Levator Veli Palatini Muscle Fatigue during Phonation in Speakers with Cleft Palate with Borderline Velopharyngeal Incompetence

2006 ◽  
Vol 43 (1) ◽  
pp. 103-107 ◽  
Author(s):  
Kanji Nohara ◽  
Takashi Tachimura ◽  
Takeshi Wada
Keyword(s):  
Cleft Palate ◽  
Regression Line ◽  
Power Spectral Analysis ◽  
Levator Muscle ◽  
Control Group ◽  
Mean Power ◽  
Mean Power Frequency ◽  
Levator Veli Palatini ◽  
Velopharyngeal Incompetence ◽  
Syllable Repetition

Objective This study examined whether the levator veli palatini muscle in speakers with borderline velopharyngeal incompetence (BVP) with surgically treated cleft palate might be more fatigable during speech than that in speakers without clefts. Design Each subject was asked to pronounce the syllable /pu/ more than 50 times at a rate of one time per second. Mean power frequency (MPF) of one syllable was obtained from electromyogram data of the levator muscle by power spectral analysis. Participants Five patients with postsurgical cleft palates, who were identified as having BVP by nasopharyngeal fiberscopy, served as subjects, and five participants without clefts served as the control group. Results In all participants without clefts, the slopes of the regression line relating MPF to the course of syllable repetition were negative but not significant. However, in all participants with BVP, the slopes of the regression line were significantly negative. Conclusions These findings demonstrated that the levator muscle of speakers with BVP was more fatigable than that of speakers without clefts during repetition of syllables. This study suggests that the fatigability of levator muscle contributed to mild hypernasality in patients with BVP.

Evaluation of Fatigability of the Levator Veli Palatini Muscle during Continuous Blowing Using Power Spectra Analysis

2004 ◽  
Vol 41 (3) ◽  
pp. 320-326 ◽  
Author(s):  
Takashi Tachimura ◽  
Kanji Nohara ◽  
Koichi Satoh ◽  
Takeshi Wada
Keyword(s):  
Cleft Palate ◽  
Muscle Activity ◽  
Statistical Significance ◽  
Power Spectra ◽  
Mean Power ◽  
Mean Power Frequency ◽  
Spectra Analysis ◽  
Levator Veli Palatini ◽  
Velopharyngeal Incompetence ◽  
Power Frequency

Objective The purpose of this study was to compare the fatigability of the levator veli palatini (LVP) muscle during blowing in speakers who exhibit velopharyngeal incompetence with that from normal speakers by means of power spectra analysis. Design All subjects were instructed to blow into a tube for more than 10 seconds at maximum possible effort. The LVP muscle activity (electromyography) was sampled at 2 kHz for 10 seconds from the time when the oral air pressure during blowing was stabilized. These samples were subjected to Fast Fourier Transfer analysis with analytic windows of 0.5-second width. The electromyography mean power frequency slope with respect to time for each subject was estimated. Participants Three speakers with repaired cleft palate and three normal speakers were selected as subjects. Results The slopes of the regression lines for all three subjects with repaired cleft palate were negatively signed with statistical significance (t test, p < .01). The slopes for all of the normal speakers were negatively signed, but these were not statistically significant. Conclusion These results suggest that the LVP muscle of speakers with repaired cleft palate who exhibit varying degrees of velopharyngeal dysfunction may deteriorate more easily in comparison with the LVP muscle of normal speakers.

Levator Veli Palatini Muscle Activity in Relation to Intraoral Air Pressure Variation in Cleft Palate Subjects

1995 ◽  
Vol 32 (5) ◽  
pp. 376-381 ◽  
Author(s):  
David P. Kuehn ◽  
Jerald B. Moon
Keyword(s):  
Cleft Palate ◽  
Air Pressure ◽  
Levator Muscle ◽  
Emg Activity ◽  
High Activation ◽  
Levator Veli Palatini ◽  
Activation Level ◽  
High Activation Level ◽  
Intraoral Air Pressure ◽  
Total Activation

A comparison of the ranges of levator veli palatini EMG activity for speech versus a nonspeech task for subjects with cleft palate was the focus of this study. EMG values are also compared with subjects without cleft palate obtained in a previous study. Hooked-wire electrodes were inserted into the levator muscle of five adult subjects with cleft palate exhibiting mild hypernasality. Intraoral air pressure was measured concurrently. A blowing task was used to determine the subject's operating range for the levator muscle. Both the nonspeech and speech tasks were designed to sample the widest possible ranges of levator EMG activity. It was found that the subjects with cleft palate used a relatively high activation level for the levator muscle during speech, in relation to their total activation range, compared with the subjects without cleft palate. Implications are discussed In relation to possible anatomic and physiologic differences for cleft palate subjects compared to normal.

