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Thickness and Histologic and Histochemical Properties of the Superior Pharyngeal Constrictor Muscle in Velocardiofacial Syndrome
Shane Zim, MD;
Robert Schelper, MD;
Robert Kellman, MD;
Sherard Tatum, MD;
Robert Ploutz-Snyder, PhD;
Robert Shprintzen, PhD
Arch Facial Plast Surg. 2003;5:503-510.
Background Velocardiofacial syndrome (VCFS) is one of the most common multiple anomaly syndromes in humans. Pharyngeal hypotonia, one of the most common findings in VCFS, contributes to hypernasal speech, which occurs in approximately 75% of individuals with VCFS.
Objective To evaluate the thickness and histologic and histochemical properties of the superior pharyngeal constrictor (SPC) muscle in patients with VCFS to determine whether a muscle abnormality exists that might contribute to the hypotonia seen in these patients.
Subjects The SPC muscle thickness in 26 VCFS patients (18 male and 8 female; age range, 3-29 years) was compared with SPC muscle thickness in age- and sex-matched controls using magnetic resonance images. The histologic and histochemical properties of the SPC muscle in 9 VCFS patients (6 male and 3 female; age range, 4-12 years) were compared with SPC muscle in 3 adult cadavers without VCFS (all male; age range, 80-86 years) using specimens obtained during pharyngeal flap surgery.
Results The thickness of the SPC muscle was significantly less in patients with VCFS (2.03 mm) than in patients without VCFS (2.85 mm). The SPC muscle contained a significantly greater proportion of type 1 fibers in patients with VCFS (27.7%) than in adults without VCFS (17.9%), and the diameter of the type 1 fibers was significantly smaller in patients with VCFS (21.6 µm) than in adults without VCFS (26.6 µm).
Conclusions Differences in the thickness and histologic and histochemical properties of the SPC muscle found in patients with VCFS compared with individuals without VCFS may offer insight into the cause of pharyngeal hypotonia and hypernasal speech seen in these patients.
From the Department of OtolaryngologyHead and Neck Surgery (Dr Zim), University of Southern California, Keck School of Medicine, Los Angeles; Departments of OtolaryngologyHead and Neck Surgery (Drs Kellman, Tatum, and Shprintzen) and Pathology (Dr Schelper) and Center for Outcomes Research and Evaluation (Dr Ploutz-Snyder), State University of New York, Upstate Medical University, Syracuse, NY.
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