individuals with normal velopharyngeal anatomy indicated that increased velar thickness resulted in decreased levator muscle shortening and contraction velocity 29 and that a larger velopharyngeal opening required increased levator activation and closure force to achieve velopharyngeal closure. 30 Findings from the present study indicate that in children with 22q11.2DS, a deep pharynx is correlated with greater levator muscle shortening and increased effective velar stretch.…”

Section: Differences Across Conditionsmentioning

confidence: 99%

Assessment of the Velopharyngeal Mechanism at Rest and During Speech in Children With 22q11.2DS: A Cross-Sectional Study

Kollara

Perry

Kirschner

et al. 2022

The Cleft Palate Craniofacial Journal

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Objective Velopharyngeal dysfunction (VPD) associated with 22q11.2 deletion syndrome (22q11.2DS) has a complex etiology. This study had 3 aims: (1) assess differences in velopharyngeal and levator muscle configuration during rest versus sustained speech production (2) compare differences in velopharyngeal changes between children with and without 22q11.2DS (3) examine the relationship between adenoid thickness, pharyngeal depth, and velopharyngeal changes. Design Cross-sectional. Methods A total of 22 participants, 11 with 22q11.2DS and 11 controls with normal speech and velopharyngeal anatomy (ages 4-12 years), underwent nonsedated MRI at rest and during sustained /i/. Differences in velar and levator muscle contraction across the 2 different conditions were analyzed, using matched paired t-tests. Mean differences across participant groups were examined. Correlation analyses were also conducted. Results When comparing differences between rest and sustained phoneme production (aim 1), significant ( P < .05) differences were noted for all velar and levator muscle variables. For differences in velopharyngeal changes between children with and without 22q11.2DS (aim 2), VP ratio and effective VP ratio were noted to be significantly different. Pharyngeal depth and adenoid thickness were correlated with velar and levator muscle change measures and ratios (aim 3). Conclusion Results from this study provide quantitative in vivo measurements of the contracted levator muscle and velum in young children with 22q11.2DS. Results demonstrated that VP ratio and EVP ratio are significantly different between children with and without 22q11.2DS and that pharyngeal depth is a strong clinical determinant of VPD in children with 22q11.2DS.

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“…Subsequent studies, often using MRI, frequently report measures of curvilinear velar length. 1–3,15,17–19,21,42–47 Nasal surface measures of velar length during phonation have also been reported. 36,48,49 However, variability, both in the definitions provided and measurement technique applied for velar length, is consistently observed across the literature.…”

Section: Introductionmentioning

confidence: 97%

Measurement Matters: MRI Analysis of Differing Anatomic Measurement Techniques for Velar Length and the Velopharyngeal Needs Ratio

Mason,

Hanson,

Black

2024

Plastic and Reconstructive Surgery - Global Open

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Background: Advances in imaging tools provide opportunities to enhance how velopharyngeal (VP) variables are quantified to facilitate surgical decisions. The purpose of this study was to use magnetic resonance imaging (MRI) to determine if quantitative differences were present between measures of linear and curvilinear velar length, and subsequently, the VP needs ratio. Methods: Data were prospectively collected from patients presenting with repaired cleft palate and/or congenital palatal insufficiency with or without VPI at a single center tertiary children’s hospital. Quantitative measures of the velopharynx using a novel nonsedated MRI protocol were obtained. Paired samples t tests were conducted to assess if differences were present between the VP needs ratio and measurements of linear and curvilinear velar length at rest and during sustained phonation. Intraclass correlation coefficients were calculated to assess intra/inter-rater reliability. Results: Significant differences were present between measurements of linear and curvilinear velar length at rest (P ≤ 0.001) and during sustained phonation (P ≤ 0.001). Significant differences were also present in the VP needs ratio (P ≤ 0.001). Curvilinear velar length at rest and during sustained phonation was longer than that of linear velar length at rest and during sustained phonation. No significant differences were observed between measures of effective velar length (P = 0.393). Conclusions: Measurement differences influence the VP needs ratio. This may have implications for comparisons to previously reported normative reference values and for those who are anatomically at risk for VPI. MRI provides an enhanced imaging modality to assess normative benchmarks and the anatomic variables used to define VP anatomy for clinical decision-making.

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Identifying Predictors of Levator Veli Palatini Muscle Contraction During Speech Using Dynamic Magnetic Resonance Imaging

Cited by 4 publications

References 32 publications

Diversity of Research Participant Gender, Race, and Ethnicity in Communication Sciences and Disorders: A Systematic Review and Quantitative Synthesis of ASHA Publications in 2020

Diversity of Research Participant Gender, Race, and Ethnicity in Communication Sciences and Disorders: A Systematic Review and Quantitative Synthesis of ASHA Publications in 2020

Assessment of the Velopharyngeal Mechanism at Rest and During Speech in Children With 22q11.2DS: A Cross-Sectional Study

Measurement Matters: MRI Analysis of Differing Anatomic Measurement Techniques for Velar Length and the Velopharyngeal Needs Ratio

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