Histology and Function: Analyzing the Uvular Muscle

Author:

Landes Constantin A.1,Weichert Frank2,Steinbauer Thomas1,Walczak Lars2,Hasenfus Andrea3,Veith Christian3,Schröder Andreas4,Fritsch Helga5,Theegarten Dirk6,Wagner Mathias3

Affiliation:

1. Maxillofacial and Facial Plastic Surgery, Johann W Goethe-University Medical Center, Frankfurt am Main, Germany.

2. Department of Computer Science VII, Technical University, Dortmund, Germany.

3. Institute of Pathology, Saar State University, Homburg Saar Campus, Germany.

4. Department of Mathematics, Humboldt-University, Berlin, Germany.

5. Department of Anatomy, Histology and Embryology, Leopold-Franzens-University, Innsbruck, Austria.

6. Institute of Pathology and Neuropathology, Essen University, Essen, Germany.

Abstract

Objective Virtual surgery and virtual patients necessitate quantitative data on the area of interest. The study was conducted to exactly describe the embryonic and fetal uvular muscle (MU), relevant for clinical as well as virtual surgery and virtual patient generation. Method Serially sectioned viscerocrania of 10 aborted embryos and fetuses underwent three-dimensional reconstruction to obtain detailed anatomic data and perform finite element analyses. Results The MU was paired in 80% of cases, while 20% allowed no clear-cut distinction. The MU merged with the levator muscle beneath the palatal aponeurosis without a hard palate insertion. Superior longitudinal central fibers ran below the nasal mucosa, and few circular peripheral fibers crossed in the central third to the contralateral side. This was seen in 30% of the paired muscles and in all cases when no differentiation was possible; about 40% to 80% MU fibers crossed to the ipsi lateral and contralateral palatopharyngeus muscle behind the levator loop. MU fibers inserted 60% nasal and 40% oral to the basal membrane at the middle third of the macroscopic uvula, made of loose connective tissue and salivary glands. The results of the finite element simulation of the uvula showed no distinct patterns or distributions of local stress. Conclusions Detailed anatomical study supported the concept of mediocranial MU repositioning during corrective surgery, although the impact is minor to the levator muscle's action. Future mathematical models describing effects of such a maneuver should integrate surrounding structures.

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Oral Surgery

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