Examining age, sex, and race characteristics of velopharyngeal structures in 4- to 9-year-old children using magnetic resonance imaging

Objective: The purpose of this study was to quantify the growth of the various craniofacial and velopharyngeal structures and examine sex and race effects. Methods: Eight-five healthy children (53 white and 32 black) with normal velopharyngeal anatomy between 4 and 9 years of age who met the inclusion criteria and successfully completed the magnetic resonance imaging (MRI) scans were included in the study. Results: Developmental normative mean values for selected craniofacial and velopharyngeal variables by race and sex are reported. Facial skeleton variables (face height, nasion to sella, sella to basion, palate height, palate width) and velopharyngeal variables (levator muscle length, angle of origin, sagittal angle, velar length, velar thickness, velar knee to posterior pharyngeal wall, and posterior nasal spine to levator muscle) demonstrated a trend toward a decrease in angle measures and increase in linear measures as age increased (with the exception of posterior nasal spine to levator muscle). Only hard palate width and levator muscle length showed a significant sex effect. However, 2 facial skeleton and 6 velopharyngeal variables showed a significant race effect. The interactions between sex, race, and age were not statistically significant across all variables, with the exception of posterior nasal spine to posterior pharyngeal wall. Conclusion: Findings established a large age- and race-specific normative reference for craniofacial and velopharyngeal variables. Data reveal minimal sexual dimorphism among variables used in the present study; however, significant racial effects were observed.