Change in Levator Veli Palatini Muscle Activity for Patients with Cleft Palate in Association with Placement of a Speech-Aid Prosthesis

2002 ◽  
Vol 39 (5) ◽  
pp. 503-508 ◽  
Author(s):  
Takashi Tachimura ◽  
Kanji Nohara ◽  
Yoshinori Fujita ◽  
Takeshi Wada
Keyword(s):  
Cleft Palate ◽  
Pressure Change ◽  
Mean Value ◽  
Emg Activity ◽  
Reserve Capacity ◽  
Activity Levels ◽  
Levator Veli Palatini ◽  
Velopharyngeal Incompetence ◽  
Velopharyngeal Closure ◽  
The Mean

Objective: The purpose of this study was to examine whether a speech-aid prosthesis normalizes the activity of the levator veli palatini muscle for patients with cleft palate who exhibit velopharyngeal incompetence. Design: Each subject was instructed to produce repetitions of /mu/, /u/, /pu/, /su/, and /tsu/ and to blow with maximum possible effort. Electromyographic (EMG) activity of the levator veli palatini muscle was recorded with and without a hybrid speech-aid prosthesis in place. Participants: The participants were five patients with repaired cleft palate who were routinely wearing a hybrid speech-aid prosthesis. Results: With the prosthesis in place, the mean value of levator activity changed positively in relation to oral air-pressure change during blowing. Differences in levator activity in relation to speech samples were similar to those in normal speakers. With the prosthesis in place, levator activity for speech tasks was less than 50% of the maximum levator activity for all subjects. The findings were similar to those reported previously for normal speakers. Conclusion: Placement of the prosthesis changed EMG activity levels of the levator veli palatini muscle to levels that are similar to normal speakers. It is possible that, with the increase in the differential levator activity between speech and a maximum force task, the velopharyngeal mechanism has a greater reserve capacity to maintain velopharyngeal closure compared with the noprosthesis condition.

scholarly journals Asymmetry and Positioning of the Levator Veli Palatini Muscle in Children With Repaired Cleft Palate

2020 ◽  
Vol 63 (5) ◽  
pp. 1317-1325 ◽  
Author(s):  
Katelyn J. Kotlarek ◽  
Catherine M. Pelland ◽  
Silvia S. Blemker ◽  
Michael S. Jaskolka ◽  
Xiangming Fang ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Velopharyngeal Insufficiency ◽  
Levator Muscle ◽  
Future Research ◽  
Imaging Protocol ◽  
Levator Veli Palatini ◽  
Velopharyngeal Closure ◽  
History Of ◽  
Magnetic Resonance Imaging Protocol ◽  
The Impact

Purpose The purpose of this study is to examine the differences in velopharyngeal dimensions as well as levator veli palatini (levator) muscle morphology, positioning, and symmetry of children with repaired cleft palate with velopharyngeal insufficiency (VPI), children with repaired cleft palate with complete velopharyngeal closure, and children with noncleft anatomy. Method Fifteen children ranging in age from 4 to 8 years were recruited for this study. Ten of the participants had a history of repaired cleft palate, half with documented VPI and the other half with velopharyngeal closure. Five participants with noncleft anatomy were matched for age from a normative database. The magnetic resonance imaging protocol, processing methods, and analysis are consistent with that used in previous literature. Results Regarding velopharyngeal dimensions, median values were statistically significantly different between groups for sagittal angle ( p = .031) and effective velopharyngeal ratio ( p = .013). With respect to the levator muscle, median values were statistically significant for average extravelar length ( p = .018), thickness at midline ( p = .021), and thickness between the left and right muscle bundles at the point of insertion into the velum ( p = .037). Remaining measures were not statistically significant. Conclusions The levator muscle is significantly different among these three groups with respect to thickness at midline, extravelar length, and symmetry at the point of insertion into the velum. Sagittal angle and effective velopharyngeal ratio are also significantly different. Participants with repaired cleft palate and VPI displayed the greatest degree of asymmetry. Future research should control for surgical procedure type to determine the impact of surgery on the levator muscle and surrounding velopharyngeal anatomy.

