A review of the tensor veli palatine function and its relevance to palatoplasty.
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Abstract The main purpose of palatoplasty is to establish normal speech and deglutition. To enhance the chance of successful palatal repair, as well as optimal velopharyngeal competence, the anatomy of the palate has to be thoroughly understood. While carrying out the repair, some surgeons prefer to cut the tensor veli palatini (TVP) tendon, others perform a tenopexy or fracture the hamulus around which the tendon passes, to facilitate mobilisation of palatal tissue. However, the exact anatomy and function of the TVP is still controversial and severing the tendon or its path could be of potential harm. A review of the literature was conducted to summarise the current knowledge of the TVP and its relevance to palatoplasty. It was found that there is sufficient evidence that the TVP plays an important part in velar tautening and Eustachian tube opening, under normal circumstances. TVP's role in the cleft patient population is, however, less certain. Whether or not TVP tenotomy or dislocation reduces ET function further in these patients is also unclear. There is, however, little or no evidence of reduced middle ear effusions if such actions are avoided, at least not in children younger than 3 years of age.