Skip to main content
Erschienen in: Surgical and Radiologic Anatomy 7/2019

03.04.2019 | Original Article

The parapharyngeal adipose corpus: anatomic and radiologic study

verfasst von: Pauline Nicol, Jean-Marc Constans, Marie-Pia d’Ortho, Patrick Goudot, Christian Vacher

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 7/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Although the morphology of the parapharyngeal adipose corpus (PAC) has been already described, the clinical interest of its volume and weight in the genesis of obstructive sleep apnea syndrome (OSAS) is still controversial. The volume of the PAC has been determined in OSAS patients but not in a normal population. The aim of our study was to investigate the morphology of the PAC by dissection and MRI in a normal population and to determine if there is a relation between the dimensions and volume of the PAC and the Body Mass Index (BMI).

Methods

Thirty hemifaces of 15 fresh cadavers have been dissected after silicone injection with dissection of the external carotid artery and its main branches, with harvesting of the PAC. The PAC has been measured and weighed. Twenty-nine MRI of healthy subjects have been examined to determine the volume of the PAC, the palate–pharynx distance, and epiglottis–pharynx distance.

Results

In dissection study the weight of the PAC was 18.57 g ± 2.24, the vertical dimension (height) was 4.61 cm ± 0.51, the frontal dimension (width) was 1.62 cm ± 0.24. The blood supply of the PAC constituted of branches coming from the ascending palatal and ascending pharyngeal arteries. The volume of the PAC on the right side was 1.56 cm3 ± 0.38, on the left side 1.54 cm3 ± 0.37. Its horizontal greater dimension was 1.70 cm ± 0.07.

