Types Of Soft Palate Research Articles

STUDY OF SOFT PALATE DIMENSION AND NASOPHARYNGEAL DEPTH (NEED’S RATIO) USING LATERAL CEPHALOMETRICS X- RAY

Background: Soft palate is a tissue mass that hangs behind the hard palate mainly to seal the pharyngeal airway. The length of the soft palate should be adequate to close the pharyngeal depth. Failure to completely seal leads to velopharyngeal insufficiency while longer palatal length leads to obstructive sleep apnea. This study aimed to find the need’s ratio among the general Nepalese population. Methods: Lateral cephalograms of 591 of 17 years and above cases without any history of palatal surgery, orthodontic treatment or congenital defect were studied. The length of the soft palate, pharyngeal depth and thickness of the palatal tissue was measured using VLX computer program in lateral cephalograms obtained from gendex orthoralix 9200. The ratio of palatal length pharyngeal depth was calculated as Need’s ratio. Results: Soft palate length was 33.27 + 7.74 and 24.82 + 4.53 respectively. The Need’s ratio calculated is 0.75. The rat tail shape of soft palate was highly prevalent 173 (28.3%) while S shape was least 51 (8.6%) . Crook type of soft palate has highest Need’s ratio. Conclusions: The mean Need’s ratio of Nepalese population is 0.75. Need’s ratio also varies from shape of the soft palate.

The possible association between the types of soft palate and gag reflex: a preliminary study

The possible association between the types of soft palate and gag reflex: a preliminary study

Long-term average spectrum measures of consecutive snore sounds from different sources determined by drug-induced sleep endoscopy.

The goal of this study was to investigate the value of the long-term average spectrum in the acoustic analysis of snore sounds arising from different sources in the upper airway. Long-term average spectrum was used to analyze sequences of 10 consecutive snore sounds that had been divided into 2 groups, soft-palate type and lateral-wall type, according to the vibration site generating the snore sounds and the patterns of soft tissue collapse in the upper airway as identified by drug-induced sleep endoscopy. We calculated the first spectral peak, mean spectral energy, high-frequency energy, 0-1 kHz spectral energy, 1-5 kHz spectral energy, and 0-1 kHz/1-5 kHz difference from each group and compared the differences between them. All parameters except mean spectral energy showed significant differences between the 2 groups. The first spectral peak of less than 265.53 Hz, and the 0-1k/1-5 kHz difference of less than -11.6 dB strongly suggests soft-palate-type snore sounds. Long-term average spectrum has potential application for snore sound source identification. We recommend using first spectral peak and a 0-1 kHz/1-5 Hz difference to identify soft-palate-type snore sounds. Peng H, Xu H, Xu Z, Jia R, Yu H. Long-term average spectrum measures of consecutive snore sounds from different sources determined by drug-induced sleep endoscopy. J Clin Sleep Med. 2023;19(1):145-150.

Application of Berlin questionnaire in obstructive sleep apnea syndrome through soft palate morphology types

Obstructive sleep apnea (OSA) is a sleep disorder characterized by intermittent complete and partial airway collapse, resulting in frequent episodes of apnea and hypopnea. The Berlin questionnaire (BQ) is a simple, inexpensive instrument used to screen for OSA, which is about risk factors for sleep apnea, namely, snoring behavior, daytime sleepiness or fatigue, and the presence of obesity or hypertension. This 10-question test has since then become well known for its accuracy in predicting the presence of sleep apnea in patients. Cephalometry is a relatively inexpensive method and it permits a good assessment of the soft tissue elements that define the soft palate and its surrounding structures. Therefore, the present study aims to study the morphology of the soft palate using lateral cephalometry and classify it into various types. And to identify the individuals with OSA syndrome through a particular type of soft palate and correlate it with the BQ. This prospective study was conducted in the Department of Oral Medicine and Radiology of D.Y.Patil Dental College, Pune. About 150 subjects for the study were selected by random sampling from the outpatient department of Oral Medicine and Radiology and the patients were referred from the orthodontics department. Lateral cephalograms were assessed for soft palate morphology types, and all participants filled the BQ. A Chi-square test was applied. The level of significance was set at P < 0.05. Among six types of the soft palate, the maximum number of participants had type 2 (rat-tail type) of the soft palate (26.0%). A highly significant association was found between the BQ (positive and negative response) and soft palate morphology types (i.e., P < 0.01). A maximum number of participants who responded to the BQ had type 5 (S type) of the soft palate (76.47%). The type 2 (rat-tail) soft palate was the most frequent type, while the type 4 (straight-line) shape was the least common among all the six types. The persons with type 5 (S-shape) soft palate responded more positively to the BQ as compared to other types of soft palate. This shows that a particular type of soft palate could be responsible for causing OSA syndrome. Lateral cephalogram and BQ, which are relatively inexpensive and widely available, can be used in resource-limited and thickly populated countries like India to correctly identify patients with OSA syndrome.

