Abstract:Differences in insertion of the tensor veli palatini muscle (TVPM) into the lateral lamina of the eustachian tube (ET) cartilage between cleft palate (CP) cases and controls were investigated histologically. Thirty temporal bones with entire ETs were studied: 10 from individuals with CP and 20 controls. The ratio of the length of the ET cartilage with insertion of the TVPM to its total length from the nasopharyngeal end to near the tubal isthmus was calculated in all 30 cases. In all 20 controls, but in only 6… Show more
“…Craniofacial growth abnormalities of the posterior maxilla and skull base, insertion abnormalities of the tensor veli palatini muscle into the lateral lamina and immature tubal cartilage contribute to the mechanical dysfunction of the Eustachian tube in patients with cleft palate [8][9][10]. In cleft palate children, the Eustachian tube assumes a more horizontal position allowing fluid to pass freely from the oropharynx into the nasopharynx and ultimately into the Eustachian tube [11].…”
“…Craniofacial growth abnormalities of the posterior maxilla and skull base, insertion abnormalities of the tensor veli palatini muscle into the lateral lamina and immature tubal cartilage contribute to the mechanical dysfunction of the Eustachian tube in patients with cleft palate [8][9][10]. In cleft palate children, the Eustachian tube assumes a more horizontal position allowing fluid to pass freely from the oropharynx into the nasopharynx and ultimately into the Eustachian tube [11].…”
“…2 and 3a) [19]. Only the superior part of the lateral lumen is surrounded by cartilage while the larger inferior membranous part is not [12]. Fig.…”
Section: Discussionmentioning
confidence: 99%
“…of CP specimensAge of CP patientsNo. of controlsAge of controlsSmaller TVP to ET cartilage insertion ratioMatsune et al [12]19911032 gest. weeks–3 years2033 gest.…”
Section: Methodsmentioning
confidence: 99%
“…The high incidence of middle ear problem in cleft palate children is thought to be caused by Eustachian tube dysfunction, that is the result of aberrations of the paratubal muscles that are normally responsible for Eustachian tube opening [10–12]. The hampered Eustachian tube function results in poor ventilation of the middle ear cavity, which subsequently leads to a negative pressure and a retracted tympanic membrane with mucous secretion [13].…”
ObjectiveOtitis 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.Materials and methodsA 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.”ResultsSeveral 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.ConclusionMore 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.Clinical relevanceOptimized surgical management of cleft palate could potentially reduce associated middle ear problems.
“…Several studies demonstrate the benefits of palatoplasty on the reduction of otitis media in patients with cleft palate (Yules, 1970;Paradise and Bluestone, 1974;Too-Chung, 1983;Frable et al, 1985). The tensor veli palatini muscle appears to be the most accountable for tubal opening (Casselbrant et al, 1988;Finkelstein et al, 1990), and the insertions of this muscle into the auditory tube may be abnormal in patients with cleft palate (Matsune et al, 1991).…”
Intrinsic defects of the eustachian tube cartilage and of the insertion of the velopharyngeal muscles seem to contribute to the evolution of otitis media in patients with cleft palate, in addition to the actual defect of the soft palate. There was no correlation between the severity of the otoscopic findings and the degree of velopharyngeal dysfunction.
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