Tensor veli palatini preservation, transection, and transection with tensor tenopexy during cleft palate repair and its effects on eustachian tube function.
BACKGROUND
During cleft palate repair, levator sling palatoplasty with tensor veli palatini tendon transection significantly improves speech results. However, the procedure may pose a risk to eustachian tube function. This study assesses the impact of three types of palatoplasty techniques on eustachian tube function: no tensor transection, tensor transection alone, and a new addition to the palatoplasty technique, tensor tenopexy.


METHODS
A retrospective review was conducted of all patients undergoing cleft palate repair at two institutions between 1997 and 2001. Three cleft palate repair groups were studied: no tensor transection (n = 64), tensor transection alone (n = 31), and tensor tenopexy (n = 52). The percentages of patients requiring myringotomy tubes at each year of age were compared among the three groups.


RESULTS
By 7 years of age, there was a significantly decreased need for myringotomy tubes in patients who underwent no tensor transection compared with patients who underwent tensor transection alone (38 percent versus 61 percent, respectively; p = 0.05), as well as for patients who underwent tensor tenopexy compared with patients who underwent tensor veli palatini tendon transection (23 percent versus 61 percent, respectively; p < 0.001). Also, by the age of 7, there was a trend toward a decreased need for myringotomy tubes in patients who underwent tensor tenopexy compared with patients who underwent no tensor transection (23 percent versus 38 percent, respectively; p = 0.11).


CONCLUSIONS
No tensor transection and tensor tenopexy significantly decrease the need for myringotomy tubes compared with tensor transection alone. There is a small decrease in the need for myringotomy tubes when comparing tensor tenopexy with no tensor transection.
Flores
Roberto L
RL
Indianapolis, Ind.; Iowa City, Iowa; and New York, N.Y. From the Division of Plastic Surgery, Riley Hospital for Children, Indiana University Medical Center; the Division of Plastic and Reconstructive Surgery, Department of Surgery, and Department of Otolaryngology, University of Iowa Hospitals and Clinics; and the Department of Otolaryngology and the Institute of Reconstructive Plastic Surgery, New York University Medical Center.
Jones
Bethany L
BL
Bernstein
Joseph
J
Karnell
Michael
M
Canady
John
J
Cutting
Court B
CB
D002972:Cleft Palate / Q000503:physiopathology* / Q000601:surgery*; D005064:Eustachian Tube / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D019647:Oral Surgical Procedures / Q000379:methods*; D010160:Palate, Soft / Q000601:surgery*; D012189:Retrospective Studies; D014681:Velopharyngeal Insufficiency / Q000503:physiopathology / Q000601:surgery