[The applied anatomic study of palatopharyngeus muscle]

The aim of this investigation was to examine the anatomic basis of palatopharyngeus and clinical implications for sphincter pharyngoplasty.

Detailed dissections were performed on 17 sides of adult human head and neck specimens. The eight sides newborns' head and neck cadavers were also used in the study (4 normal and 4 cleft lip and palate). The observations of histologic serial sections were undertaken in six fetus head and neck specimens on coronal, transverse and sagittal direction.

The palatopharyngeus with three components of pharyngeal origins and two heads of velar insertions contributes the continuity between the velum and lateral pharyngeal wall and the bulk of muscle fibers were extended to the posterior tonsilar pillars with (27.58 +/- 6.73) mm length and (34.1 +/- 10.50) mm2 section area. The muscles were supplied dominantly from the branches of ascending pharyngeal artery and tonsilar artery and partly from the branches of ascending palatine artery and dorsal lingual artery. The muscles were innervated by the branches of pharyngeal plexus which focus on the level 10 mm to 25 mm below the hard palate and at the level of 15 mm below the hard palate there was at least one of the nerve branch entered the muscle.

The palatopharyngeus muscle is not only a major musculature of lateral pharyngeal wall but also an important portion of the soft palate, participating the middle and posterior velum, which means that the muscle may play a significant effect in the velar function and pharyngeal wall movements. It is also a good donor site for palatopharyngeus flap. The sphincter pharyngoplasty has some influence to the blood supply and innervation of the muscles, which may result to blood reversion and denervation for the distal component of palatopharyngeal flap.