Анатомо-морфологические особенности строения мягкого нёба у пациентов с храпом и синдромом обструктивного апноэ сна

The study involved 73 patients with snoring and sleep apnea, aged 25 to 74 years, who underwent reconstructive interventions on the soft palate as a surgical treatment. As part of the preoperative examination, all patients underwent night respiratory monitoring in order to identify and assess the severity of respiratory disorders during sleep. A histological analysis of all tissues removed during the operation and a comparison of the identified changes with the visual picture during a pharyngoscopic examination were carried out. Depending on the pharyngoscopy, 5 main types of soft palate were identified, on the basis of which the patients were divided into 5 groups. The mildest clinical manifestations of obstructive sleep apnea (OSA) were noted in patients from groups 1 and 2, and the most severe, in patients from group 4. Morphological changes were represented by reactive phenomena of the mucous membrane, stromal edema, transformation of the mucous glands, an increase in the vascular component, and the development of chronic inflammation. Analyzing the results obtained, a relationship was noted between the severity of OSA and the morphological features of the removed palatine uvula. It can be assumed that 5 types of soft palate are the stages of one pathophysiological process successively replacing one another.

Soft palate morphology in OSMF patients: Radiographic evaluation

Oral submucous fibrosis (OSMF) is a chronic progressive, scarring disorder of oral cavity, which includes buccal mucosa, tongue, lips, anterior faucial pillars, soft palate, and oropharynx. Changes in soft palate morphology will start even before the OSMF, present itself clinically. These changes can lead to sleep apnea, difficulty in speech, swallowing &amp; respiration. Various radiographs are good diagnostic aid to assess the soft palate and its morphology or any changes in morphology. To evaluate and compare soft palate morphology and dimensions in various stages of OSMF with control by radiographic evaluation.: 60 patients were evaluated and compared for soft palate morphology, its length, width and angle by using lateral cephalogram and Cone beam computed tomography (CBCT). Most common type of soft palate was found to be type 1 (leaf shaped) in both groups as well as by both radiographic techniques. Significant decrease in length and increase in width with increasing grades of OSMF group. As per p value CBCT gave more precise result. As the OSMF progresses soft palate becomes stout and bulky and significant changes occur in soft palate dimensions and are better evaluated by CBCT. As involvement of the soft palate is the earliest change to be noticed, radiographs should be used as one of the diagnostic aids in OSMF patients.

Relation of fovea palatine and vibrating line in different soft palatal forms

Background: The posterior palatal seal (PPS) area plays a major role in retention of a maxillary denture. Many dentures have failed due to faulty recording of posterior palatal seal area. Hence, locating posterior palatal seal area is a critical step in complete denture fabrication. Various techniques have been described in the literature for locating the posterior border of maxillary complete denture. One of the most commonly used methods is the one that uses anatomical landmark like fovea palatine for locating the palatal seal area. However, many studies show a wide range of variation regarding position of fovea palatine with the vibrating line.&#x0D; Materials and Methods: A total of 200 subjects were selected for the study and clinical examination carried out to mark the vibrating line and fovea palatine. The location of vibrating line whether it is anterior to fovea palatine, on the fovea palatine or posterior to the fovea palatine in the different soft palate type(Class I, II or III) was recorded using the phonation method.&#x0D; Results: The vibrating line was located interiorly to the fovea palatine in 70%, 54% and 60% of the subjects with Class I, II and III soft palate. The vibrating line was located on the fovea palatine in22%, 40% and 36% of the subjects with Class I, II and III soft palate and posteriorly to the fovea palatine in 23%, 5% and 3% of the subjects with Class I, II and III soft palate respectively.&#x0D; Conclusion: The vibrating line was predominantly found to be anterior to the fovea palatine in all the soft palatal forms.

