Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 172270

AbstractConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Reviews
Year : 2021 | Month : July | Volume : 15 | Issue : 7 | Page : AE01 - AE03 Full Version

Architecture of the Musculus Uvulae- A Review


Published: July 1, 2021 | DOI: https://doi.org/10.7860/JCDR/2021/50027.15105
L Daisy, S Surraj, C Mrudula, P Rao Sushma

1. Assistant Professor, Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of Dental Sciences and Research, Puducherry, India. 2. Assistant Professor, Department of Anatomy, All India Institute of Medical Sciences, Bibinagar, Telangana, India. 3. Additional Professor and Head, Department of Anatomy, All India Institute of Medical Sciences, Bibinagar, Telangana, India. 4. Senior Resident, Department of Anatomy, All India Institute of Medical Sciences, Bibinagar, Telangana, India.

Correspondence Address :
Dr. S Surraj,
Assistant Professor, Ground Floor, Department of Anatomy, All India Institute of Medical Sciences, Bibinagar, Nalgonda-508126, Telangana, India.
E-mail: surraj18@gmail.com

Abstract

The architecture of the musculus uvulae is a subject of, especially with regard to its crucial role in maintaining the morphology of the cleft palate, and its involvement in surgical procedures of palate repair. Its functional role in the closure of the velum and elevation of the same leading to voice changes are also an element of debate. The fate and orientation of its muscle fibres and its reinforcement with other related muscles of the palate raise concerns with regard to its functional role. Its positioning in the soft palate would give us an insight on the exact role played by this muscle in velopharyngeal closure. Its nerve supply also remains shrouded by various theories without conclusive evidence. Hence, this review aims to highlight its morphological role for the same.

Keywords

Cleft palate, Palate repair, Soft palate, Velopharyngeal closure

The musculus uvulae that forms the bulk of the soft palate, has until recent years, been studied with neglect both functionally and morphologically as it is a muscle that is by far the least understood with regard to its architecture within the soft palate. Its architecture and taut role within the palate has been recently observed, in adult cadaveric oral specimens and also within the foetuses (1),(2). The musculus uvulae is less understood in terms of its morphology and architecture and there are a few studies supporting it (1),(2),(3),(4),(5),(6),(7), with regard to its exact fibre orientation. In this article, an attempt has been made by the authors to delineate the exact architecture of the musculus uvulae from the existing literature so that future studies can be done.

ARCHITECTURE OF THE MUSCULUS UVULAE

This paired muscle situated in the midline of the soft palate is found to be attached in the front to the flattened band of the tensor tympani and behind to the uvular base along the medial velum but devoid of any attachment to the mural pharyngeal surface (1),(8). Though lying on the nasal side contralateral to the muscles of the velum, its sectional area is maximum transversely inside the liberal portion of the velar taste buds (behind the aponeurosis) overlying the majority of the levator sling (2). Additional fibers were observed by Langdon HL and Klueber K that was initially believed to be a part of the musculus uvulae, whorling on the oral side of the musculature of the palate transversely (6), while Kuehn DP et al., and Azzam NA and Kuehn DP reported no such fibres and identified a plane of fascia demarcating the musculus uvulae from the levator along its full length (4),(5). The distinctive feature about the origin of this muscle is that the musculus uvulae originate from the palatal aponeurosis instead of the surface directly. The speciality of this aponeurosis is that it takes a deviant turn to split itself into two distinct laminae in and around the muscle anteriorly, but with the greater and maximum part of the thickness of this unique aponeurosis concentrated on the major nasal surface of the muscle. This aponeurosis then distinctly takes a tapering hit and thins down posteriorly with some sparing of its own fibres. The musculus uvulae may be a unique muscle in the sense that it wasn't seen to blend with any of the opposite palatal muscles as thought to be, but instead it was found to be readily lifted away from them (2),(8),(9),(10),(11). It had been the sole muscle to succeed in the uvula, its major bulk being the greatest within the third quarter of the palate where it overlies the posterior part of the levator sling at the dimple area. For now, it’s believed to be surrounded by a substantial amount of glandular tissue, the majority of which is usually adequate to that of the muscle. At the level of this glandular region it lies within a trench formed by the levator muscles where the latter are relatively firm on the brink of the oral mucosa. This trench likes appearance was present consistently and was quite striking in its depth also (2).

FUNCTIONAL ROLE

These findings suggest that its action is to contribute to the eminence formed by the levator palati by its extensions towards the medial velum (1),(12). It may even have an extensor effect on the nasal aspect of the velum, displacing it toward the posterior pharyngeal wall. Both of those actions would serve to maximise midline velopharyngeal contact (1). One clinical application of this anatomic information is that the muscle should be preserved within the dissection, performed during internal velar repair. Furthermore, it should be recognised that the musculus uvulae is frequently divided and incorrect reorientation whenever double opposing repair procedures are adopted (1),(10),(13),(14),15],(16),(17).

