{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T21:57:16Z","timestamp":1772402236748,"version":"3.50.1"},"reference-count":40,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["jprasopen.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["JPRAS Open"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.jpra.2025.12.025","type":"journal-article","created":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T23:32:06Z","timestamp":1767483126000},"page":"817-827","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Anatomical analysis of the muscle layers of the soft palate in velopharyngeal closure: A cadaveric study"],"prefix":"10.1016","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8745-2725","authenticated-orcid":false,"given":"Keiko","family":"Fukino","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1803-8202","authenticated-orcid":false,"given":"Masahiro","family":"Tsutsumi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuri","family":"Kinoshita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4625-8173","authenticated-orcid":false,"given":"Yoshiro","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Ono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joe","family":"Iwanaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2927-2937","authenticated-orcid":false,"given":"Keiichi","family":"Akita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.jpra.2025.12.025_bib0001","first-page":"1","article-title":"Velopharyngeal competence and incompetence following pharyngeal flap surgery: video-fluoroscopic study in multiple projections","volume":"9","author":"Skolnick","year":"1972","journal-title":"Cleft Palate J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0002","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1055\/s-0031-1277712","article-title":"Anatomy and physiology of the velopharyngeal mechanism","volume":"32","author":"Perry","year":"2011","journal-title":"Semin Speech Lang"},{"key":"10.1016\/j.jpra.2025.12.025_bib0003","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1177\/1055665618813082","article-title":"Anatomical significance of the spatial distribution of the palatopharyngeus with regard to velopharyngeal closure","volume":"56","author":"Fukino","year":"2019","journal-title":"Cleft Palate Craniofac J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0004","series-title":"Gray's Anatomy","first-page":"571","article-title":"Pharynx","author":"Stephan","year":"2015"},{"key":"10.1016\/j.jpra.2025.12.025_bib0005","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1597\/13-107","article-title":"Effects of gravity on the velopharyngeal structures in children using upright magnetic resonance imaging","volume":"51","author":"Kollara","year":"2014","journal-title":"Cleft Palate Craniofac J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0006","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1097\/SCS.0000000000003373","article-title":"Morphology of the levator veli palatini muscle in adults with repaired cleft palate","volume":"28","author":"Kotlarek","year":"2017","journal-title":"J Craniofac Surg"},{"key":"10.1016\/j.jpra.2025.12.025_bib0007","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1177\/1055665617732786","article-title":"Clinical significance of the levator veli palatini muscle in velocardiofacial syndrome patients: implications in velopharyngeal incompetence and pharyngeal flap surgery","volume":"55","author":"Myung","year":"2018","journal-title":"Cleft Palate Craniofac J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0008","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1177\/1055665619851660","article-title":"Velopharyngeal structural and muscle variations in children with 22q11.2 deletion syndrome: an unsedated MRI study","volume":"56","author":"Kollara","year":"2019","journal-title":"Cleft Palate Craniofac J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0009","doi-asserted-by":"crossref","first-page":"2713","DOI":"10.1044\/2019_JSLHR-S-18-0459","article-title":"A dynamic magnetic resonance imaging-based method to examine in vivo levator veli palatini muscle function during speech","volume":"62","author":"Pelland","year":"2019","journal-title":"J Speech Lang Hear Res"},{"key":"10.1016\/j.jpra.2025.12.025_bib0010","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.ijom.2019.08.001","article-title":"Evaluation of velopharyngeal function using high-speed cine-magnetic resonance imaging based on T2-weighted sequences: a preliminary study","volume":"49","author":"Joujima","year":"2020","journal-title":"Int J Oral Maxillofac Surg"},{"key":"10.1016\/j.jpra.2025.12.025_bib0011","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1177\/1055665620933472","article-title":"Contracted extravelar segments of the levator veli palatini muscle: a magnetic resonance imaging morphometric study","volume":"58","author":"Bae","year":"2021","journal-title":"Cleft