title: The role of the tensor veli palatini muscle in the development of cleft palate-associated middle ear problems.
abstract: OBJECTIVE
  Otitis media with effusion is common in infants with an unrepaired cleft palate. Although its prevalence is reduced after cleft surgery, many children continue to suffer from middle ear problems during childhood. While the tensor veli palatini muscle is thought to be involved in middle ear ventilation, evidence about its exact anatomy, function, and role in cleft palate surgery is limited. This study aimed to perform a thorough review of the literature on (1) the role of the tensor veli palatini muscle in the Eustachian tube opening and middle ear ventilation, (2) anatomical anomalies in cleft palate infants related to middle ear disease, and (3) their implications for surgical techniques used in cleft palate repair.
  
  
  METHODS
  A literature search on the MEDLINE database was performed using a combination of the keywords "tensor veli palatini muscle," "Eustachian tube," "otitis media with effusion," and "cleft palate."
  
  
  RESULTS
  Several studies confirm the important role of the tensor veli palatini muscle in the Eustachian tube opening mechanism. Maintaining the integrity of the tensor veli palatini muscle during cleft palate surgery seems to improve long-term otological outcome. However, anatomical variations in cleft palate children may alter the effect of the tensor veli palatini muscle on the Eustachian tube's dilatation mechanism.
  
  
  CONCLUSIONS
  More research is warranted to clarify the role of the tensor veli palatini muscle in cleft palate-associated Eustachian tube dysfunction and development of middle ear problems.
  
  
  CONCLUSIONS
  Optimized surgical management of cleft palate could potentially reduce associated middle ear problems.
authors.affiliation: Division of Plastic, Reconstructive and Hand Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, KE.04.140.0, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands.
authors.forename: David S P
authors.initials: DS
authors.lastname: Heidsieck
authors.affiliation: Division of Plastic, Reconstructive and Hand Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, KE.04.140.0, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands.
authors.forename: Bram J A
authors.initials: BJ
authors.lastname: Smarius
authors.affiliation: Division of Otorhinolaryngology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Karin P Q
authors.initials: KP
authors.lastname: Oomen
authors.affiliation: Division of Plastic, Reconstructive and Hand Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, KE.04.140.0, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands. c.c.breugem@umcutrecht.nl.
authors.forename: Corstiaan C
authors.initials: CC
authors.lastname: Breugem
mesh_terms: D002972:Cleft Palate / Q000503:physiopathology / Q000601:surgery*; D005064:Eustachian Tube / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009130:Muscle, Smooth / Q000503:physiopathology*; D010034:Otitis Media with Effusion / Q000209:etiology* / Q000503:physiopathology
keywords: Cleft palate; Eustachian tube; Otitis media with effusion; Tensor veli palatini muscle