title: Variations in the tensor veli palatini muscle with special reference to its origin and insertion.
abstract: OBJECTIVE
  Previous research on the tensor veli palatini muscle (TVP) has produced conflicting descriptions of its functions and topographical relationships with other orofacial structures. The goal of this study was to describe the morphology of the TVP in a systematic and comprehensive manner.
  
  
  METHODS
  One hundred nineteen sides of 77 human heads from donated cadavers were partially dissected under a binocular microscope. Histological examination of the hard tissue-muscle interfaces was also undertaken.
  
  
  RESULTS
  There were two adjacent origins of the TVP: the cranial base origin (CB origin) and the auditory tube cartilage origin (AT origin). The CB origin always lay anterior to the AT origin and there was no septum or loose tissue between the two muscular laminae leading from these origins. The muscle fibers converged on a central tendinous plate in the muscle belly, which gradually became a common tendon that rounded the pterygoid hamulus before inserting into the palatine aponeurosis. Notably, secondary insertions were found on the maxillary tuber (33.6%) and/or in the submucosal tissue near the palatoglossal arch (37.8%). Maxillary insertions were almost exclusively associated with an AT origin that was wide as or wider than the CB origin. Histological observations confirmed that the hamulus acted purely as a pulley and suggested that a connecting band to the tensor tympani had no or few functions of an intermediate tendon.
  
  
  CONCLUSIONS
  The TVP appears to act as the dilator tubae and that this function can be maintained by preserving or reconstructing the maxillary insertion during push-back surgery, even if hamulotomy is necessary.
authors.affiliation: Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1, West 17, Sapporo 060-8556, Japan. abem@sapmed.ac.jp
authors.forename: Masato
authors.initials: M
authors.lastname: Abe
authors.forename: Gen
authors.initials: G
authors.lastname: Murakami
authors.forename: Makoto
authors.initials: M
authors.lastname: Noguchi
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Kitamura
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shimada
authors.forename: Gen-Iku
authors.initials: GI
authors.lastname: Kohama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003238:Connective Tissue / Q000033:anatomy & histology; D005064:Eustachian Tube / Q000033:anatomy & histology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010156:Palatal Muscles / Q000033:anatomy & histology* / Q000502:physiology; D021362:Palate, Hard / Q000033:anatomy & histology; D010160:Palate, Soft / Q000033:anatomy & histology; D019291:Skull Base / Q000033:anatomy & histology