Anatomic Continuity of Longitudinal Pharyngeal and Esophageal Muscles

Wang, Qin; Xu, Shaochun; Tu, Lili; Liu, Yehai; Zhang, Ming

doi:10.1097/01.mlg.0000249935.81808.df

Cited by 16 publications

(12 citation statements)

References 8 publications

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“…Also, a recent study on 30 cadavers showed that upper longitudinal esophageal muscle fibers are anatomically continuous with the pharyngeal muscles, highlighting the importance of the contribution of the upper esophagus to UES function. 15 …”

Section: Discussionmentioning

confidence: 99%

Anatomic-manometric correlation of the upper esophageal sphincter: a concurrent US and manometry study

Hernandez

Dua

Surapaneni

et al. 2010

Gastrointestinal Endoscopy

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Background The pharyngoesophageal segment commonly referred to as the upper esophageal sphincter (UES) generates a high-pressure zone (HPZ) between the pharynx and the esophagus. However, the exact anatomical components of the UES-HPZ remain incompletely determined. Objective To systematically define the US signature of various components of the pharyngoesophageal junction and to determine how these structures contribute to the development of the UES-HPZ. Design Prospective, experimental study. Setting Tertiary Academic Medical Center. Patients This study involved 18 healthy volunteers. Intervention We studied 5 participants by using a high-frequency US miniprobe (US-MP) and concurrent fluoroscopy and another 13 participants by using the US-MP and concurrent manometry. Main Outcome Measurements Relative contribution of various muscles in the UES-HPZ. Results Manometrically, the UES-HPZ had a median length of 4.0 cm (range 3.0–4.5 cm). A C-shaped muscle, believed to represent the cricopharyngeus muscle, was observed for a median length of 3.5 cm (range 2.0–4.0 cm). The oval configuration representing the esophageal contribution to the UES was seen in 10 of 13 participants (77%) at the distal HPZ (esophagus to UES transition zone). The flat configuration of the inferior constrictor muscle was noted in 7 of 13 participants (54%) at the proximal HPZ (UES to pharynx transition zone). There were 4 to 5 wall layers versus 3 layers in the distal and proximal HPZ, respectively. The mean (± SD) muscle thickness was relatively constant along the length of the UES-HPZ. Limitations Air artifacts in the UES-HPZ. Conclusion The configuration and layers of the UES-HPZ vary along its length. The upper esophagus is a significant contributor to the distal UES-HPZ.

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Section: Discussionmentioning

confidence: 99%

Anatomic-manometric correlation of the upper esophageal sphincter: a concurrent US and manometry study

Hernandez

Dua

Surapaneni

et al. 2010

Gastrointestinal Endoscopy

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“…In general, the palatopharyngeus is inserted into the piriform fossa and the posterior border of the thyroid cartilage [3,[15][16][17][18][19][20]. Okuda et al [17] have reported that the palatopharyngeus sometimes interlaces with the inferior constrictor.…”

Section: Discussionmentioning

confidence: 99%

“…The palatopharyngeus is one of the essential muscles required in proper swallowing, because it contributes to its various events, such as the movement of the soft palate, the shortening of the pharynx, and the elevation of the hyolaryngeal complex [3,7,8,[12][13][14]. The evidence of these contributions has been anatomically explained based on its attachments to the soft palate, the pharyngeal raphe, the epiglottis, and the thyroid cartilage [15][16][17][18][19][20]. Fukino et al [20] reported that the palatopharyngeus spreads radially and extends inferiorly.…”

Section: Introductionmentioning

confidence: 99%

Anatomy of inferior end of palatopharyngeus: its contribution to upper esophageal sphincter opening

Fukino

Tsutsumi

Nimura

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose The palatopharyngeus is one of the longitudinal pharyngeal muscles which contributes to swallowing. It is reported that the palatopharyngeus has muscle bundles in various directions and with attachment sites, and each muscle bundle has a specific function. Although previous reports suggest that the palatopharyngeus is partly interlaced with some parts of the inferior constrictor, the precise relationship remains unclear. The purpose of this study was to examine the precise manner of the connection between the palatopharyngeus and inferior constrictor, and to examine the histological characteristics of this connection. Methods We examined 15 halves of nine heads from Japanese cadavers (average age: 76.1 years); 12 halves, macroscopically, and three halves, histologically. Results Our observation suggests that the palatopharyngeus spreads radially on the inner aspect of the pharyngeal wall. The most inferior portion of the palatopharyngeus extended to the inner surface of the cricopharyngeal part of the inferior constrictor. Histological analysis showed that the inferior end of the palatopharyngeus continued into the dense connective tissue located at the level of the cricoid cartilage. The dense connective tissue not only covered the inner surface of the inferior constrictor but also entered its muscle bundles and enveloped them. Conclusion Therefore, the palatopharyngeus interlaced the cricopharyngeal part of the inferior constrictor through the dense connective tissues. The findings of this study show that the palatopharyngeus may act on the upper esophageal sphincter directly and help in its opening with the aid of the pulling forces in the superolateral direction.

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“…We assume that a larger defect of the outer fascia had either occurred intraoperatively or was preexisting. The latter might be explained by the presence of preexisting thinner regions or even circumscribed absence of fibrous reticulation as the longitudinal esophageal and pharyngeal muscles merge to a membrane-like fascia that anchors the pharyngoesophageal wall to the surroundings [3] .…”

Section: Discussionmentioning

confidence: 99%

Carbon Dioxide Laser Endoscopic Diverticulotomy for Zenker’s Diverticulum: Results and Complications in a Consecutive Series of 40 Patients

Helmstaedter

Engel²,

Hüttenbrink³

et al. 2008

ORL

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Background: Numerous studies regarding CO₂ laser endoscopic diverticulotomy for the treatment of Zenker’s diverticulum exist. They show differences in complications, hospitalization time and postoperative treatment. Objectives: We report our experiences and work out recommendations for postoperative care. Methods: All charts of patients who were treated for Zenker’s diverticulum at the University Department of Otolaryngology, Cologne, Germany, between 1983 and 2003, were reviewed retrospectively. Results: The median age was 58 years. Postoperatively, patients were fed nonorally and received postoperative antibiotic treatment. One patient developed mediastinitis and 3 patients a rise in body temperature. A control radiography disclosed pharyngeal leakages in 3 patients. Overall morbidity averaged 10%. Conclusion: To avoid severe complications we recommend postoperative antibiotic treatment and parenteral feeding. In comparison to the stapler-assisted technique the use of the CO₂ laser allows a good view at the diverticular wall throughout the procedure. The transcervical technique should be reserved for cases of anatomic abnormalities or for complicated revision surgeries.

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Anatomic Continuity of Longitudinal Pharyngeal and Esophageal Muscles

Cited by 16 publications

References 8 publications

Anatomic-manometric correlation of the upper esophageal sphincter: a concurrent US and manometry study

Anatomic-manometric correlation of the upper esophageal sphincter: a concurrent US and manometry study

Anatomy of inferior end of palatopharyngeus: its contribution to upper esophageal sphincter opening

Carbon Dioxide Laser Endoscopic Diverticulotomy for Zenker’s Diverticulum: Results and Complications in a Consecutive Series of 40 Patients

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