![]() The anatomic dissection was performed with the aid of an operating microscope (Zeiss OPMI VISU S7). This study aims to analyze the anatomic relationship of the LN with the lateral oropharyngeal structures and also its orientation and distance from the PR. Since the LN can be damaged during palatal surgery when using PR as a fixation point, especially at its caudal third, it is essential to know its orientation and its relationship with the lateral oropharyngeal walls. At this level the PC contains exclusively fat tissue and the anterior and medial portion of the medial pterygoid muscle (MPM), on which the lingual nerve (LN) runs on its lateral side (Fig. The PR or the accentuated mucosal fold in the oral cavity where the SCM and BM converge in subjects without PR, lies medial to the prestyloid compartment (PC). However, anatomical studies have shown that the presence of this structure is not always constant, and that it is only identifiable in a third of adults. The PR provides attachment along its anterior aspect for a portion of the buccinator muscle (BM), and from its posterior aspect to the superior constrictor muscle (SCM). The PR is considered a tendinous band of the buccopharyngeal fascia that courses from the apex of the hamulus of the medial pterygoid plate to the posterior limit of the retromolar trigone of the mandible. One anchoring point frequently described in the literature in the lateral wall is the pterygomandibular raphe (PR). Īlthough the use of BS has evolved and will continue to do so, the anchoring points remain the same. Many surgeons have discovered the advantages and unique properties of the BS and allowed the popular surgical pharyngoplasty techniques to be updated and improved. Following the same line, Vinici in 2015 described the Barbed reposition pharyngoplasty (BRP), adding an anterior and lateral mobilization of the palatopharyngeal muscle. Later, Montovani would improve this technique by introducing barbed sutures (BS) and anchoring the sutures to bony structures (pterygoid hamulus and posterior nasal spine). In 2008, Hur introduced the sling snoreplasty with a permanent thread, a technique based on retention sutures along the soft palate to make it more rigid and pull it forward and upward. Since Quesada and Perelló in 1979 and Fujita in 1981, different surgical techniques of palatopharyngoplasty have been described. Moreover, soft palate vibration has also been related to snoring in patients without a partial or complete upper airway obstruction. The soft palate and lateral pharyngeal walls are considered one of the primary collapse sites during sleep in patients with OSA. However, in patients without treatment adherence and in those without a good response to other conservative treatments such as mandibular advancement device (MAD), positional therapy or myofunctional therapy, surgical treatment is an option. Considered a highly prevalent disorder and a risk factor for cardiovascular disease, its first-line treatment is continuous positive airway pressure (CPAP). Obstructive sleep apnea (OSA) is a sleep disorder characterized by recurrent upper airway obstruction during sleep. ![]()
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