Conclusions

There is a correlation between the volume of the PAC and the BMI in a normal population. A surgical resection of the PAC in OSAS patients by transoral robotic-assisted surgery can be proposed with preservation of the ascending palatal and ascending pharyngeal arteries.
Literatur
1.
Zurück zum Zitat Colin V, Gavid M, Timochenko A, Prades JM (2017) Le corps adipeux parapharyngé: anatomie chirurgicale et imagerie. Morphologie 101:71–76CrossRefPubMed Colin V, Gavid M, Timochenko A, Prades JM (2017) Le corps adipeux parapharyngé: anatomie chirurgicale et imagerie. Morphologie 101:71–76CrossRefPubMed
2.
Zurück zum Zitat Godoy IRB, Martinez-Salazar EL, Eajazi A, Genta PR, Bredella MA, Torriani M (2016) Fat accumulation in the tongue is associated with male gender, abnormal upper airway patency and whole-body adiposity. Metabolism 65:1657–1663CrossRefPubMedPubMedCentral Godoy IRB, Martinez-Salazar EL, Eajazi A, Genta PR, Bredella MA, Torriani M (2016) Fat accumulation in the tongue is associated with male gender, abnormal upper airway patency and whole-body adiposity. Metabolism 65:1657–1663CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Horner RL, Mohiaddin DG, Lowell SA (1989) Sites and sizes of fat deposits around the pharynx in obese patients with obstructive sleep apnoea and weight matched controls. Eur Respir J 2:613–632PubMed Horner RL, Mohiaddin DG, Lowell SA (1989) Sites and sizes of fat deposits around the pharynx in obese patients with obstructive sleep apnoea and weight matched controls. Eur Respir J 2:613–632PubMed
4.
Zurück zum Zitat Jang MS, Kim HY, Dhong HJ, Chung SK, Hong SD, Cho HJ, Jung TY (2014) Effect of parapharyngeal fat on dynamic obstruction of the upper airway in patients with obstructive sleep apnea. Am J Respir Crit Care Med 190:1318–1321CrossRefPubMed Jang MS, Kim HY, Dhong HJ, Chung SK, Hong SD, Cho HJ, Jung TY (2014) Effect of parapharyngeal fat on dynamic obstruction of the upper airway in patients with obstructive sleep apnea. Am J Respir Crit Care Med 190:1318–1321CrossRefPubMed
5.
Zurück zum Zitat Kahn JL, Bourjat P (1996) La région péripharyngée: anatomie et imagerie normale. J Radiol 77:87–97PubMed Kahn JL, Bourjat P (1996) La région péripharyngée: anatomie et imagerie normale. J Radiol 77:87–97PubMed
6.
Zurück zum Zitat Kahn JL, Sick H, Laude M, Koritke JG (1987) La boule de Bichat ou corpus adiposum buccae. Arch Anat Histol Embryol Norm Exp 70:33–71 Kahn JL, Sick H, Laude M, Koritke JG (1987) La boule de Bichat ou corpus adiposum buccae. Arch Anat Histol Embryol Norm Exp 70:33–71
7.
Zurück zum Zitat Kim AM, Keenan BT, Jackson N, Chan EL, Staley B, Poptani H et al (2014) Tongue fat and its relationship to obstructive sleep apnea. Sleep 37:1639–1648CrossRefPubMedPubMedCentral Kim AM, Keenan BT, Jackson N, Chan EL, Staley B, Poptani H et al (2014) Tongue fat and its relationship to obstructive sleep apnea. Sleep 37:1639–1648CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Li Y, Lin N, Ye J, Chang Q, Han D, Sperry A (2012) Upper airway fat tissue distribution in subjects with obstructive sleep apnea and its effect on retropalatal mechanical loads. Respir Care 57:1098–1105CrossRefPubMed Li Y, Lin N, Ye J, Chang Q, Han D, Sperry A (2012) Upper airway fat tissue distribution in subjects with obstructive sleep apnea and its effect on retropalatal mechanical loads. Respir Care 57:1098–1105CrossRefPubMed
9.
Zurück zum Zitat Mortimore I, Marshall J, Wraith PKP, Sellar R, Douglas N (1998) Neck and total body fat deposition in non-obese and obese patients with sleep apnea compared with that in control subjects. Am J Respir Crit Care Med 157:280–283CrossRefPubMed Mortimore I, Marshall J, Wraith PKP, Sellar R, Douglas N (1998) Neck and total body fat deposition in non-obese and obese patients with sleep apnea compared with that in control subjects. Am J Respir Crit Care Med 157:280–283CrossRefPubMed
10.
Zurück zum Zitat Ozturk E, Dalayman D, Sonmez G, Mutlu H, Sildiroglu HO, Basekim CC, Kizilkaya E (2007) The effect of pharyngeal soft tissue components on snoring. Clin Imaging 31:259–263CrossRefPubMed Ozturk E, Dalayman D, Sonmez G, Mutlu H, Sildiroglu HO, Basekim CC, Kizilkaya E (2007) The effect of pharyngeal soft tissue components on snoring. Clin Imaging 31:259–263CrossRefPubMed
11.
Zurück zum Zitat Pahkala R, Seppä J, Ikonen A, Smirnov G, Tuomilehto H (2014) The impact of pharyngeal fat tissue on the pathogenesis of obstructive sleep apnea. Sleep Breath 18:275–282CrossRefPubMed Pahkala R, Seppä J, Ikonen A, Smirnov G, Tuomilehto H (2014) The impact of pharyngeal fat tissue on the pathogenesis of obstructive sleep apnea. Sleep Breath 18:275–282CrossRefPubMed
12.
Zurück zum Zitat Shelton KE, Woodson H, Spencer G, Suratt PM (1993) Pharyngeal fat in obstructive sleep apnea. Am Rev Respir Dis 148:462–466CrossRefPubMed Shelton KE, Woodson H, Spencer G, Suratt PM (1993) Pharyngeal fat in obstructive sleep apnea. Am Rev Respir Dis 148:462–466CrossRefPubMed
13.
Zurück zum Zitat Schwab RJ, Gupta KB, Gefter WB, Hoffman EA, Pack AI (1995) Upper airway soft tissue anatomy in normal and patients with sleep-disordered breathing: significance of the lateral pharyngeal walls. Am Respir Crit Care Med 152:1673–1689CrossRef Schwab RJ, Gupta KB, Gefter WB, Hoffman EA, Pack AI (1995) Upper airway soft tissue anatomy in normal and patients with sleep-disordered breathing: significance of the lateral pharyngeal walls. Am Respir Crit Care Med 152:1673–1689CrossRef
14.
Zurück zum Zitat Sutherland K, Lee RWW, Philips CL, Dungan G, Yee BJ, Magnussen JS, Grunstein RR, Cistulli PA (2011) Effect of weight loss on upper airway size and facial fat in men with obstructive sleep apnoea. Thorax 66:797–803CrossRefPubMed Sutherland K, Lee RWW, Philips CL, Dungan G, Yee BJ, Magnussen JS, Grunstein RR, Cistulli PA (2011) Effect of weight loss on upper airway size and facial fat in men with obstructive sleep apnoea. Thorax 66:797–803CrossRefPubMed
15.
Zurück zum Zitat White HN, Moore EJ, Rosenthal EL, Carrol WR, Olsen KD, Desmond RA et al (2010) Transoral robotic-assisted surgery for head and neck squamous cell carcinoma: 1- and 2-year survival analysis. Arch Otolaryngol Neck Surg 136:1248CrossRef White HN, Moore EJ, Rosenthal EL, Carrol WR, Olsen KD, Desmond RA et al (2010) Transoral robotic-assisted surgery for head and neck squamous cell carcinoma: 1- and 2-year survival analysis. Arch Otolaryngol Neck Surg 136:1248CrossRef
16.
Zurück zum Zitat Wolfram-Gabel R, Kahn JL, Bourjat P (1997) The parapharyngeal adipose corpus: morphologic study. Surg Radiol Anat 19:249–255PubMed Wolfram-Gabel R, Kahn JL, Bourjat P (1997) The parapharyngeal adipose corpus: morphologic study. Surg Radiol Anat 19:249–255PubMed
17.
Zurück zum Zitat Young T, Peppard PE, Taheri S (2005) Excess weight and sleep-disordered breathing. J Appl Physiol 99:1592–1599CrossRefPubMed Young T, Peppard PE, Taheri S (2005) Excess weight and sleep-disordered breathing. J Appl Physiol 99:1592–1599CrossRefPubMed
Metadaten
Titel
The parapharyngeal adipose corpus: anatomic and radiologic study
verfasst von
Pauline Nicol
Jean-Marc Constans
Marie-Pia d’Ortho
Patrick Goudot
Christian Vacher
Publikationsdatum
03.04.2019
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 7/2019
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-019-02230-x

Weitere Artikel der Ausgabe 7/2019

Surgical and Radiologic Anatomy 7/2019 Zur Ausgabe

Anatomic Bases of Medical, Radiological and Surgical Techniques

Presence of isthmi in mandibular mesial roots and associated factors: an in vivo analysis

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.