Endoscopic findings of the pharyngeal orifices of the eustachian tube in cleft palates.

概要

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Pharyngeal orifices of the Eustachian tube were observed by a flexible endoscope in 100 cases of cleft palate. Cleft palates frequently showed abnormal movement of the pharyngeal orifice, which were classified into four types: 1. no opening of the orifices during swallowing (8.5%), 2. closure of the orifices during swallowing (4.2%), 3. opening of the orifices during phonation (28.9%) and 4. closure of the orifices during phonation (15.5%). The ears with abnormal movement of the pharyngeal orifice during swallowing showed decreased hearing, whereas the ears with abnormal movement during phonation had normal hearing. Dysfunction of the tensor veli palatini muscle in cleft palates was thought to cause failure of tubal opening during swallowing. On the other hand, both the abnormal course and attachment of the levator veli palatini muscle in cleft palates was considered to be responsible for other types of abnormal movement of the pharyngeal orifice. Therefore, formation of the levator muscle sling in palatal surgery would be very important in the prevention of ear diseases due to tubal dysfunction in patients with cleft palates.