[Applied anatomy of arterial supply for the soft palate].

OBJECTIVE

The correct design of a myomucosal or mucosal flap of the soft palate in the surgical procedure for cleft palate and velopharyngeal incompetence should be made with a thorough knowledge of the arterial supply for the soft palate, which is an important premise for functional rehabilitation of the soft palate postoperatively.

METHODS

Anatomical dissection was undertaken in 14 cadavers (10 normal adults, 2 normal newborns and 2 newborns with cleft lip & palate). The arteriography and histological studies have been used in 10 newborn and 6 aborted fetuses.

RESULTS

The results showed that the arterial supply of the soft palate is multi-original and the principal artery is the ascending palatal artery. Its anterior and posterior branches are myomucosal perforators. The other vessels to supply the soft palate are direct mucosal branches, which include the lesser palatine artery, the palatal branch of the ascending pharyngeal artery and the tonsillar artery. All above arteries anastomose under the mucosal, muscular and fascial layers in the soft palate. In cleft cases, all arteries in the soft palate are displaced anterior-laterally because of the deformities of the palatal muscles and bone structure.

CONCLUSIONS

This study supports the facts that the major blood supply of the soft palate comes from ascending palatine artery and the generous arterial anastomosis of the velum allows it to tolerate the proper dissection during palatoplasty. We believe that decreasing the damage of the intrapalatal vascular supply by carefully dissection around the hamulus is very important to prevent wound break down, muscular fibrosis, flap failure, and also is the basis of design for surgical procedure and postoperative functional recovery in cleft palate patients.