The role of the tensor veli palatini muscle in the development of cleft palate-associated middle ear problems

Abstract

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.

Glue Ear in Children with Cleft Lip and Palate: An Update

“…This, in turn, can lead to tubal obstruction and secondary OME [22]. Abnormal development of the tensor veli palatini muscle (TVP) and levator veli palatini muscle in children with CLP can cause maladjustment in the regular opening of the Eustachian tube [26][27][28]. Changes in the atmospheric pressure (e.g., during descent in an airplane) or the absorption of gas in the middle ear by mucosa can prevent the Eustachian tube from opening to relieve pressure in the middle ear.…”

Prevalence of hearing loss and clinical otologic manifestations in patients with 22q11.2 deletion syndrome: A literature review

“…As in patients with 22q11DS, otitis media is also frequently present in (non-syndromatic) children with a cleft palate, which is presumably caused by Eustachian tube dysfunction. 49,50 A cleft palate (mostly submucosal) is an important feature of 22q11DS and present in many patients with 22q11DS. 1,12 Possibly, the same pathophysiology is causing otitis media in patients with a cleft palate and in patients with 22q11DS.…”

Patulous Eustachian tube and palatine defect in a Dachshund with chronic unilateral otitis externa and otitis media

“…Despite the unilateral occurrence of ETD, the authors speculate that a congenital bilateral incomplete hypoplasia of the soft palate predisposed this dog to develop pET. The tensor and levator palatine muscles are very important in the ET opening and closing mechanisms . Therefore, an abnormal palate can result in defective function of these muscles .…”

“…The tensor and levator palatine muscles are very important in the ET opening and closing mechanisms . Therefore, an abnormal palate can result in defective function of these muscles . Moreover, there is a high incidence of middle ear effusions in children with congenital cleft palates, which is thought to be caused by ETD as a result of the abnormal palate …”