Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8519, Japan.
Dysphagia. 2024 Aug;39(4):642-647. doi: 10.1007/s00455-023-10645-3. Epub 2024 Jan 10.
The pterygomandibular raphe (PMR) is a tendinous bundle between the bucinator (BM) and the superior constrictor of pharynx (SC) and has been considered essential for swallowing. Despite its functional significance, previous studies reported that the PMR is not always present. Another study reported presence of the connecting fascia between the BM and deep temporalis tendon (dTT). Therefore, the present study analyzed the three-dimensional relationship between the BM, SC, and dTT. We examined 13 halves of 11 heads from adult Japanese and Caucasian cadavers: eight halves macroscopically and five halves histologically. There was no clear border between the BM and SC in any specimens macroscopically. The BM attachment varied depending on its levels. At the level of the superior part of the internal oblique line, the BM fused with the SC with no clear border. At the level of the midpart of the internal oblique line of the mandible, the BM attached to the dTT directly, and the SC attached to the dTT via collagen fibers and the BM. Based on these results, these muscles should be described as the BM/dTT/SC (BTS) complex. The three-dimensional relationship of the BTS complex might result in the so-called "pterygomandibular raphe." The BTS complex could be important as a muscle coordination center in chewing and swallowing.
翼下颌韧帯（PMR）是位于嚼肌（BM）和咽上缩肌（SC）之间的腱性束，被认为对吞咽至关重要。尽管它具有重要的功能，但之前的研究报告称，PMR 并不总是存在。另一项研究报告了 BM 和深部颞肌肌腱（dTT）之间存在连接筋膜。因此，本研究分析了 BM、SC 和 dTT 之间的三维关系。我们检查了 11 个头骨的 13 个半部分，这些头骨来自日本和白种人的成人尸体：8 个半部分进行了宏观检查，5 个半部分进行了组织学检查。在任何标本的宏观检查中，BM 和 SC 之间都没有明显的边界。BM 的附着取决于其水平。在内部斜肌上部分的水平，BM 与 SC 融合，没有明显的边界。在下颌内部斜肌中部水平，BM 直接附着于 dTT，而 SC 通过胶原纤维和 BM 附着于 dTT。基于这些结果，这些肌肉应被描述为 BM/dTT/SC（BTS）复合体。BTS 复合体的三维关系可能导致所谓的“翼下颌韧帯”。BTS 复合体在咀嚼和吞咽中作为肌肉协调中心可能很重要。
