Finkelstein Y, Talmi Y P, Nachmani A, Hauben D J, Zohar Y
Department of Otolaryngology, Hasharon Hospital, Petah Tiqva, Israel.
Plast Reconstr Surg. 1992 Apr;89(4):631-9. doi: 10.1097/00006534-199204000-00006.
The oropharynx stripped of the tonsils and the excessive mucosal folds after the uvulopalatopharyngoplasty operation allows a closed observation of the outline of the pharyngeal muscles. Forty-two consecutive patients undergoing uvolopalatopharyngoplasty were subjected to peroral examination of the oropharynx combined with nasendoscopic examination of the velopharyngeal valve. At rest, the oropharynx of the patients with coronal closure patterns was found to be flat relative to the oropharynx of the patients with the other closure patterns. During closure of the velopharyngeal valve, an anteroposterior movement of the velum, forming the nasendoscopic coronal closure pattern, was observed in patients with a flat oropharynx. On the other hand, a medial movement of the pharyngeal walls was found, forming the circular or sagittal closure pattern seen in patients with a deep oropharynx. Our conclusion is therefore that a different muscular orientation is responsible for both the different pharyngeal configuration at rest and the different contribution of the lateral and posterior pharyngeal walls to velopharyngeal valve closure.
在悬雍垂腭咽成形术后，去除扁桃体和过多黏膜皱襞的口咽可对咽肌轮廓进行直视观察。连续42例行悬雍垂腭咽成形术的患者接受了口咽的经口检查及腭咽瓣的鼻内镜检查。静息状态下，发现呈冠状闭合模式的患者的口咽相对于其他闭合模式患者的口咽更为扁平。在腭咽瓣闭合过程中，口咽扁平的患者观察到软腭的前后运动，形成鼻内镜下的冠状闭合模式。另一方面，发现咽壁向内运动，形成口咽较深患者所见的圆形或矢状闭合模式。因此，我们的结论是，不同的肌肉取向导致了静息状态下不同的咽形态以及咽侧壁和后壁对腭咽瓣闭合的不同作用。