Correlation of soft palate morphology to growth pattern: A retrospective cephalometric study.

Aim:The aim of the present study was to evaluate the radiographic length of velum (LV), width of velum (WV), velum angle (AV), depth of pharynx (PD), Need's ratio (NR), inclination angle (AI) in different morphological types of soft palate according to growth patterns in skeletal class I individuals.Methodology:80 pretreatment lateral cephalograms of patients with skeletal class I malocclusion (ANB 2--4°) were divided on basis of six types of soft palate and further into three subgroups according to growth pattern and evaluation of LV, WV, angle with the palatal plane, and NR was done. Kruskal--Wallis test was used for the comparison between the groups.Results:Statistically significant difference was verified among all groups for measurement of NR. The highest NR was seen in Crook type of soft palate (mean 0.9). Similarly, the vertical growth pattern in all the six types of soft palate exhibited a higher NR than the average and horizontal growth pattern group; the highest being exhibited by vertical group in type VI (crook shaped). Velopharyngeal insufficiency is directly related to NR.Conclusion:Vertical growth pattern has the highest susceptibility to velopharyngeal insuffiency and speech and sleep apnea disorders.

The association between soft palate shape and Need's ratio in various sagittal skeletal malocclusions: A digital lateral cephalometric study

Aim: The present study was aimed to investigate the variation of soft palate morphology and Need's ratio in various sagittal skeletal malocclusions. Materials and Methods: The study was conducted on 300 individuals (aged 15–25 years) who presented to the department of orthodontics for orthodontic treatment. The participants were divided into skeletal Class I, II, and III based on ANB angle on the lateral cephalogram. The soft palate morphology was examined and individuals were grouped into six types. The Need's ratio was calculated for all the participants by division of pharyngeal depth by soft palate length. The results were then subjected to statistical analysis to find the association between morphological variants of soft palate and skeletal malocclusions. Results: The most common type of soft palate was leaf shaped and the least common was S shaped. Leaf-shaped soft palate was the most common in males and rat tail-shaped soft palate was common in females. Individuals with skeletal Class I malocclusion were most frequently found to have leaf-shaped soft palate, skeletal Class II malocclusion had rat tail type, and skeletal Class III had leaf shape and crooked shape in equal proportions. Need's ratio was maximum in skeletal Class III and minimum in Class II malocclusions. Conclusions: There was a significant correlation between the variants of soft palate and the types of skeletal malocclusion in North Indian individuals. The knowledge of morphological variants of soft palate helps the clinician in etiological study of obstructive sleep apnea syndrome, snoring, and other conditions.

Prevalence of Types of Soft Palate in Indian Population in Wardha Region, Maharashtra, India: An in vivo Study

Prevalence of Types of Soft Palate in Indian Population in Wardha Region, Maharashtra, India: An in vivo Study

Morphological Diversity of Soft Palate in Nepalese Population: A Retrospective Cephalometric Study

Introduction: Soft palate is a fibromuscular portion constituting the back of roof of the mouth which is essential for phonation, deglutition, respiration and velopharyngeal competence.Objective: To study various morphologies of soft palate, difference in proportion of each type and their differencesamong gender and agegroups in Nepalese sample.Materials &amp; Method: A retrospective study was conducted on patients seeking orthodontic treatment. 263 lateral cephalograms were classified on the basis of radiographic appearance. Analysis was done using SPSS (version 20.0). Pearson chi square and descriptive statistics were performed and level of significance was set at p&lt;0.05. Result: In the order of occurrence; rat tail type of soft palate was most prevalent followed by leaf type, butt type, straightline, crooked type and S shaped. There was no significant difference between male and female subjects (p=0.338) and through age groups (p=0.998).Conclusion: The study highlights various types of soft palate present in Nepalese sample which will help as a reference for research pertaining to cleft palate/ velopharyngeal closure and in obstructive sleep apnoea syndrome in Nepalese population

