biostudies-literatureMason KNNational Center for Advancing Translational SciencesNCATS NIH HHSNIDCD NIH HHSNational Institute on Deafness and Other Communication Disorders250-262https://www.ebi.ac.uk/biostudies/studies/S-EPMC12684033biostudies-literatureUnknown62(2)ObjectiveVelopharyngeal insufficiency (VPI) poses challenges for normal speech production, often necessitating surgical intervention. Determining optimal candidates for surgery remains complex and requires a nuanced understanding of underlying anatomic factors contributing to VPI. This study aimed to identify anatomic predictors that drive surgical recommendations for VPI.DesignProspective observational cohort study.SettingPediatric tertiary care hospital.MethodsMagnetic resonance imaging data were acquired from 150 children (aged 4-17) to identify anatomic predictors of VPI and surgical need. Fourteen velopharyngeal variables were measured in the oblique coronal and midsagittal imaging planes. Calculations included differences in levator veli palatini (LVP) muscle angles of origin, mean eThe Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial AssociationLevator Veli Palatini Muscle Ratio Is a Clinically Significant Anatomic Predictor for Velopharyngeal Surgical Need.PMC12684033R21 DC021023UL1 TR003015KL2 TR003016KL2TR003016R21DC021023Black JMason KNGampper TfalseLevator Veli Palatini Muscle Ratio Is a Clinically Significant Anatomic Predictor for Velopharyngeal Surgical Need.ObjectiveVelopharyngeal insufficiency (VPI) poses challenges for normal speech production, often necessitating surgical intervention. Determining optimal candidates for surgery remains complex and requires a nuanced understanding of underlying anatomic factors contributing to VPI. This study aimed to identify anatomic predictors that drive surgical recommendations for VPI.DesignProspective observational cohort study.SettingPediatric tertiary care hospital.MethodsMagnetic resonance imaging data were acquired from 150 children (aged 4-17) to identify anatomic predictors of VPI and surgical need. Fourteen velopharyngeal variables were measured in the oblique coronal and midsagittal imaging planes. Calculations included differences in levator veli palatini (LVP) muscle angles of origin, mean e2025-01-01T00:00:00Z2025 Feb2026-06-06T00:00:44.095Z2026-05-23T03:13:48.696ZS-EPMC126840333963352110.1177/10556656241298833