Evaluation of velopharyngeal closure by 4D imaging using 320-detector-row computed tomography. Issue 4 (April 2015)

• Record Type: Journal Article
• Authors: Sakamoto, Yoshiaki; Soga, Shigeyoshi; Jinzaki, Masahiro; Yamada, Yoshitake; Ogata, Hisao; Kishi, Kazuo
• Is Part Of: Journal of plastic, reconstructive & aesthetic surgery. Volume 68:Issue 4(2015:Apr.)
• Page Start: 479
• Page End: 484
• Publication Date: 2015-04
• Subjects: Surgery, Plastic -- Great Britain -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Great Britain -- Periodicals; 617.9505
• DOI: 10.1016/j.bjps.2014.12.020
• Languages: English
• ISSNs: 1748-6815

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Objective</title> <p id="abspara0010">Current imaging techniques for velopharyngeal closure (VPC) evaluation are two-dimensional, static, or distressing, thus necessitating multiple procedures to understand this three-dimensional and dynamic area. We validated the use of a novel four-dimensional (4D) computed tomography (CT) technique for the morphological and kinematic evaluation of VPC in cleft palate patients based on dynamic volume scanning with 320-detector-row CT.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">Five patients aged 4–10 years (40% males) with persistent velopharyngeal insufficiency post palatoplasty underwent conventional tests (cephalometry and video-nasal endoscopy) and 4D-CT. For each patient, complete multiplanar reconstruction, 4D airway CT, and 4D-CT endoscopy data for all scanning phases were compared with cephalometric and video-nasal endoscopy data. The movements of the velum and posterior pharyngeal walls were graded by each modality.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">4D airway CT revealed higher anatomical detail than cephalometry, additionally providing dynamic images. 4D-CT endoscopy and video-nasal endoscopy were in agreement for all patients regarding the patterns of VPC, with complete visualization of VPC in five versus one patient, respectively. 4D airway CT and cephalometry showed a discrepancy in one case, wherein grading by cephalometry was overestimated. 4D-CT was also useful in determining the width and length of a proposed pharyngeal flap. The examination time (mean ± standard deviation (SD), seconds), including patient preparation time, was 224 ± 73, 492 ± 145, and 718 ± 123 for cephalometric radiographs, CT, and video-nasal endoscopy, respectively. The mean estimated radiation dose during 4D-CT was 4.44 ± 1.64 mSv.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">4D-CT provides detailed morphological and kinematic analysis of VPC and may offer advantages over conventional procedures.</p> </sec> </abstract>