A preliminary and exploratory investigation of velopharyngeal structural MRI following a modified Z-plasty approach in patients with cleft palate

To validate and refine the existing understanding of the effectiveness of modified Z-plasty in cleft palate patients by comparing postoperative velopharyngeal function with that of healthy non-cleft individuals using MRI. The study involved six adults one year after modified Z-plasty and fourteen adults with healthy palates. MRI was used to assess the levator veli palatini (LVP) muscle and velopharyngeal structures during rest and phonation, including measurements of soft palate length and thickness. Patients post-modified Z-plasty demonstrated restored LVP muscle trajectory and contractility, yet differences in velopharyngeal dimensions persisted compared to the control group. MRI is a valuable tool for assessing velopharyngeal function. Modified Z-plasty can improve, but not fully normalize, velopharyngeal structures and function in cleft palate patients. These findings provide a reference for future optimization of surgical techniques and rehabilitation strategies in cleft palate repair.