Comparative morphometric analysis of soft palate between OSMF and normal individuals: A digital cephalometric study

Aim: To investigate morphometric variation of the soft palate on lateral cephalogram in different stages of. Oral submucous fibrosis. Objectives: To evaluate the radiographic velum length, velum width, angle/inclination of velum and pharnygeal depth divided by velum length giving Need’s ratio in different morphological types of soft palate and different stages of OSMF and to determine correlation of all metric parameters with respect to staging of OSMF. Also, correlation of staging of OSMF with respect to different types of soft palate was evaluated. Materials & Method: Lateral cephalographs of 80 cases with age range 18-45years irrespective of gender were evaluated. Soft palatal patterns were categorized based on You et al. et al’s classification & staging of OSMF was done according to Kiran Kumar et al’s classification. Total 80 cases were divided into two groups such as Group A (OSMF = 40) and Group B (Control =40) Group A (40 OSMF) and Group B (40 Control). The length, width, angle of inclination and need’s ratio was evaluated in each type of soft palate. Mann-Whitney est and Kruskal Wallis test was used for statistical analysis. Results: The mean age of the 80 cases was 40.5years. The highest incidence of soft palate seen in group A and B was type 1, whereas the lowest incidence was type 5 in Group A and type 6 in Group B. The mean and Standard deviation of length, width, angle of inclination and need’s ratio in group A was 22.43 + 0.76, 23.91 + 0.94, 127.72° + 1.21 and 0.8+ 0.57 respectively and that of control group was 24.47 + 1.10, 21.60 + 0.58, 131.6° + 0.75 and 0.63+ 0.97 respectively. Stage 1 OSMF subjects had maximum type 2 soft palate(4%), Stage 2 had type 1 (45%) and stage 3 had type 6 (5%). Conclusion: With OSMF staging advancement, length and angle of inclination of soft palate shows negative, whereas width and the need’s ratio shows positive correlation. Keywords: Obstructive sleep apnea, Oral submucous fibrosis, Soft palate

A Novel Approach to Determine the Prevalence of Type of Soft Palate Using Digital Intraoral Impression

Aim To determine the prevalence of type of soft palate in targeted population. Materials and Methods Using computer technology in dentistry, intraoral digital scanner, and 3D analysis software tool, study was conducted. 100 patients selected from the outpatient clinics were divided into two groups based on the ages of 20–40 years and 41–60 years with equal ratio of males and females. Each selected patient's maxillary arch was scanned with intraoral scanner; images so obtained were sectioned in anteroposterior cross section and with the 3D analysis software; the angulation between hard and soft palate was determined. Results The prevalence of type II soft palate (angulation between hard and soft palate is between 10 and 45 degrees) was highest, 60% in group 1 and 44% in group 2. The difference between genders was statistically significant with p value <0.05 in both the groups, although females had higher angulation compared to the males in all classes of both groups. Conclusions In targeted population of Aseer Province, Saudi Arabia, the prevalence of type II soft palate was more common, with higher soft palate angulation among females. The advanced age had no effect in the type of soft palate in the region.

A Focus on Variation in Morphology of Soft Palate Using Cone-Beam Computed Tomography with Assessment of Need's Ratio in Central Madhya Pradesh Population.

Soft palate is an anatomical structure that helps in modifying the quality of voice and to breathe while swallowing. Through the variants and shapes of the soft palate, we can assess the age and gender of an individual. The aim of the present study was to investigate the variation in morphology of soft palate and to find its association with the Need's ratio, Velar Length (VL), Velar Width (VW) and Pharyngeal Depth (PD), in age groups and gender using CBCT in Central Madhya Pradesh population. The study sample consisted of 121 CBCT scans of individuals aged between 15 to 45 years. These scans were retrieved from the Department of Oral Radiology. The velar morphology on CBCT was examined and grouped into six types. The results obtained were subjected to a statistical analysis to find the association between variants of the soft palate with gender and different age groups. ANOVA and Z-test were used for statistical analysis. The p≤0.05 was considered as significant while p≤0.001 was considered as highly significant. The most frequent type of soft palate was rat tail shaped. The mean VL and VW values were significantly higher in males while PD and Need's ratio were higher among females, insignificantly associated with the types of soft palate. A significant association was observed between the mean VL and VW with various age groups, showing an increase in values with an increase in age. A variation in morphology of soft palate plays an important role in the assessment of velopharyngeal closure and in diagnosing obstructive sleep apnoea individuals.

