Surgical anatomy of human soft palate

Abstract

Objectives/hypothesis: The soft palate is composed of several muscles. So far, these muscles have been analyzed separately and the whole structure of the soft palate has been described very vaguely. The purpose of this study was to describe the structure of soft palate collectively.

Study design: Human cadaver dissection.

Methods: Anatomical dissection was performed on 20 Korean, formalin-fixed cadavers (13 men and 7 women). The heads were randomly assigned to either dissection groups, medial-to-lateral (10 heads) or posterior-to-anterior (10 heads).

Results: Fibro-fatty layer was located in the oral side of the soft palate and became thick and dense along the midline. The levator veli palatini was distributed on the nasal side of the soft palate. The average vertical distance from the top of palatopharyngeal arch to the levator veli palatini was 12.3 ± 5.2 mm. The palatopharyngeus was also spread out widely and filled the palatopharyngeal arch. The periosteum of the hard palate became the fascia of the soft palate, which was merged with the aponeurosis of the tensor veli palatini in the midline. The Passavant's ridge was located between the levator veli palatini and palatopharyngeus, inserting onto the aponeurosis. The palatoglossus was very thin and embedded in the palatoglossal arch.

Conclusion: The muscles of the soft palate are intermingled with each other in the fibro-fatty layer. Comprehensive anatomical knowledge is needed to reduce unnecessary damage and obtain good surgical results for obstructive sleep apnea.

Keywords: Passavant's ridge; Soft palate; levator veli palatini; palatoglossus; palatopharyngeus; tensor veli palatini.