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Palatal anatomy for sleep apnea surgery. Laryngoscope Investig Otolaryngol 2019 Feb;4(1):181-187

Date

03/05/2019

Pubmed ID

30828637

Pubmed Central ID

PMC6383450

DOI

10.1002/lio2.238

Scopus ID

2-s2.0-85077904671 (requires institutional sign-in at Scopus site)   30 Citations

Abstract

UNLABELLED: The goal of this review is to advance the understanding of the muscular and soft tissue palatal anatomy as it relates to palatal surgery for sleep apnea and the phenotypic variations that generate the shape and collapsibility of the retropalatal airway. Anatomically, the soft palate has both a proximal and distal segments separated by the palatal genu. The proximal palatal segment has a variable angle from the hard palate (ie, alpha angle) determined by the position and length of the levator veli palatini muscle. The palatopharyngeus muscle (PP) is a major defining element of the palate and lateral pharyngeal wall and forms the medial wall of the lateral palatal space. It is composed of two divisions: the longitudinal palatopharyngeus fasciculi which acts to elevate the pharynx and depress the soft palate and the transverse palatopharyngeus fascicle (Passavant's ridge) which function is a nasopharyngeal sphincter. The lateral palatal space incorporates the supra-tonsilar fat, and is bounded by muscles that determine the structure of the palate and associated lateral pharyngeal walls. Understanding of palatal muscles and pharyngeal airway phenotypes provides insight into the steps and mechanisms of pharyngoplasty procedures.

LEVEL OF EVIDENCE: N/A.

Author List

Olszewska E, Woodson BT

Author

B Tucker Woodson MD Chief, Professor in the Otolaryngology department at Medical College of Wisconsin