Pterygomandibular raphe

The pterygomandibular raphe (pterygomandibular ligament) is a ligamentous band of the buccopharyngeal fascia. It is attached superiorly to the pterygoid hamulus of the medial pterygoid plate, and inferiorly to the posterior end of the mylohyoid line of the mandible. It connects the buccinator muscle in front to the superior pharyngeal constrictor muscle behind.

Pterygomandibular raphe
Muscles of the pharynx and cheek. (Pterygo-Mandibular ligament labeled at center, vertically.)
Details
Part ofbuccopharyngeal fascia
Originpterygoid hamulus of the medial pterygoid plate
Insertionmylohyoid line of the mandible
Identifiers
Latinraphe pterygomandibularis
TA98A05.3.01.102
TA22178
FMA55618
Anatomical terminology

Structure

Open mouth, view from front. The pterygomandibular ligaments are marked with arrows. Note that in this mouth the lower wisdom teeth have been removed, slightly changing the shape of the pterygomandibular ligaments that usually curve and attach to the mandible around them.

The pterygomandibular raphe is a ligament that forms from the buccopharyngeal fascia.[1] It is a paired structure, with one on each side of the mouth. Superiorly, it is attached to the pterygoid hamulus of the medial pterygoid plate of the sphenoid bone.[1] Inferiorly, it is attached to the posterior end of the mylohyoid line of the mandible.[1]

Variation

In foetuses, the pterygomandibular raphe is always very prominent.[2] However, in adults, it may become less distinctive.[2] It is very large and distinctive in around 36% adults.[2] It is fairly small, and only an upper triangular portion visible, in around 36% of adults.[2] It is not visible in around 28%, making the superior pharyngeal constrictor muscle and the buccinator muscle continuous.[2] This may vary by ethnic group.[2]

Function

The pterygomandibular raphe is the common meeting point of the superior pharyngeal constrictor muscle and the buccinator muscle. It holds them together, forming part of the mouth.[1]

Clinical significance

When the mandible is splinted for gradual realignment (such as to treat sleep apnea), the pterygomandibular ligament slightly resists the realignment.[3]

History

The pterygomandibular ligament was first noted in 1784.[1]

See also

References

This article incorporates text in the public domain from page 384 of the 20th edition of Gray's Anatomy (1918)

  1. Rao, D.; Sandhu, S.J.S.; Ormsby, C.; Natter, P.; Haymes, D.; Cohen, I.; Jenson, M. (2017-04-01). "Review of the Pterygomandibular Raphe". Neurographics. 7 (2): 121–125. doi:10.3174/ng.2170196.
  2. Shimada, Kazuyuki; Gasser, Raymond F. (1989). "Morphology of the pterygomandibular raphe in human fetuses and adults". The Anatomical Record. 224 (1): 117–122. doi:10.1002/ar.1092240115. ISSN 1097-0185.
  3. Brown, Elizabeth C; Jugé, Lauriane; Knapman, Fiona L; Burke, Peter G R; Ngiam, Joachim; Sutherland, Kate; Butler, Jane E; Eckert, Danny J; Cistulli, Peter A; Bilston, Lynne E (2021-04-01). "Mandibular advancement splint response is associated with the pterygomandibular raphe". Sleep. 44 (4). doi:10.1093/sleep/zsaa222. ISSN 0161-8105.
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