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Anatomy of the Pharynx and Oesophagus
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The pharyngobasilar fascia is the next layer and is firmly adherent to the skull base in the region of the occipital bone and petrous temporal bone. Superiorly, the fascia is thicker and fuses with the buccopharyngeal fascia to form a dense fibrous structure that suspends the pharynx from the base of skull. The muscular wall does not fully reach the skull base and this fascial layer is important in maintaining the integrity of the pharynx.
Case 16
Published in Simon Lloyd, Manohar Bance, Jayesh Doshi, ENT Medicine and Surgery, 2018
Simon Lloyd, Manohar Bance, Jayesh Doshi
The parapharyngeal space is shaped like an inverted pyramid, with the skull base superiorly (i.e. the base) and the hyoid bone inferiorly (at the apex). It is bound posteriorly by prevertebral fascia and laterally the medial pterygoids, mandible and deep lobe of parotid. Medially it is bound by the buccopharyngeal fascia overlying the pharyngeal constrictors.
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
In human adult anatomy, the term pharynx is usually used to refer to the region that extends from the level of the base of the skull to the inferior border of the cricoid cartilage (vertebral level C6) anterior to the retropharyngeal space (Plates 3.35 through 3.37). The three layers of the pharyngeal wall are the buccopharyngeal fascia, the muscular layer, and pharyngobasilar fascia. The muscular layer is composed of an outer circular part (superior, middle, and inferior pharyngeal constrictors) and an inner longitudinal part (salpingopharyngeus and palatopharyngeus, fused inferiorly with the stylopharyngeus). Attachments of the pharyngeal constrictor muscles include: the pharyngeal raphe in the posterior midline (all 3 muscles); the pharyngeal tubercle of the occipital bone superiorly, the pterygomandibular raphe anterosuperiorly, the tongue and the mandible (the superior constrictor); the hyoid bone (the middle constrictor), and the thyroid and cricoid cartilages inferiorly (the inferior constrictor). The dense connective tissue membrane that attaches the superior margin of the superior constrictor to the skull is the pharyngobasilar fascia. The stylopharyngeus muscle and the glossopharyngeal nerve (CN IX) pass between the middle and superior constrictors (Plates 3.21 and 3.36; described in detail in Section 3.4.3.1). The pharyngeal plexus of nerves is located on the posterolateral surface of the pharynx and receives branches of the glossopharyngeal nerve—sensory to the pharyngeal mucosa, vagus nerve (CN X)—motor to almost all pharyngeal muscles, and contributing to the pharyngeal plexus via the pharyngeal plexus of the vagus nerve, and superior cervical sympathetic ganglion-vasomotor (Plates 3.20 and 3.22).
Upgraded hydrodissection and its safety enhancement in microwave ablation of papillary thyroid cancer: a comparative study
Published in International Journal of Hyperthermia, 2023
Zhen-Long Zhao, Ying Wei, Li-Li Peng, Yan Li, Nai-Cong Lu, Jie Wu, Ming-An Yu
In the present study, a total of three anatomical perithyroidal fascial spaces were hydrodissected with an improved protocol for separating thyroid lobes far from adjacent vital structures and guaranteeing a safe procedure. These spaces included: (1) the anterior cervical space (ACS), which is located between the infrahyoid muscles (infrahyoid fascia) and thyroid (visceral fascia), and could protect infrahyoid muscles and the carotid sheath from heat injury after hydrodissection; (2) the visceral space (VS), which is between the thyroid and trachea and could protect the trachea, esophagus, RLN, and superior laryngeal nerve (SLN) after hydrodissection; and 3) the post-thyroid space (POTS), which is posterior to the thyroid and carotid sheath and includes the retropharyngeal space and/or danger space (surrounded by the alar fascia, buccopharyngeal fascia, and prevertebral fascia); this space could protect the carotid sheath, RLN and stellate ganglion. The VS at the level of the suspensory ligament of the thyroid gland could not be hydrodissected because of the suspensory ligament. A schematic of the spaces is shown in Figure 2.