title: Tensor veli palatini preservation, transection, and transection with tensor tenopexy during cleft palate repair and its effects on eustachian tube function.
abstract: 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.
authors.affiliation: 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.
authors.forename: Roberto L
authors.initials: RL
authors.lastname: Flores
authors.forename: Bethany L
authors.initials: BL
authors.lastname: Jones
authors.forename: Joseph
authors.initials: J
authors.lastname: Bernstein
authors.forename: Michael
authors.initials: M
authors.lastname: Karnell
authors.forename: John
authors.initials: J
authors.lastname: Canady
authors.forename: Court B
authors.initials: CB
authors.lastname: Cutting
mesh_terms: 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