Kawamoto-Hirano Ai, Honkura Yohei, Yamamoto Masahito, Abe Shin-Ichi, Murakami Gen, Katori Yukio
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Department of Anatomy, Tokyo Dental College, 2-9-18 Misakicho, Chiyoda-Ku, Tokyo, 101-0061, Japan.
Dysphagia. 2016 Oct;31(5):635-43. doi: 10.1007/s00455-016-9721-y. Epub 2016 Jul 19.
Although the pharyngeal wall is well known to have high elasticity, the distribution of submucosal elastic fibers has not been described. Observations of histological sections of the mid and lower pharyngeal walls from 15 elderly donated cadavers were made. We found two distinct submucosal tissue layers with a high content of elastic fibers (tentatively termed the "submucosal elastic laminae"). The inferolateral elastic lamina was restricted to the level from the upper part of the arytenoid to the lower end of the inferior cornu of the thyroid cartilage. It originated from the pharyngeal submucosa, extended laterally along the inner aspect of the thyropharyngeal muscle, and inserted into the posterior margin of the thyroid cartilage including the cornu. The posteromedial lamina extended along the supero-inferior axis from a level above the greater horn of the hyoid bone to reach the muscularis mucosae of the cervical esophagus. The inferolateral and posteromedial laminae were connected at levels below the cricoarytenoid joint. Individual variations were evident in their thicknesses (ranging from almost absent to 0.3 mm) as well as the extent of connection between them. In association with striated muscle function, the inferolateral lamina seemed to suspend the lower pharyngeal mucosa, while the posteromedial lamina seemed to provide mucosal fold forcing smoothly peristaltic conveyance of a bolus during swallowing.
虽然咽壁具有高弹性是众所周知的,但黏膜下弹性纤维的分布尚未见描述。我们对15具老年捐赠尸体的咽壁中下部组织切片进行了观察。我们发现了两个不同的黏膜下组织层,其弹性纤维含量很高(暂称为“黏膜下弹性板”)。外侧下弹性板局限于从杓状软骨上部至甲状软骨下角下端的水平。它起源于咽黏膜下层,沿咽下缩肌内侧面向外侧延伸,并插入包括角在内的甲状软骨后缘。后内侧板从舌骨大角上方的水平沿上下轴延伸,到达颈段食管的黏膜肌层。外侧下板和后内侧板在环杓关节下方的水平相连。它们的厚度(从几乎不存在到0.3毫米不等)以及它们之间的连接程度存在明显的个体差异。与横纹肌功能相关,外侧下板似乎悬吊着下咽黏膜,而后内侧板似乎在吞咽过程中提供黏膜皱襞,促使食团顺利蠕动输送。