THEORIES OF INNERVATION

A few studies which have considered the innervation of the musculus uvulae suggest that it's not solely supplied by the direct pharyngeal plexus, as are the opposite intra-palatal muscles, but instead it is supplied indirectly by the same plexus via the lesser palatine nerve (2). However, Boorman JG and Sommerlad BC found the lesser palatine nerve to be the sole nerve to supply the musculus uvulae in cadavers, and later confirmed this observation in human foetuses as well (2). However, one differed their opinion to that of Boorman JG and Sommerlad BC after conducting a developmental study of human embryos and postulated that the pharyngeal plexus may only have an innervational role in human foetuses and not in adults where the lesser palatine nerve nerve takes a dominant role (1),(2).

Support for Boorman JG and Sommerlad BC on the innervation of the musculus uvulae is provided by the nerve stimulation studies (2),(3),(4),(5),(6),(14),(15),(16). This is the only such muscle within the uvula in a diseased subject, where by running along the margin of an existing birth defect, it would produce closure results so erroneously that the entire pair of uvulae may be retorted, and it presumably is also the muscle specifically activated by lesser palatine nerve stimulation (3). The lesser palatine nerve block, however, did not produce any change in either speech nor did the image produced by nasendoscopes dramatically increase the velopharyngeal mechanism of glottis closure during speech and also after speech. This meant a strong negative association between the activity of the musculus uvulae and normal speech within the non-cleft subject (3),(4),(5). It provides further evidence that the action of other muscles (mainly the levators) alone can create the traditional convexity of the nasal surface of the palate during velopharyngeal closure. The evidences given by current literature states that the levator veli palatini and the musculus uvulae are the chief muscles responsible for palatopharyngeal closure during speech in a normal individual under normal circumstances (3),(4),(6),(11),(12),(13),(14).

Electromyographic reports suggest that the patterns of myographic spike activity in the musculus uvulae and the levator veli palatini muscle were similar in all palatal task movements except speech (4). The significance of the presence of the musculus uvulae along the medial aspect of the velum lies in the fact that the filling function of this muscle with regard to the space between the raised velum and the posterior pharyngeal wall is boosted (4). In addition, this muscle may serve to modify the taut nature of the tissue adjacent to the insertion of the levator veli palatini and to produce extension of the velum (4).

POSITIONAL INFLUENCE

The position and course of the musculus uvulae, as reported by various workers (1),(2),(3),(4),(5), agrees with previous work by Kuhn DP et al., and Azzam NA and Kuehn DP (4),(5). The majority of glandular tissue within the palate generally has been noted as beneficial to velar closure as also has been the case with that of the surrounding muscles in the vicinity of the musculus uvulae within the area of the eminence (1),(2),(3),(4). It might seem that this glandular tissue comprises a substantial part of the majority, on the nasal aspect of the levator sling (2). The trough formed by levators in this area, on which this tissue bulk lies, has not previously been reported. The rationale could also be that in other studies palate specimens were deliberately flattened before serial section, while certain other studies specifically focused on the efforts made to repair the tissues within the normal position as nearly as possible. Contraction of the levator muscles might be expected to decrease the depth of the palatine aponeurosis, or eliminate, this trough, throwing the overlying glandular and musculus uvulae bulk into prominence, creating the nasal convexity or ridge, and this effect was observed within the cadaver simulation model (3),(4),(5),(7),(8),(9),(10),(11).

Gross anatomical dissection studies and histological staining studies on sectioned soft palates focusing on the morphology of the musculus uvulae indicated that the musculus uvulae is not only paired as previously described in most anatomy texts but also is arranged as discrete bundles and the peculiar feature of every bundle is that it takes an origin deviating away from the median plane in such a way that it moves away from the tendinous palatal aponeurosis behind the hard palate and just before the insertion of the levator veli palatini muscle (5). Both the bundles meet in a place facing the muscular sling of the levator and travel along the back portion of the soft palate terminating as two discrete fascicles which inter-divide and insert between the mucous glands and corium of the uvula proper and its mucosal basement (5),(17). Because of its location and size, it seems as though the contraction of this musculus uvulae would add bulk to the back surface of the raised soft palate thereby aiding in closure of the velopharyngeal doorway during speech and deglutition (5).

HISTOLOGY AND INTERNAL ARCHITECTURE

Histologically stained sections of early fetal human soft palate specimens showed a structural relationship between the longitudinal fibromuscular component of the soft palate and musculus uvulae and its raphe (6). Musculus uvulae begin on par with the palatine aponeurosis near the origin of the second quadrant of the velum, follows a sigmoid course, and terminates near the uvular base. Sometimes, an occasional loop of muscle may arise from the bony palate, arch downwards, and then recurve back into the uvular muscle (6),(7),(8),(9),(10),(11). Such a complex relationship therefore exists between the raphe in the velum and several palatal muscles. Small fascicles of the uvular muscle also begin as branches from the midline band an entwine it near its crest. These branches may aid in shaping the velar back surface regionally with respect to the levator bulk to reinforce and strengthen the mural surface of the pharynx behind and thus enhance the efficiency of the sealing process of velopharyngeal wall (6). The musculus uvulae muscle functions to shorten the uvula. Contraction of the musculus uvulae muscle on the same side pulls up the uvula ipsilaterally (7),(10).