Palate Craniofac J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0012","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1002\/bjs.1800259715","article-title":"The technique of operation for cleft palate","volume":"25","author":"Wardill","year":"1937","journal-title":"Brit J Surg"},{"key":"10.1016\/j.jpra.2025.12.025_bib0013","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1097\/00006534-196205000-00003","article-title":"Surgical lengthening of the cleft palate by dissection of the neurovascular bundle","volume":"29","author":"Edgerton","year":"1962","journal-title":"Plast Reconstr Surg Transplant Bull"},{"key":"10.1016\/j.jpra.2025.12.025_bib0014","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1097\/00006534-198678060-00002","article-title":"Cleft palate repair by double opposing Z-plasty","volume":"78","author":"Furlow","year":"1986","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.jpra.2025.12.025_bib0015","first-page":"62","article-title":"Velopharyngeal competence and primary cleft palate surgery, 1960-1971: a critical review","volume":"10","author":"Morris","year":"1973","journal-title":"Cleft Palate J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0016","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1597\/1545-1569_1998_035_0095_vfincp_2.3.co_2","article-title":"Velopharyngeal function in nonsyndromic cleft palate: relevance of surgical technique, age at repair, and cleft type","volume":"35","author":"Marrinan","year":"1998","journal-title":"Cleft Palate Craniofac J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0017","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1597\/1545-1569_2003_040_0612_vmopwp_2.0.co_2","article-title":"Velopharyngeal morphology of patients with persistent velopharyngeal incompetence following repushback surgery for cleft palate","volume":"40","author":"Nakamura","year":"2003","journal-title":"Cleft Palate Craniofac J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0018","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/ocr.12112","article-title":"The Cleft Care UK study. Part 4: perceptual speech outcomes","volume":"18","author":"Sell","year":"2015","journal-title":"Orthod Craniofac Res"},{"key":"10.1016\/j.jpra.2025.12.025_bib0019","doi-asserted-by":"crossref","first-page":"852e","DOI":"10.1097\/PRS.0000000000000184","article-title":"Cleft palate repair and velopharyngeal dysfunction","volume":"133","author":"Hopper","year":"2014","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.jpra.2025.12.025_bib0020","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/j.jcms.2020.08.006","article-title":"Palatal lengthening by double opposing buccal flaps for surgical correction of velopharyngeal insufficiency in cleft patients","volume":"48","author":"Chauhan","year":"2020","journal-title":"J Craniomaxillofac Surg"},{"key":"10.1016\/j.jpra.2025.12.025_bib0021","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1177\/27325016211006850","article-title":"An MRI case study: the anatomic cleft restoration concept utilizing buccal flaps in a primary palatoplasty","volume":"2","author":"Haenssler","year":"2021","journal-title":"FACE"},{"key":"10.1016\/j.jpra.2025.12.025_bib0022","doi-asserted-by":"crossref","first-page":"2413","DOI":"10.1097\/PRS.0b013e3182131d3e","article-title":"The double-opposing buccal flap procedure for palatal lengthening","volume":"127","author":"Mann","year":"2011","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.jpra.2025.12.025_bib0023","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1097\/PRS.0000000000010443","article-title":"Buccal myomucosal flap repair for velopharyngeal dysfunction","volume":"152","author":"Chiang","year":"2023","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.jpra.2025.12.025_bib0024","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1007\/s00455-007-9133-0","article-title":"Morphologic characteristics of palatopharyngeal muscle","volume":"23","author":"Okuda","year":"2008","journal-title":"Dysphagia"},{"key":"10.1016\/j.jpra.2025.12.025_bib0025","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1097\/SCS.0b013e3181b0dbb2","article-title":"Microscopic relation of palatopharyngeus with levator veli palatini and superior constrictor","volume":"20","author":"Hwang","year":"2009","journal-title":"J Craniofac Surg"},{"key":"10.1016\/j.jpra.2025.12.025_bib0026","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1007\/s00455-014-9568-z","article-title":"Anatomical considerations of the longitudinal pharyngeal muscles in relation to their function on the internal surface of pharynx","volume":"29","author":"Choi","year":"2014","journal-title":"Dysphagia"},{"key":"10.1016\/j.jpra.2025.12.025_bib0027","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1007\/s00276-015-1444-5","article-title":"Spatial relationship between the palatopharyngeus