腭帆提肌及相关肌肉的尸体解剖研究

（1）目的 观察腭帆提肌（levator veli palatini,LVP)、腭咽肌（palatopharyngeus,PP)及咽上缩肌（supe-rior constrictor,SC)的解剖结构和组成，及其与腭裂修复术式的关系和意义。（2）方法 选择10例健康成人、4例健康新生儿、4例左侧完全性唇腭裂及2例双侧完全性唇腭裂新生儿尸体的头颈标本，对LVP，PP及SC行解剖学和组织学观察。（3）结果 LVP是软腭的主要功能肌肉，PP为一扁圆形的肌肉，呈扇形分布于腭帆中线，被LVP分为前后两束，包裹LVP，在腭中线与对侧肌束相连接，占据腭帆长度的1/2.SC为一薄弱的片状弯曲的阔肌，于咽侧壁与PP交叉，在咽后壁中线与对侧肌束汇合，两肌共同构成腭咽闭合环的侧、后壁，腭理解病人的LVP与腭咽肌在裂缘融合，附着点向硬腭裂缘和后缘延伸前移，肌纤维数量明显减少，可见肌纤维退行性变，同时软腭长度缩短。（4）结论 发音或吞咽时LVP和PP使腭帆形成向上、向后的力，以上提、后退软腭完成腭咽闭合，腭裂病人LVP及PP肌纤维数量的明显减少及肌纤维退行性变，是造成术后发音时软腭后退、上提乏力的原因。

ANATOMY OF THE LEVATOR VELI PALATINI, PALATOPHARYNGEUS AND SUPERIOR CONSTRICTOR MUSCLES IN THE CADAVERIC SPECIMENS

Objective\ To study the anatomic findings of the levator veli palatini, palatopharyngeus and superior constrictor muscles in fresh cadaveric specimens and to explain the significance of those in cleft palate surgery. \ Methods\ Fresh cadaveric specimens of head and neck were used for observation of levator veli palatini, palatopharyngeus and superior constrictor muscles anatomically and histologically. The specimens included 10 normal adults, 4 normal neonates, 4 neonates with unilateral cleft palate and 2 neonates with bilateral cleft palate. \ Results\ The levator veli palatini was main component to form a muscular sling. The palatopharyngeus consisted of two heads clasping the levator in the velum and inserted into the superior constrictor in the lateral and posterior pharyngeal walls. The muscle fibers of these three muscles decreased significantly in quantity and the degeneration of the muscle fibers was observed in the specimens with cleft palate. \ Conclusion\ The elevation and retrodisplacement of the velum in velopharyngeal closure was achieved by the upward and backward pulling the velum in speech and swallowing. Due to decrease and degeneration of the muscle fibers with cleft palate, the elevation and retrodisplacement of the velum in velopharyngeal closure was achieved insufficiently resulting in VPI after cleft palate surgery.