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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
Levator veli palatini is a cylindrical muscle that arises from a small tendon on the inferior, roughened, portion of the petrous temporal bone, known as the quadrate area, situated in front of the inferior opening of the carotid canal. Some of its fibres also originate from the lower part of the cartilaginous pharyngotympanic tube and yet more from the vaginal process of the tympanic bone. It inserts onto the nasal surface of the palatine aponeurosis and sits between the two heads of the palatopharyngeus muscle, forming a rounded belly. The levator muscles pass anteromedially and together they form a V-shaped sling just above and behind the palatine aponeurosis, which allows elevation and slight retraction of the vertical posterior part of the soft palate when closure of the nasopharynx is required. The soft palate then touches the posterior pharyngeal wall, closing off the nasopharyngeal isthmus to prevent nasal regurgitation during speech and swallowing. Additionally, its fibres also pull the lateral nasopharyngeal wall anteromedially to narrow that space. The effects of levator veli palatini on the pharyngotympanic tube and its role in the equalization of air pressure are controversial. This muscle, along with the palatoglossus, palatopharyngeus and uvular muscle, are all supplied by the cranial part of the accessory nerve via the pharyngeal plexus.
Head and neck
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Muscles of soft palate– tensor veli palatini– levator veli palatini– palatoglossus– palatopharyngeus
Oral cavity
Published in Paul Ong, Rachel Skittrall, Gastrointestinal Nursing, 2017
The soft palate extends posteriorly to the uvula which can be observed suspended into the palatoglossal arch. The uvula prevents the premature movement of nutrients into the pharynx. Movement of the soft palate is achieved by contraction of the levator veli palatini and tensor veli palatini muscles. This is important during swallowing, as elevation of the soft palate prevents nutrients from passing into the nasopharynx. The muscles also open the entrance to the auditory tubes. Posterior to the palatoglossal arch is the palatopharyngeal arch. The palatine tonsils sit on both sides of the oral cavity between the palatoglossal and palatopharyngeal arches. This opening between the oral cavity and oropharynx is called the fauces.
Long-term outcomes in children with and without cleft palate treated with tympanostomy for otitis media with effusion before the age of 2 years
Published in Acta Oto-Laryngologica, 2020
Maki Inoue, Mariko Hirama, Shinji Kobayashi, Noboru Ogahara, Masahiro Takahashi, Nobuhiko Oridate
Otitis media with effusion (OME) is common in infants with cleft palate due to Eustachian tube (ET) dysfunction [1]. Various studies have reported that up to 90% and more of children with cleft palate may suffer from OME [2,3]. In children with cleft palate, ET dysfunction is probably caused by abnormal insertion of the tensor veli and levator veli palatini muscles. The tensor veli palatini muscle is involved in middle ear ventilation through the ET opening mechanism. Velopharyngeal disclosure, owing to the levator veli palatini muscle impairment, may also lead to ET dysfunction, specifically related to peritubal lymphoid hyperplasia, resulting from soiling of the nasal cavity with food [1]. Additionally, poor ventilation of the middle ear cavity owing to ET dysfunction causes negative pressure and retraction of the tympanic membrane (TM), thus leading to OME.
Treatment of congenital short palate using bilateral buccal musculomucosal flaps
Published in Case Reports in Plastic Surgery and Hand Surgery, 2020
Shinji Kobayashi, Yukie Ohashi, Ryouko Fukushima, Takashi Hirakawa, Toshihiko Fukawa, Toshihiko Satake, Jiro Maegawa
The causes of velopharyngeal insufficiency (VPI), excluding neurogenic and myogenic disorders, can include anatomical abnormalities. Most VPI patients without the stigmata of a submucous cleft palate (SMCP) might be identified as having congenital short palate (CSP), which has a continuous levator veli palatini muscle (LVPM) without separation, or occult cleft palate (OCP), which has a separation of the LVPM [1–6].