Digital cephalometric analysis illustrating morphological variation of the soft palate

Introduction and Objectives: The soft palate plays a vital role in velopharyngeal closure which is strongly dependent on a close coordination of the velum and the contiguous pharyngeal structures. It is reasonable to hypothesize that these structures may have different characteristics to match up to different soft palate morphologies. Considering this, the present study was done to investigate the variation in the morphology of the soft palate. Materials and Methods: A total of 200 patients belonging to both the genders, in the age group 5-55 years, were selected from the outpatients visiting the Department of Oral Medicine and Radiology. All the study samples were subjected to lateral cephalogram and the morphology of the soft palate was categorized as described by You et al. Any additional finding was further differentiated as type 7 and so on. The length of soft palate was also evaluated using Sidexis next generation software. The data obtained were tabulated and subjected to statistical analysis. Results: The morphology of soft palate was categorized into eight types. Type 1 was the commonest type observed. The relationship between the different types of soft palate in various age groups was found to be non-significant. The mean length of the soft palate was found to be more in group V (46-55 years). The mean length of soft palate was found to be higher in males. There was a positive correlation between age and type of soft palate. Conclusion: The present study draws a new set of morphological classification for the soft palate.

Correlation of morphological variants of soft palate and types of malocclusion: A digital lateral cephalometric study

Aims and Objectives: The morphology of soft palate has variable presentations on lateral cephalometry. The aim of our study was to investigate the correlation between various shapes of soft palate and types of malocclusion in different gender groups among North Indian individuals. Materials and Methods: The study sample comprised randomly selected 250 healthy North Indian individuals (125 males and 125 females) seeking orthodontic treatment for malocclusion without any speech abnormality or any other syndromes or diseases and with age ranging from 14 to 28 years. Clinically, in all subjects, the type of malocclusion was examined and categorized according to Angle's classification of malocclusion. The morphological variants of soft palate were also assessed on digital lateral cephalogram and were allocated to one of the six patterns as described by You et al. The differences in the proportion of each type were studied and variation of malocclusion and soft palate morphology between gender groups was also assessed. The results obtained were subjected to a statistical analysis to find the correlation between variants of the soft palate and types of malocclusion in different gender groups. Results: In our study, the frequency of rat tail (37.2%) type of soft palate was seen in highest proportion, whereas the frequency of distorted S-shape (6.80%) was least in both the genders. Angle's class II malocclusion (51.2%) was the most common, followed by class I (43.2%), whereas class III (5.6%) was found to be the least prominent type in both the genders. Patients with Angle's class I malocclusion were most frequently found to have rat tail type soft palate, those with Angle's class II had leaf-shaped soft palate, and those with Angle's class III had crooked shaped soft palate. Angle's class II and class III malocclusions were significantly correlated with soft palate shapes, whereas Angle's class I malocclusion was highly significantly correlated with the shape of soft palate. Conclusion: It was found in our study that there was a significant correlation between variants of soft palate and types of malocclusion.

Morphometric evaluation and comparison of soft palate in individuals with and without oral submucous fibrosis: A digital cephalometric study

Objectives: Oral submucous fibrosis (OSMF) is one of the most common premalignant conditions affecting the oral cavity of people consuming arecanut and gutka. According to the available literature, as the disease progresses the morphology of the soft palate changes. So, the objective of present study was to evaluate and compare the morphology of soft palate in individuals with and without OSMF, using digital lateral cephalogram. Materials and Methods: Sixty male individuals were selected and divided into three groups, Group I-20 individuals (habit group), Group II-20 individuals (OSMF group), and Group III-20 individuals (individuals with no habit and/or OSMF group). The morphology of soft palate was assessed using digital lateral cephalogram. Statistical analysis was carried out using Scheffe multiple comparison test. Results: The superoinferior dimension of soft palate was increased with statistically significant difference in the habit and OSMF groups. The anteroposterior dimension was reduced in the habit group as compared to normal individuals, with statistically significant difference in the OSMF group. The type of soft palate more common in normal individuals and habit group was type 1 and 2, while type 6 was seen more commonly in OSMF group. Conclusion: Cephalometry can be efficiently used to assess the morphology of soft palate and the morphology of soft palate is altered in individuals with the habit even before the development of OSMF. So, cephalometry can be beneficial in assessing fibrosis in individuals with the habit at an early stage, which can further help in prognosis.

