The tensor stitch for soft palate closure revisited.

The tensor veli palatini muscle is involved in opening of the Eustachian tube during chewing and swallowing, allowing for equilibration of pressure between the middle ear and external environment. In patients with cleft palate, abnormal musculature in the region of the cleft results in Eustachian tube dysfunction. A palatoplasty with muscle repositioning is advocated to reduce the incidence of otitis media, which is a result of this. A special suture is described which can be incorporated into a palatoplasty procedure to further reduce the incidence of otitis media. This suture is inserted around the tendon of the tensor veli palatini muscle bilaterally, and when activated under tension in the midline, it results in opening of the Eustachian tube with improved middle ear ventilation. This novel suture results in a reduction in the incidence of otitis media due to improved middle ear ventilation and reduces tension across the suture margins.