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Supplemental Digital Content APPENDIX Appendix 1. Palatoplasty knowledge test administered before and after the educational workshop. The pre-test and post-test were identical and scored using the same scale. 1. What is the insertion point of the levator veli palatini in a cleft patient? a. Posterior bony cleft margin b. Within the middle soft palate c. Hamulus and anterior fibres of the tensor d. Nasal side of the tensor aponeurosis e. Medial side of superior constrictor 2. Which of the following best describes the location of the Eustachian tube? a. Posterior to the levator veli palatini b. Anterior to the tensor veli palatini c. Posterior to the tensor veli palatini d. Oral to the superior constrictor e. Traversing through the superior constrictor 3. What is the origin of the tensor veli palatini (select all that apply)? a. Adjacent to the carotid canal b. Petrous portion of the temporal bone c. Spine of the sphenoid d. Scaphoid fossa e. Lateral side of anterior occipital bone 4. What is the origin of the palatopharyngeus? a. Posterior buccinators b. Pterygomandibular raphe c. Palatoglossus d. Superior constrictor e. Styloglossus 5. Where does the levator lie with respect to the palatopharyngeus? a. On its oral surface b. On its nasal surface c. On its nasal and oral surface d. Medial e. Lateral 6. Where does the palatopharyngeus lie with respect to the anterior tensor fibres? a. On its oral surface b. On its nasal surface c. On its nasal and oral surface d. Medial e. Lateral 1 7. What muscle forms the levator tunnel? a. Muscular belly of palatopharyngeus origin b. Oral surface of cephalic muscle belly of levator c. Nasal side of anterior tensor fibres d. Caudal surface of the Eustachian tube e. Cephalic margin of superior constrictor 8. The following is a line drawing of the right posterior bony cleft. Draw the position of the palatopharyngeus and anterior fibres of the tensor. 9. Order the following layers of the palate from nasal to oral: _____ Palatopharyngeus nasal head _____ Palatopharyngeus oral head _____ Levator veli palatini _____ Muscular aponeurosis _____ Oral mucosa _____ Nasal mucosa 10. How many muscles is each side of the soft palate comprised of? a. 3 b. 4 c. 5 d. 6 e. 7 11. When performing a cleft palate repair, where is the lateral relaxing incision initiated? a. Directly above the hamulus b. Medial to the palatoglossus Just posterior to the hamulus c. 3 mm anterior to the posterior extent of the alveolus d. At the dimple area e. Just medial and within the same anterior posterior plane of the hamulus 12. What anatomical structure is encountered first when elevating the oral mucosa at the level of the medial hard palate soft palate Junction? a. Aponeurosis b. Anterior fibres of the tensor veli palatini c. Palatopharyngeus d. Levator e. Palatoglossus 2 13. What are insertion points of the superior constrictor? a. Lateral pterygoid plate and lateral palatine bone b. Medial pterygoid plate and hamulus c. Scaphoid fossa d. Just medial to hamulus at the posterior bony cleft margin e. Just lateral to hamulus at the posterior bony cleft margin 14. Draw your surgical markings for a von Langenback palatoplasty. 15. What does an intravelar veloplasty entail? a. Suturing the elevated left and right aponeurosis together b. Reconstruction of a retropositioned levator sling c. Suturing the elevated left and right levator veli palatini with oral and nasal mucosa together d. Suturing the elevated left and right palatopharyngeus with oral and nasal mucosa together 16. What muscle is released from the posterior bony cleft margin? a. Levator veli palatini b. Tensor veli palatini c. Palatoglossus d. Palatopharyngeus e. Styloglossus 17. What structure does the pedicle traverse through? a. Incisive foramen b. Lesser palatine foramen c. Greater palatine foramen d. Sphenopalatine foramen e. Interpalatine groove 3 18. Where would you dissect in order to fully mobilize the palatopharyngeus (select all that apply)? a. Nasal component of the tensor veli palatini tendon b. Oral component of the tensor veli palatini tendon c. Levator tunnel d. Medial pterygoid plate e. Posterior bony cleft margin 4 .
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