![]() ![]() To improve surgical success in adults, palatopharyngoplasty techniques have evolved from primarily excisional methods to those that reconstruct and reposition the palate. However, many alternative surgical therapies in adults are sub‐optimal. Treatment success using nonsurgical methods such as positive airway pressure therapy (PAP) is limited due to patient noncompliance. Obstructive sleep apnea (OSA) causes significant social and medical morbidity. Understanding of palatal muscles and pharyngeal airway phenotypes provides insight into the steps and mechanisms of pharyngoplasty procedures. The lateral palatal space incorporates the supra‐tonsilar fat, and is bounded by muscles that determine the structure of the palate and associated lateral pharyngeal walls. It is composed of two divisions: the longitudinal palatopharyngeus fasciculi which acts to elevate the pharynx and depress the soft palate and the transverse palatopharyngeus fascicle (Passavant's ridge) which function is a nasopharyngeal sphincter. The palatopharyngeus muscle (PP) is a major defining element of the palate and lateral pharyngeal wall and forms the medial wall of the lateral palatal space. The proximal palatal segment has a variable angle from the hard palate (ie, alpha angle) determined by the position and length of the levator veli palatini muscle. Anatomically, the soft palate has both a proximal and distal segments separated by the palatal genu. The goal of this review is to advance the understanding of the muscular and soft tissue palatal anatomy as it relates to palatal surgery for sleep apnea and the phenotypic variations that generate the shape and collapsibility of the retropalatal airway. ![]()
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