Growth Effects on Velopharyngeal Anatomy From Childhood to Adulthood

Purpose: The observed sexual dimorphism of velopharyngeal structures among adult populations has not been observed in the young child (4- to 9-year-old) population. The purpose of this study was to examine the age at which sexual dimorphism of velopharyngeal structures become apparent and to examine how growth trends vary between boys and girls. Method: Static 3-dimensional magnetic resonance imaging velopharyngeal data were collected among 202 participants ranging from 4 to 21 years of age. Participants were divided into 3 groups based on age, including Group 1: 4–10 years of age, Group 2: 11–17 years of age, and Group 3: 18–21 years of age. Nine velopharyngeal measures were obtained and compared between groups. Results: Significant sex effects were evident for levator length (p = .011), origin to origin (p = .018), and velopharyngeal ratio (p = .036) for those in Group 2 (11–17 years of age). Sex effects became increasingly apparent with age, with 7 of 9 variables becoming significantly different between male and female participants in Group 3. Boys, in general, displayed a delayed growth peak in velopharyngeal growth compared to girls. Conclusion: Results from this study demonstrate the growth of velopharyngeal anatomy with sexual dimorphism becoming apparent predominantly after 18 years of age. However, velopharyngeal variables displayed variable growth trends with some variables presenting sexual dimorphism at an earlier age compared to other velopharyngeal variables.

研究目的：成人群体中已观测到的腭咽结构（velopharyngeal structures）性别二态性（sexual dimorphism），在4至9岁的幼儿群体中并未显现。本研究旨在探究腭咽结构性别二态性显现的年龄节点，同时分析男孩与女孩的腭咽生长趋势差异。
方法：本研究纳入202名年龄介于4至21岁的受试者，采集其静态三维磁共振成像（3-dimensional magnetic resonance imaging，MRI）腭咽相关数据。根据年龄将受试者划分为3组：第1组（4~10岁）、第2组（11~17岁）及第3组（18~21岁）。提取9项腭咽测量指标，并在各组间开展比较分析。
结果：在第2组（11~17岁）受试者中，腭帆提肌长度（levator length，p=0.011）、双侧起点间距（origin to origin，p=0.018）及腭咽比值（velopharyngeal ratio，p=0.036）均存在显著的性别效应。性别效应随年龄增长愈发显著，第3组受试者中有7项指标在男女间出现显著差异。总体而言，与女孩相比，男孩的腭咽结构生长峰值出现时间更晚。
结论：本研究结果显示，腭咽解剖结构的生长伴随性别二态性，该特征主要在18岁之后显现。不过，不同腭咽指标的生长趋势存在差异，部分指标的性别二态性出现时间早于其他腭咽指标。