Correlation of Types of Soft Palate, Body Mass Index and Apnoea Hypoapnoea Index in Patients with Sleep Apnoea: A Pilot Study

Aim: Sleep Apnoea a common disorder in young and adults has been studied extensively by pulmonologists, ENT specialists and dentists for various reasons. In the literature it is documented that Sleep Apnoea patient confirmed by polysomography have higher incidence of hook-shaped (S -type) of soft palate. The aim of our study is to correlate types of soft palate, body mass index (BMI) and apnoea hypoapnoea index (AHI) in sleep apnoea patients. Materials & Methods: This preliminary study was carried out in 20 diagnosed patients of sleep apnoea and 20 normal subjects between the age ranges of 12 to 60 yrs in VSPM'S Dental College & Research Center. The morphology of the soft palate was studied on Digital lateral cephalograms (using Kodak software-72kvp, 12mA, 1sec exposure). The BMI index, polysomography, Epworth sleepiness scale was recorded in all these patients. Results: Patients with increase BMI and severe AHI had higher incidence of butt type of palate followed by leaf type. In normal patient the commonest type was found to be leaf type followed by rat tail type. Conclusion: The present study indicated that severe sleep apnoea patient had higher incidence of butt type of soft palate.

Correlation of morphological variants of the soft palate and Need's ratio in normal individuals: A digital cephalometric study.

PurposeThe present study was aimed to investigate the variation of soft palate morphology in different age and gender groups. The correlations of radiographic velar length (VL), velar width (VW), pharyngeal depth (PD), and Need's ratio with soft palate variants were also studied in the North Indian subpopulation.Materials and MethodsThe study sample consisted of 300 subjects aged between 15 and 45 (mean: 31.32) years. The velar morphology on lateral cephalograms was examined and grouped into six types. The results obtained were subjected to a statistical analysis to find the correlation between variants of the soft palate with gender and different age groups.ResultsThe most frequent type of soft palate was leaf shaped (48.7%), and the least common was crook shaped (3.0%) among both the genders and various age groups, showing a significant correlation. The mean VL, VW, and PD values were significantly higher in males and significantly correlated with the types of soft palate. A significant correlation was observed between the mean VL, VW, PD, and Need's ratio with various age groups, showing an inconsistent pattern with an increase in age. The types of soft palate, gender, and Need's ratio were also significantly correlated, with an overall higher mean value of the Need's ratio among female subjects and the S-shaped soft palate.ConclusionThe knowledge of a varied spectrum of velar morphology and the variants of the soft palate help in a better understanding of the velopharyngeal closure and craniofacial anomalies.

Morphometric evaluation of soft palate in oral submucous fibrosis—A digital cephalometric study

The Present study was carried out to evaluate the morphology of soft palate in Oral Submucous Fibrosis (OSF) patients using digital lateral cephalogram. A total number of 70 patients were included in the study (Control group had 35 patients and Study group had 35 OSF patients) were evaluated for soft palate by digital lateral cephalogram. The anterio-posterior length and superior–inferior length of soft palate were measured. The morphology of soft palate was categorized as type 1, to type 6. Different types of soft palate were compared with stages of OSF. Among the Study group (35 patients) 62.9% had Stage 2 OSF. Leaf shaped (Type 1) soft palate was seen commonly in stage 2 OSF whereas butt shaped (Type 3) in stage 3 OSF. In the present study there was statistically significant difference in length (anterio-posterior) of Type 1 soft palate of OSF patients. In the present study as the OSF progressed to advanced stage there was gradual change from Type 1 and Type 2 variety of Soft palate to Type 3 and Type 6 variety of soft palate. The study observed that there was gradual reduction in the length of soft palate in anterior-posterior direction in OSF patients.