About one in 700 babies is born with a cleft palate. Even after surgery to suture the lip or the hard and soft palates, some 20 to 30 percent of such children have lingering speech impediments—and evaluating the problem often requires threading a fiber-optic camera up the patient’s nose. If plastic surgeon Alex Kane and radiologist John Butman have their way, such unpleasantness will soon be replaced by magnetic resonance imaging (MRI), which is both painless and far more revealing.
During speech, the soft palate normally shifts upwards to close off the air passageway between the mouth and the nose. If the palate can't move easily, air escapes through the nose, and speech is indistinct. Additional operations can correct these post-reconstruction defects, but only if the doctor can see where the problem lies. Conventional MRI requires that the subject be motionless, so it is a poor tool for studying errant motions of the soft palate. Kane has overcome that limitation using "gated" MRI, a method originally developed to view a heart beating. While the patient repeats a simple phrase up to 200 times, the imaging machine collects snapshots at successive stages of speaking. When viewed one after another, the resulting stills play like a three-dimensional movie of the palate at work. "We hope to have an all-purpose tool to study speech, not only in cleft-lip-and-palate kids but also in people who've had strokes," says Kane.