Journal
CLEFT PALATE-CRANIOFACIAL JOURNAL
Volume 45, Issue 2, Pages 113-120Publisher
ALLIANCE COMMUNICATIONS GROUP DIVISION ALLEN PRESS
DOI: 10.1597/06-171.1
Keywords
levator veli palatini; velopharyngeal incompetence
Categories
Funding
- NIA NIH HHS [P30 AG 13283, P30 AG013283, P01 AG015434-059003] Funding Source: Medline
- NIDDK NIH HHS [T90 DK 070071, T90 DK070071] Funding Source: Medline
- NIGMS NIH HHS [T32 GM008616, T32 GM 008161-06A1] Funding Source: Medline
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Objective: Despite cleft palate repair, velopharyngeal competence is not achieved in similar to 15% of patients, often necessitating secondary surgical correction. Velopharyngeal competence postrepair may require the conversion of levator veil palatini muscle fibers from injury-susceptible type 2 fibers to injury-resistant type 1 fibers. As an initial step to determining the validity of this theory, we tested the hypothesis that, in most cases, repair induces the transformation to type 1 fibers, thus diminishing susceptibility to injury. Interventions: Single permeabilized levator veil palatini muscle fibers were obtained from normal palates and nonrepaired congenitally-clefted palates of young (2 months old) and adult (14 to 15 months old) goats and from repaired palates of adult goats (8 months old). Repair was done at 2 months of age using a modified von Langenbeck technique. Main Outcome Measures: Fiber type was determined by contractile properties and susceptibility to injury was assessed by force deficit, the decrease in maximum force following a lengthening contraction protocol expressed as a percentage of initial force. Results: For normal palates and cleft palates of young goats, the majority of the fibers were type 2 with force deficits of similar to 40%. Following repair, 80% of the fibers were type 1 with force deficits of 20% +/- 2%; these deficits were 45% of those for nonrepaired cleft palates of adult goats (p <.0001). Conclusion: The decrease in the percentage of type 2 fibers and susceptibility to injury may be important for the development of a functional levator veil palatini muscle postrepair.
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