Prediction of Deterioration of Velopharyngeal Function Associated with Maxillary Advancement Using Electromyography of Levator Veli Palatini Muscle

2006 ◽  
Vol 43 (2) ◽  
pp. 174-178 ◽  
Author(s):  
Kanji Nohara ◽  
Takashi Tachimura ◽  
Takeshi Wada
Keyword(s):  
Maximal Activity ◽  
Levator Muscle ◽  
Perceptual Judgment ◽  
Levator Veli Palatini ◽  
Maximum Value ◽  
Maxillary Advancement ◽  
Total Range ◽  
Velopharyngeal Incompetence ◽  
Velopharyngeal Closure ◽  
Velopharyngeal Function

Objective The purpose of the present study was to examine the possibility that postoperative velopharyngeal function following maxillary advancement could be predicted using preoperative electromyography of the levator veli palatini. Design Levator muscle electromyography was recorded preoperatively during speech and blowing. Levator activity was expressed as a percentage relative to the maximum value observed throughout the experiment. Postoperative velopharyngeal function was evaluated by means of perceptual judgment and nasoendoscopy. Participants The subjects were four patients with repaired cleft palates who underwent maxillary advancement, two by osteotomy and two by distraction osteogenesis. None of the subjects presented with preoperative hypernasality, and nasoendoscopy demonstrated complete velopharyngeal closure in all subjects prior to maxillary advancement. Results Preoperative levator activity for speech of two subjects was similar to that for normal speakers (<60% of total range), and postoperative nasality and nasoendoscopic findings revealed no detectible changes. For the other two subjects, levator activity for speech exceeded 60% of the total range, similar to that of speakers with velopharyngeal incompetence. These subjects showed increased hypernasality and deteriorated velopharyngeal closure following maxillary advancement. Conclusion The deterioration of velopharyngeal function associated with maxillary advancement was demonstrated for subjects whose levator activity was at higher levels during speech in comparison with maximal activity observed during blowing, regardless of the amount of maxillary advancement. Preoperative levator muscle electromyography could be a predictor in identifying patients at higher risk of postsurgical deterioration of velopharyngeal function.

Postural sway following inversion sprain of the ankle

1991 ◽  
Vol 81 (5) ◽  
pp. 243-247 ◽  
Author(s):  
MW Cornwall ◽  
P Murrell
Keyword(s):  
Ankle Sprain ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Control Group ◽  
Mean Power ◽  
Mean Power Frequency ◽  
Linear Distance ◽  
History Of ◽  
Power Frequency ◽  
The Mean

The single-limb sway of 20 individuals with a history of unilateral inversion ankle sprain was compared to that of a control group of 30 individuals without a history of ankle sprain. Using a force platform to obtain center-of-pressure data, the linear distance traveled (mm) and the mean power frequency, (Hz) of postural sway were calculated for each subject. The results of this study showed that postural sway amplitude was significantly greater in the injured group than in the control group. Contrary to previous investigations, this study indicates that individuals with a history of inversion ankle sprain are less stable in single-limb stance compared to a noninjured control group. This decreased stability is evident as much as 2 years following the injury.

Velopharyngeal Muscle Morphology in Children With Unrepaired Submucous Cleft Palate: An Imaging Study

2020 ◽  
pp. 105566562095474 ◽  
Author(s):  
Graham C. Schenck ◽  
Jamie L. Perry ◽  
Mary M. O’Gara ◽  
Amy Morgan Linde ◽  
Mitchell F. Grasseschi ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Imaging Study ◽  
The Body ◽  
Analysis Of Covariance ◽  
Velopharyngeal Insufficiency ◽  
Levator Muscle ◽  
Levator Veli Palatini ◽  
Submucous Cleft Palate ◽  
Α Angle ◽  
Normal Speech

Objective: To identify quantitative and qualitative differences in the velopharyngeal musculature and surrounding structures between children with submucous cleft palate (SMCP) and velopharyngeal insufficiency (VPI) and noncleft controls with normal anatomy and normal speech. Methods: Magnetic resonance imaging was used to evaluate the velopharyngeal mechanism in 20 children between 4 and 9 years of age; 5 with unrepaired SMCP and VPI. Quantitative and qualitative measures of the velum and levator veli palatini in participants with symptomatic SMCP were compared to noncleft controls with normal velopharyngeal anatomy and normal speech. Results: Analysis of covariance revealed that children with symptomatic SMCP demonstrated increased velar genu angle (15.6°, P = .004), decreased α angle (13.2°, P = .37), and longer (5.1 mm, P = .32) and thinner (4 mm, P = .005) levator veli palatini muscles compared to noncleft controls. Qualitative comparisons revealed discontinuity of the levator muscle through the velar midline and absence of a musculus uvulae in children with symptomatic SMCP compared to noncleft controls. Conclusions: The levator veli palatini muscle is longer, thinner, and discontinuous through the velar midline, and the musculus uvulae is absent in children with SMCP and VPI compared to noncleft controls. The overall velar configuration in children with SMCP and VPI is disadvantageous for achieving adequate velopharyngeal closure necessary for nonnasal speech compared to noncleft controls. These findings add to the body of literature documenting levator muscle, musculus uvulae, and velar and craniometric parameters in children with SMCP.

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