Conclusion

The musculus uvulae not only provides a bulk leverage to the soft palate but also stabilises it by its sealing effect that is quite unique to this muscle owing to the fact that the origin of this muscle is aided by a velar aponeurotic grip as well. The splitting of this muscle into two lamina with the posterior one being thinner and its reinforcement by extra muscle loops also contributes to the above function.

Authors contribution: LD- preparation and initial write-up of the manuscript, SS- idea of the manuscript and final write-up of the manuscript, CM- suggestions and modifications to the body of the manuscript, PRS- citation insertions, and arrangement of references.

References

1.
Huang MH, Lee ST, Rajendran K. Structure of the musculus uvulae: Functional and surgical implications of an anatomic study. Cleft Palate Craniofac J. 1997;34(6):466-74. Doi: 10.1597/1545-156919970340466sotmuf2.3.co2. PMID: 9431463. 2.3.CO;2>[crossref]
2.
Boorman JG, Sommerlad BC. Musculus uvulae and levator palati: Their anatomical and functional relationship in velopharyngeal closure. Br J Plast Surg. 1985;38(3):333-38. Doi: 10.1016/0007-1226(85)90237-1. PMID: 4016419. [crossref]
3.
Casey DM. Palatopharyngeal anatomy and physiology. J Prosthet Dent. 1983;49(3):371-78. Doi: 10.1016/0022-3913(83)90280-9. PMID: 6341551. [crossref]
4.
Kuehn DP, Folkins JW, Linville RN. An electromyographic study of the musculus uvulae. Cleft Palate J. 1988;25(4):348-55. PMID: 3203466.
5.
Azzam NA, Kuehn DP. The morphology of musculus uvulae. Cleft Palate J. 1977;14(1):78-87. PMID: 264280.
6.
Langdon HL, Klueber K. The longitudinal fibromuscular component of the soft palate in the fifteen-week human fetus: Musculus uvulae and palatine raphe. Cleft Palate J. 1978;15(4):337-48. PMID: 281277.
7.
Helwany M, Rathee M. Anatomy, Head and Neck, Palate. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 32491749.
8.
Sales SAG, Santos ML, Machado RA, Dias VO, Nascimento JE, Swerts MSO, et al. Incidence of bifid uvula and its relationship to submucous cleft palate and a family history of oral cleft in the Brazilian population. Braz J Otorhinolaryngol. 2018;84(6):687-90. [crossref] [PubMed]
9.
Shprintzen RJ, Schwartz RH, Daniller A, Hoch L. Morphologic significance of bifid uvula. Pediatrics. 1985;75(3):553-61. PMID: 3975126. [crossref] [PubMed]
10.
Feka P, Banon J, Leuchter I, La Scala GC. Prevalence of bifid uvula in primary school children. Int J Pediatr Otorhinolaryngol. 2019;116:88-91. Doi: 10.1016/j.ijporl.2018.10.026. Epub 2018 Oct 22. PMID: 30554716. [crossref] [PubMed]
11.
Iriarte Ortabe JI, Piette E. La presentación aislada y sindrómica de la fisura palatina [The presentation of cleft palate in isolation or as part of a syndrome]. An Otorrinolaringol Ibero Am. 1990;17(4):405-43. PMID: 2221311.
12.
Cohen MM Jr. Syndromes with cleft lip and cleft palate. Cleft Palate J. 1978;15(4):306-28. PMID: 281275.
13.
Galvez-Cardenas KM, Varela DC. Uvula Amyloidosis. N Engl J Med. 2020;383(6):577. Doi: 10.1056/NEJMicm1915258. PMID: 32757526. [crossref] [PubMed]
14.
Goldin M, Ji L. Uvula necrosis, an atypical presentation of sore throat. J Emerg Med. 2013;44(1):185-86. Doi: 10.1016/j.jemermed.2011.09.001. Epub 2012 Apr 9. PMID: 22494597. [crossref] [PubMed]
15.
Salengros JC, El Founas W, Velghe-Lenelle CE, Willemse E, Sosnowski M, Andry G, et al. Uvular and tonsillar pillar mucosal necrosis as a cause of severe sore throat after orotracheal intubation. Anaesth Intensive Care. 2011;39(4):772-73. PMID: 21823405.
16.
Ylikoski J. Outpatient uvuloplasty. Otolaryngol Head Neck Surg. 1996;115(4):373. Doi: 10.1016/S0194-5998(96)70058-X. PMID: 8861896. [crossref]
17.
Herford AS, Finn R. Single-stage CO2 laser assisted uvuloplasty for treatment of snoring and mild obstructive sleep apnoea. J Craniomaxillofac Surg. 2000;28(4):213-16. Doi: 10.1054/jcms.2000.0148. PMID: 11110152. [crossref] [PubMed]

DOI and Others

10.7860/JCDR/2021/50027.15105

Date of Submission: Apr 20, 2021
Date of Peer Review: May 06, 2021
Date of Acceptance: Jun 07, 2021
Date of Publishing: Jul 01, 2021

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? NA
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Apr 21, 2020
• Manual Googling: Jun 03, 2021
• iThenticate Software: Jun 26, 2021 (12%)

ETYMOLOGY: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com