Fukino Keiko, Tsutsumi Masahiro, Sanudo Jose, Ono Takashi, Akita Keiichi
1 Division of Oral Health Sciences, Department of Orofacial Development and Function, Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
2 Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
Cleft Palate Craniofac J. 2019 Jul;56(6):744-750. doi: 10.1177/1055665618813082. Epub 2018 Nov 18.
Coordination of the various soft palate and pharyngeal muscles should be considered while evaluating velopharyngeal closure. However, it remains unclear whether different muscle bundles have specific functions during velopharyngeal closure. We macroscopically and microscopically examined these muscles in detail and particularly clarified the morphology of the palatopharyngeus (PP) in velopharyngeal closure.
Forty halves of 21 heads from Japanese cadavers (average: 83.9 years) were used for analysis; 37 halves of 19 heads were macroscopically examined and 3 halves of 2 heads were histologically examined.
The PP consisted of muscle bundles originating from the superior and inferior surfaces of the palatine aponeurosis. The most superior part of the superior constrictor (SC) and most lateral part of PP on the palatine aponeurosis initially ran in parallel and subsequently, in superoposterior and inferoposterior directions, respectively. The PP appeared as a single continuous sheet that was radially spread as a whole. Its medial margins, located superior and inferior to the aponeurosis, formed a fold that established the palatopharyngeal arch. The stylopharyngeus (StP) adjoined the base of this arch.
Since PP consisted of muscle bundles running in various directions, various functions of these bundles should be considered during velopharyngeal closure. The PP can function as a sphincter with SC and as an elevator with StP. In addition, PP forms the medial protrusion in collaboration with StP and SC. Thus, PP plays an important role in velopharyngeal closure with the coordination of various muscles.
在评估腭咽闭合时，应考虑软腭和咽部各肌肉之间的协调性。然而，不同肌束在腭咽闭合过程中是否具有特定功能仍不清楚。我们对这些肌肉进行了详细的宏观和微观检查，尤其阐明了腭咽肌在腭咽闭合中的形态。
使用来自21具日本尸体（平均年龄83.9岁）的42个半侧头部进行分析；对19具尸体的38个半侧头部进行宏观检查，对2具尸体的3个半侧头部进行组织学检查。
腭咽肌由起源于腭腱膜上、下表面的肌束组成。腭腱膜上咽上缩肌最上部和腭咽肌最外侧部分最初平行走行，随后分别向上后和下后方向走行。腭咽肌呈现为一个整体呈放射状展开的连续薄片。其位于腱膜上方和下方的内侧边缘形成一个皱襞，构成腭咽弓。茎突咽肌毗邻该弓的底部。
由于腭咽肌由向不同方向走行的肌束组成，在腭咽闭合过程中应考虑这些肌束的多种功能。腭咽肌可与咽上缩肌一起发挥括约肌作用，并与茎突咽肌一起发挥提升肌作用。此外，腭咽肌与茎突咽肌和咽上缩肌协同形成内侧突起。因此，腭咽肌在腭咽闭合中与多种肌肉协调发挥重要作用。
