The effects of tying the neurovascular bundle during palatoplasty

Controversy rages in the literature over the possibility of denervation and atrophy of the palate that may occur secondary to severance of the greater palatine neurovascular bundles during palatoplasty. A pilot study was undertaken to assess palatal bulk, mobility, sensation, and mucous gland population, as well as speech, in a group of cleft palate patients, some of whom had severance of the bundles during their palatal repair and some who did not. These same parameters were tested in a group of patients who had juvenile nasopharyngeal angiofibromata, in whom one bundle was tied and the other was not during the transpalatal exposure of the tumor. Severing the neurovascular bundle produced no appreciable differences between the two cleft groups except they all had depressed mucous gland counts. The procedure produced no problems in the angiofibroma patients.