An Anatomical Study of the Arterial Supply to the Soft Palate

The arterial blood supply to the soft palate is traditionally described as being from the ascending palatine (branch of the facial artery), greater palatine (branch from the third part of the maxillary artery), and ascending pharyngeal (branch of the external carotid artery) arteries (Moore et al., 2009; Standring, 2009). Variations to this description include additional contributions from the recurrent pharyngeal (branch of the external carotid artery) and lesser palatine (branch of the third part of maxillary artery) arteries (Huang et al., 1998a) and tonsillar branches of the facial artery (Cheng et al., 2000). Anastomoses between the greater palatine and ascending palatine arteries (Mercer & MacCarthy, 1995a, 1995b), ascending palatine and recurrent pharyngeal arteries, lesser, greater and ascending palatine arteries (Huang et al., 1998b), and mucosal branches of the lesser palatine, ascending pharyngeal and tonsillar arteries (Cheng et al.) were documented. Broomhead (1951) conducted an investigation on a single fetal specimen and provided a limited description of the soft palate arteries. Girgis (1966) examined the arterial supply only to the musculus uvula whilst Freelander (1992) described the supply to the levator and tensor veli palatini muscles. Standard anatomical textbooks misrepresent the arterial supplies to the soft palate (viz. greater palatine, ascending palatine and ascending pharyngeal arteries; or lesser palatine, greater palatine and ascending palatine arteries) which could be misleading to the surgeon during reconstructive surgery (Hollinshead, 1954; Standring). Mercer & MacCarthy (1995b) described the arterial supply to the pharynx in detail and Huang et al. (1998b) examined the velopharyngeal muscles in detail. A review of the literature revealed a limited description of the arterial anatomy of the soft palate (Cheng et al.). Despite this lack of information, many surgical procedures have been documented for cleft palate repair and for the correction of velopharyngeal insufficiency (Rosenthal, 1924; Rosselli, 1935; Hynes, 1950; Skoog, 1965; Orticochea, 1968; Kriens, 1969; Furlow, 1986). During the latter procedures, the position and relations of the soft palate arteries is of significance to minimize the risk of vascular disruption and myomucosal or mucosal flap failure (Huang et al., 1998a).