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Parapharyngeal Space
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
The medial surface is distensible and comprises the superior pharyngeal constrictor muscle, the buccopharyngeal membrane, and the pharynx. The lateral surface, which is relatively immobile, comprises the medial pterygoid muscle, the ramus of the mandible, the deep lobe of the parotid gland, and the posterior belly of the digastric muscle. The posterior surface is part of the prevertebral fascia, bordered by the carotid sheath posterolaterally and the retropharyngeal space posteromedially.
Tumours of the Parapharyngeal Space
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The medial surface is distensible and comprises the superior pharyngeal constrictor muscle, the buccopharyngeal membrane and the pharynx. The lateral surface, which is relatively immobile, comprises the medial pterygoid muscle, the ramus of the mandible, and the deep lobe of the parotid gland, and below the level of the mandible, the lateral aspect is bordered by the fascia of the posterior belly of the digastric muscle. It has a posterior surface which is part of the prevertebral fascia, bordered by the carotid sheath posterolaterally and the retropharyngeal space posteromedially.
Primary repair of cleft palate
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
The physiological functioning of the soft palate is essentially due to an anatomically correct restoration and reorientation of the velar musculature which has to be detached from the posterior aspect of the palatine bone. Important muscles of the soft palate are as follows:Levator veli palatini, which originates from the petrous portion of the temporal bone, is attached to the medial wall of the eustachian (auditory) tube and runs ventral to the tensor muscle into the velum to fuse with its counterpart on the opposite side. Its function is to lift the soft palate in a cranioposterior direction. This muscle is most important for the velopharyngeal seal and creates the velar ‘knee’ in a lateral videofluoroscopy. Functionally, it is most effective in a more posterior position.Tensor veli palatini which originates from the scaphoid fossa of the sphenoid bone and the lateral rim of the eustachian tube runs with a tendon through the sulcus of the pterygoidean hamulus and forms the palatal aponeurosis with the opposite side in the anterior third of the soft palate. Next to stretching the velum, its main function is to open the auditory tube.Musculus uvulae are a paramedian pair of muscles running from the posterior nasal spine to the tip of the uvula. Supports the levator bulge and thus helps with the oropharyngeal seal.Palatopharyngeus muscle which forms the posterior pillar of the fauces (pharyngopalatine arch) originates with a wide base from the posterior and lateral pharyngeal wall and inserts with its posterior fasciculus at the posterior aspect of the hard palate and the anterior fasciculus into the soft palate. It can send the small sal- pingopharyngeus muscle to the eustachian tube, but this muscle is not always present. Functionally, the palatopharyngeus elevates the pharynx and larynx, constricts the isthmus faucium while swallowing and depresses the soft palate opposing the action of the levator muscle.Palatoglossus muscle runs from the velar aponeurosis to the posterior superior parts of the tongue. It is another antagonist of the levator muscle and forms the anterior pillar of the fauces (palatoglossal arch).Superior pharyngeal constrictor muscle arises from the pterygoid hamulus of the sphenoid bone and the pterygomandibular raphe. The fibres run in a backward curve to unite in the median pharyngeal raphe with the opposite side. Its function is a constriction of the upper pharynx in collaboration with the levator veli palatini muscle while swallowing. If hyperplastic, this muscle is the anatomical substratum of the Passavant’s ridge. Its significance for speech is doubtful.
Radiation dose-painting with protons vs. photons for head-and-neck cancer
Published in Acta Oncologica, 2020
Katrin Håkansson, Bob Smulders, Lena Specht, Mingyao Zhu, Jeppe Friborg, Jacob H. Rasmussen, Søren M. Bentzen, Ivan R. Vogelius
Estimations of normal tissue complication probability (NTCP) for grade >2 xerostomia [19] and grade >2 dysphagia [20] were performed for both treatment modalities. Delta-NTCP values were calculated following Langendijk et al. [21]. In the model for xerostomia, the dose to the contra-lateral parotid gland was the predictor. In the model for dysphagia, the dose to the superior pharyngeal constrictor muscle (PCM) and the oral cavity were the predictors. As the PCM and oral cavity were not part of the planning constraints in the CONTRAST trial, these structures were retrospectively contoured and not included in the plan optimization. For one patient, a re-optimization of both photon and proton plans was performed with the PCM and oral cavity included in the optimization, to estimate the potential impact on NTCP/delta-NTCP.