FASCIO-LIGAMENTOUS BODY OF THE OROPHARYNX AS AN ANATOMICAL STRUCTURE AND ITS RATIONALE

Abstract

The paper presents an analysis of our own clinical observations and topographic and anatomical studies regarding the act of swallowing. Since one of the serious problems of postoperative and post-traumatic rehabilitation of patients with defects in the oral cavity and pharynx is the restoration of the act of swallowing. The success of the restoration of the act of swallowing largely depends on the volume of removed tissues, the possibility of restoring the neuromuscular complex of the floor of the oral cavity, tongue and oropharyngeal muscles. The purpose of the work. Among the known anatomical structures to distinguish a new functionally active anatomical formation – fascial-ligamentous sheath, as a closed belt of the oropharynx, which takes an auxiliary part in the act of swallowing. When carrying out functionally preserving operations, the possibility of maximizing the preservation of the muscles of the tongue and pharynx is usually assessed. However, no less important is the preservation of the fascial-ligamentous base, which is narrowed at the border of the nasopharynx and oropharynx, ensuring the separation of these two sections during swallowing. This constriction provides a tightly elastic fascial sheath that encompasses the pharynx from the pharyngeal suture to the corner of the mouth. The case includes the buccopharyngeal and pharyngeal-basal, myopharyngeal fascia, muscles and ligaments of the stylo diaphragm. The fascial sheath of the oropharynx is sequentially reinforced with connective tissue cords and includes a number of ligaments (pterygomandibular, main-maxillary, stylo-maxillary, stylohyoid and pharyngeal suture). This supporting ligamentous apparatus of the fascial sheath of the oropharynx provides more tense muscle contraction, enhancing their work and the most difficult stage of eating – swallowing. The size of the postoperative defect (except for the muscle defect) has a significant effect on the preservation of pharyngeal function. Scientific novelty. The concept of the oropharyngeal fascial-ligamentous sheath should be included in the topographic and anatomical structure, which ensures the strengthening of the oropharyngeal region, the possibility of its peristalsis expansion and contraction, and the successful act of swallowing. Conclusion: 1. The fascial-tendon sheath of the oropharynx is an essential support for the muscular structures of the pharynx, which ensures effective food intake and swallowing. 2. When planning functionally preserving operations on the tissues of the oral cavity and oropharynx in combination with muscle structures, it is necessary to take into account the structural features of the fascial-ligamentous sheath of the oropharynx. 3. In the oral cavity and oropharynx, the pterygomandibular and pharyngeal-epiglottis folds can be visible boundaries of the optimal excision of neuromuscular blocks enclosed in the fascial-ligamentous sheath.