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

  • Verma, Pradhuman (Department of Oral Medicine and Radiology, Surendera Dental College and Research Institute) ;
  • Verma, Kanika Gupta (Department of Pedodontics and Preventive Dentistry, Surendera Dental College and Research Institute) ;
  • Kumaraswam, Kikkeri Lakshminarayana (Department of Oral Pathology and Microbiology, Farooqia Dental College) ;
  • Basavaraju, Suman (Department of Periodontics, J.S.S Dental College) ;
  • Sachdeva, Suresh K. (Department of Oral Medicine and Radiology, Surendera Dental College and Research Institute) ;
  • Juneja, Suruchi (Department of Pedodontics and Preventive Dentistry, Surendera Dental College and Research Institute)
  • Received : 2013.10.29
  • Accepted : 2013.12.27
  • Published : 2014.09.30


Purpose: The 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 Methods: The 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. Results: The 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. Conclusion: The 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.


  1. You M, Li X, Wang H, Zhang J, Wu H, Liu Y, et al. Morphological variety of the soft palate in normal individuals: a digital cephalometric study. Dentomaxillofac Radiol 2008; 37: 344-9.
  2. Moore KL, Agur AM. Essential clinical anatomy. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2002.
  3. Kumar DK, Gopal KS. Morphological variants of soft palate in normal individuals: a digital cephalometric study. J Clin Diagn Res 2011; 5: 1310-3.
  4. Pepin JL, Veale D, Ferretti GR, Mayer P, Levy PA. Obstructive sleep apnea syndrome: hooked appearance of the soft palate in awake patients - cephalometric and CT findings. Radiology 1999; 210: 163-70.
  5. Subtelny JD. A Cephalometric study of the growth of the soft palate. Plast Reconstr Surg 1957; 19: 49-62.
  6. Stellzig-Eisenhauer A. The influence of cephalometeric parameters on resonance of speech in cleft lip and palate patients. An interdisciplinary study. J Orofac Orthop 2001; 62: 202-23.
  7. Akcam MO, Toygar TU, Wada T. Longitudinal investigation of soft palate and nasopharyngeal airway relations in different rotation types. Angle Orthod 2002; 72: 521-6.
  8. Mazaheri M, Krogman WM, Harding RL, Millard RT, Mehta S. Longitudinal analysis of growth of the soft palate and nasopharynx from six months to six years. Cleft Palate J 1977; 14: 52-62.
  9. Haapanen ML, Kalland M, Heliovaara A, Hukki J, Ranta R. Velopharyngeal function in cleft patients undergoing maxillary advancement. Folia Phoniatr Logop 1997; 49: 42-7.
  10. Simpson RK, Colton J. A cephalometric study of velar stretch in adolescent subjects. Cleft Palate J 1980; 17: 40-7.
  11. Taylor M, Hans MG, Strohl KP, Nelson S, Broadbent BH. Soft tissue growth of the oropharynx. Angle Orthod 1996; 66: 393-400.
  12. Niu YM, Wang H, Zheng Q, He X, Zhang J, Li XM, et al. Morphology of the soft palate in normal humans with digital cephalometry. Hua Xi Kou Qiang Yi Xue Za Zhi 2006; 24: 321-7.
  13. Guttal KS, Breh R, Bhat R, Burde KN, Naikmasur VG. Diverse morphologies of soft palate in normal individuals: a cephalometric perspective. J Indian Acad Oral Med Radiol 2012; 24: 15-9.
  14. Cohen SR, Chen L, Trotman CA, Burdi AR. Soft-palate myogenesis: a developmental field paradigm. Cleft Palate Craniofac J 1993; 30: 441-6.<0441:SPMADF>2.3.CO;2
  15. Maltais F, Carrier G, Cormier Y, Series F. Cephalometric measurements in snorers, non-snorers, and patients with sleep apnoea. Thorax 1991; 46: 419-23.
  16. Praveen BN, Amrutesh S, Pal S, Shubhasini AR, Vaseemuddin S. Various shapes of soft palate: a lateral cephalometric study. World J Dent 2011; 2: 207-10.
  17. Johnston CD, Richardson A. Cephalometric changes in adult pharyngeal morphology. Eur J Orthod 1999; 21: 357-62.
  18. Kollias I, Krogstad O. Adult craniocervical and pharyngeal changes - a longitudinal cephalometric study between 22 and 42 years of age. Part II. Morphology of uvulo-glossopharyngeal changes. Eur J Orthod 1999; 21: 345-55.
  19. Johns DF, Rohrich RJ, Awada M. Velopharyngeal incompetence: a guide for clinical evaluation. Plast Reconstr Surg 2003; 112: 1890-8.
  20. Nakamura N, Ogata Y, Kunimitsu K, Suzuki A, Sasaguri M, Ohishi M. Velopharyngeal morphology of patients with persistent velopharyngeal incompetence following repushback surgery for cleft palate. Cleft Palate Craniofac J 2003; 40: 612-7.<0612:VMOPWP>2.0.CO;2
  21. Hoopes JE, Dellon AL, Fabrikant JI, Edgerton MT Jr, Soliman AH. Cineradiographic definition of the functional anatomy and apathophysiology of the velopharynx. Cleft Palate J 1970; 7: 443-54.
  22. Wada T, Satoh K, Tachimura T, Tatsuta U. Comparison of nasopharyngeal growth between patients with clefts and noncleft controls. Cleft Palate Craniofac J 1997; 34: 405-9.<0405:CONGBP>2.3.CO;2