Anatomy of the Soft Palate and Its Role in Upper Airway Function: A Narrative Review

The soft palate is a complex anatomical structure, located at the posterior aspect of the oral and nasal cavities, able to dynamically create valve closure of the nasal and the oral cavities. Its precise movement is critical for speech, swallowing, and respiration. Despite its functional importance, detailed characterization of its constituent muscles-the levator veli palatini (LVP), palatopharyngeus (PP), tensor veli palatini (TVP), musculus uvulae (MU), and palatoglossus (PG)-as well as the palatine aponeurosis (PA) remains limited and inconsistent. This narrative review synthesizes findings from 75 studies, using anatomic dissection, magnetic resonance imaging (MRI), computed tomography (CT), micro-CT, and histology to provide a comprehensive overview of normal human soft palate anatomy. The LVP forms a bilateral muscular sling elevating the velum, predominantly composed of Type I fibers, whereas the PP and MU contain more Type II fibers, supporting rapid velopharyngeal closure. The TVP functions as a pulley around the pterygoid hamulus, regulating soft palate tension and facilitating auditory tube function, while the PG assists in velar lowering and tongue-palate coordination. The PA serves as a fibrous insertion point for multiple muscles, although its exact anatomical relationships remain debated. Substantial interindividual variability exists in muscle origins, insertions, fiber composition, and interdigitation, particularly for the PP, TVP, and PA, complicating standardized descriptions. Methodological differences between dissection and imaging studies further contribute to these discrepancies. This review emphasizes the functional integration of soft palate muscles and the need for consistent anatomical nomenclature. By combining dissection and imaging data, it provides a detailed reference framework for understanding the three-dimensional architecture and functional relationships of the soft palate, supporting clinical applications in speech, swallowing, and airway management. Future research should clarify unresolved anatomical controversies, particularly concerning the PA, PP, and TVP.