and the superior constrictor of the pharynx","volume":"37","author":"Sakamoto","year":"2015","journal-title":"Surg Radiol Anat"},{"key":"10.1016\/j.jpra.2025.12.025_bib0028","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1007\/s00276-017-1855-6","article-title":"Anatomical status of the human palatopharyngeal sphincter and its functional implications","volume":"39","author":"Sumida","year":"2017","journal-title":"Surg Radiol Anat"},{"key":"10.1016\/j.jpra.2025.12.025_bib0029","doi-asserted-by":"crossref","first-page":"389e","DOI":"10.1097\/PRS.0000000000008275","article-title":"Three-dimensional anatomy of the palatopharyngeus and its relation to the levator veli palatini based on micro-computed tomography","volume":"148","author":"Di","year":"2021","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.jpra.2025.12.025_bib0030","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1177\/10556656231176867","article-title":"Three-dimensional anatomy of the velopharyngeal muscles in the cleft palate","volume":"61","author":"Zhao","year":"2024","journal-title":"Cleft Palate Craniofac J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0031","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s00405-020-06437-2","article-title":"Anatomy of inferior end of palatopharyngeus: its contribution to upper esophageal sphincter opening","volume":"278","author":"Fukino","year":"2021","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"10.1016\/j.jpra.2025.12.025_bib0032","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1007\/s12565-023-00709-7","article-title":"Evaluation of morphological features of palatopharyngeus insertion into the thyroid cartilage","volume":"98","author":"Fukino","year":"2023","journal-title":"Anat Sci Int"},{"key":"10.1016\/j.jpra.2025.12.025_bib0033","first-page":"280","article-title":"Normal and cleft palate anatomy","volume":"9","author":"Dickson","year":"1972","journal-title":"Cleft Palate J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0034","first-page":"144","article-title":"Morphology of the levator veli palatini muscle in adults with repaired cleft palate","volume":"54","author":"Perry","year":"2017","journal-title":"Cleft Palate Craniofac J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0035","first-page":"187","article-title":"Magnetic resonance imaging study of the levator veli palatini muscle in cleft palate patients","volume":"21","author":"Tian","year":"2010","journal-title":"J Craniofac Surg"},{"issue":"3","key":"10.1016\/j.jpra.2025.12.025_bib0036","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/0007-1226(85)90236-X","article-title":"Levator palati and palatal dimples: their anatomy, relationship and clinical significance","volume":"38","author":"Boorman","year":"1985","journal-title":"Br J Plast Surg"},{"issue":"2","key":"10.1016\/j.jpra.2025.12.025_bib0037","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1097\/01.PRS.0000131869.45025.5A","article-title":"Surgical anatomy of the levator veli palatini: a previously undescribed tendinous insertion of the anterolateral fibers","volume":"114","author":"Mehendale","year":"2004","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.jpra.2025.12.025_bib0038","series-title":"Craniofacial Embryogenetics and Development","author":"Sperber","year":"2010"},{"key":"10.1016\/j.jpra.2025.12.025_bib0039","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1177\/1055665619828226","article-title":"Morphology of the musculus uvulae in vivo using MRI and 3D modeling among adults with normal anatomy and preliminary comparisons to cleft palate anatomy","volume":"56","author":"Perry","year":"2019","journal-title":"Cleft Palate Craniofac J"},{"key":"10.1016\/j.jpra.2025.12.025_bib0040","first-page":"871","article-title":"Growth and symmetry of the levator veli palatini muscle: a magnetic resonance imaging study","volume":"60","author":"Perry","year":"2023","journal-title":"Cleft Palate Craniofac J"}],"container-title":["JPRAS Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2352587826000021?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2352587826000021?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T21:23:18Z","timestamp":1772400198000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2352587826000021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":40,"alternative-id":["S2352587826000021"],"URL":"https:\/\/doi.org\/10.1016\/j.jpra.2025.12.025","relation":{},"ISSN":["2352-5878"],"issn-type":[{"value":"2352-5878","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Anatomical analysis of the muscle layers of the soft palate in velopharyngeal closure: A cadaveric study","name":"articletitle","label":"Article Title"},{"value":"JPRAS Open","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jpra.2025.12.025","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.","name":"copyright","label":"Copyright"}]}}