superior pharyngeal constrictor function

The pharyngeal muscles have two layers: the most external, cross-sectional and 'U-shaped', made up by three pairs of constrictor muscles (superior, middle and inferior), which act on pushing food to the esophagus by means of sequential involuntary contraction the innermost layer, formed by three pairs of longitudinal muscles, stemming from the styloid process, cartilaginous portion of the auditory tube and soft palate6. Nonetheless, there are other muscles on this wall participating in the pharyngeal functions. This approach removes the constricting tension of the lateral pharyngeal walls, enabling its lateral expansion. In its second version, from 20045, the LP no longer included uvulectomy, palatopharyngeal zetaplasty and the need to use the surgical microscope. LP is based on reconstructing the pharyngeal lateral wall, by the myotomy of its superior constrictor muscles and suturing of the laterally pedicle flaps to the palatoglossus muscle4. The lateral pharyngoplasty (LP) was developed in order to act on these pathophysiological aspects of OSA. The lateral pharyngeal wall of patients with obstructive sleep apnea (OSA) has a greater tendency to collapse during the passage of air flow when compared to patients without OSA1,2, very likely because of a delay in the relaxation of the constrictor muscles on the expiratory-inspiratory transition3. All patients recover normal swallowing after the procedures, with a maximum recovery time of 33 days.ĬONCLUSION: In this study, all patients who underwent lateral pharyngoplasty with total preservation of the stylopharyngeus muscle reported complete normalization of swallowing with a recovery time up to 33 days. RESULTS: Patients have returned to their normal feeding habits in a mean of 10.9 days after the procedures and they presented a completely normal swallowing, on average, 21.6 days after the surgeries. METHOD: We have prospectively evaluated the swallowing function in 20 patients, through the daily application of a visual analogue scale from the first post-op until the complete disappearance of dysphagia. OBJECTIVE: The aim of this study is to provide a daily analysis of the follow-up of the swallowing function. One of them, the stylopharyngeus muscle, seems to play an important role during swallowing. Experience with lateral pharyngoplasty has shown that the superior pharyngeal constrictor muscle plays a minor role in swallowing. Dysphagia after any pharyngeal surgery is influenced by pain, discomfort from the sutures, the healing process and by the adaptation to the changes in pharyngeal structures. Lateral pharyngoplasty manages obstructive sleep apnea through the myotomy and repositioning of the muscles of the lateral pharyngeal wall. Keywords: deglutition, deglutition disorders, snoring. Jayson Junior Mesti 1 Michel Burihan Cahali 2

Evolution of swallowing in lateral pharyngoplasty with stylopharyngeal muscle preservation

Superior pharyngeal constrictor function