Palatoplasty and Growth of the Temporal Bone Mastoid Air Cells

• Published in: The Cleft palate-craniofacial journal Vol. 49; no. 5; pp. 541 - 545
• Main Authors: Kobayashi, Hitome, Sakuma, Takaaki, Terao, Hajime, Sanbe, Takeyuki, Suzaki, Harumi, Ohkubo, Fumio
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.09.2012; American Cleft Palate-Craniofacial Association; SAGE PUBLICATIONS, INC
• Subjects: Bacterial diseases; Biological and medical sciences; Birth defects; Child; Child, Preschool; Cleft Palate - surgery; Deformities; Dentistry; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Ent and stomatologic bacterial diseases; Female; Human bacterial diseases; Humans; Infectious diseases; Male; Mastoid - cytology; Mastoid - diagnostic imaging; Maxillofacial surgery; Medical sciences; Middle Ear Ventilation; Mouth; Non tumoral diseases; Otitis Media with Effusion - diagnosis; Otitis Media with Effusion - therapy; Otorhinolaryngology. Stomatology; Palatal Muscles - surgery; Prognosis; Radiography; Retrospective Studies; Risk Factors; Studies; Surgical Flaps; middle ear ventilation; mastoid pneumatization; otitis media with effusion; Eustachian tube; Temporal bone; Effusion; Growth; Mastoid; Stomatology; Middle ear disease; Air; Pneumatization; Plasty; Treatment; Surgery; ENT disease; Otitis media; Ventilation; Middle ear; Cell
• ISSN: 1055-6656; 1545-1569
• DOI: 10.1597/10-108

Objectives The present study was undertaken to analyze the relationship between the method used for manipulation of the levator veli palatini muscle and the area of the mastoid air cells in patients with cleft palate. Design Retrospective study. Patients The subjects were 50 patients seen for surgical treatment of cleft palate. Interventions Palatoplasty was carried out using the mucosal flap method in 25 patients and the mucoperiosteal flap method in 25 patients. In the mucosal flap method, the levator veli palatini muscle was overlapped and sutured, followed by posterior movement of the muscle bundle (the posterior relocation group). In the mucoperiosteal flap method (the control group), the mucoperiosteal flap was pushed back, followed by end-to-end suturing of the muscle. The area of the mastoid air cells was measured on X-rays when patients were 5 years old. Results The mastoid air cell area did not differ significantly between the posterior relocation group (mean, 5.00 cm2; range, 1.66 to 19.7 cm2) and the control group (mean, 5.3 cm2; range, 2.29 to 15.9 cm2). Conclusion No significant growth of mastoid air cells was noted following posterior relocation of the levator veli palatini muscle. Thus, in cases of cleft palate in which significant growth of mastoid air cells is not expected following reconstruction of the levator veli palatini muscle, the results confirm the view that tympanic ventilation tube insertion is the most suitable method for the treatment of otitis media.