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Buccopharyngeal fascia

The buccopharyngeal fascia is a thin, fibrous layer that forms part of the pretracheal fascia in the neck. It envelopes the constrictor muscles of the pharynx and continues anteriorly to cover the buccinator muscle. Functionally, it separates the pharynx from the prevertebral fascia and provides a protective barrier between the pharynx and nearby neurovascular structures. Its anatomical significance lies in its role as a conduit for the spread of infections, as well as its importance in surgical approaches to the pharyngeal region.

Anatomical Features

  • Origin:

    • Arises from the base of the skull and is continuous with the pharyngeal basilar fascia.

  • Insertion:

    • Extends downwards to blend with the fascia of the esophagus and the connective tissue of the neck, merging with the adventitia of the esophagus inferiorly.

  • Relations:

    • Anteriorly: Continuous with the fascia of the buccinator muscle

    • Posteriorly: Related to the prevertebral fascia

    • Laterally: Closely associated with the carotid sheath and its contents

Nerve Supply

  • The buccopharyngeal fascia itself does not have a direct nerve supply, but the muscles it covers (pharyngeal constrictors, buccinator) are innervated by branches of the pharyngeal plexus (mainly from the vagus nerve [CN X]) and the facial nerve (CN VII) for the buccinator.

Arterial Supply

  • Supplied indirectly through the vascularization of underlying muscles:

    • Ascending pharyngeal artery (branch of the external carotid artery)

    • Facial artery (buccinator region)

    • Branches from the maxillary artery

Venous Drainage

  • Venous drainage follows the arterial supply:

    • Drained primarily by the pharyngeal venous plexus

    • Tributaries to the internal jugular vein

MRI Appearance

  • T1-Weighted Images:

    • Appears as a thin, low-signal-intensity (dark) linear structure outlining the pharyngeal wall.

  • T2-Weighted Images:

    • Typically low to intermediate signal intensity, maintaining a thin linear appearance.

  • STIR (Short Tau Inversion Recovery):

    • Remains as a low-signal line; pathology or edema may cause increased signal intensity if there is associated inflammation or infection.

CT Appearance

  • Appears as a thin, hypodense (low attenuation) linear layer between the pharyngeal wall and the surrounding soft tissue.

MRI image

Buccopharyngeal fascia mri axial image -img-00000-00000