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Salpingopalatine fold

The salpingopalatine fold, also known as the palatovestibular fold, is a mucosal ridge extending from the torus tubarius of the nasopharynx to the soft palate. It lies lateral to the pharyngeal opening of the Eustachian tube and is an important landmark in the nasopharynx and oropharynx junction. Understanding its anatomy, function, and imaging characteristics is crucial for ENT specialists, radiologists, and surgeons, especially in evaluating nasopharyngeal pathologies or planning endoscopic procedures.

Synonyms

  • Palatovestibular fold

  • Fold of the torus tubarius

  • Nasopharyngeal mucosal fold

  • Lateral nasopharyngeal fold

Function

  • Guides airflow from the nasopharynx toward the oropharynx

  • Supports the pharyngeal opening of the Eustachian tube

  • Plays a minor role in swallowing by assisting soft palate movement

  • Serves as a surgical and endoscopic landmark in the nasopharynx

MRI Appearance
T1-weighted images:

  • Appears as thin mucosal soft tissue of intermediate signal intensity

  • Surrounded by air in the nasopharyngeal lumen, which appears as signal void (black)

  • Adjacent fat, when present, appears hyperintense, enhancing visualization of the fold

  • Pathological thickening or lesions appear hypo- to isointense and may enhance with contrast

T2-weighted images:

  • The fold itself is intermediate signal

  • Mucosal edema, inflammation, or cysts appear hyperintense, contrasting with surrounding air

  • Highlights subtle inflammatory or neoplastic changes

STIR (Short Tau Inversion Recovery):

  • Fat suppression improves detection of soft tissue abnormalities

  • Air remains a signal void, while pathological changes appear bright hyperintense

  • Useful for detecting inflammation, edema, or early tumors

CT Appearance

  • The salpingopalatine fold appears as a soft tissue density ridge lateral to the Eustachian tube opening

  • The nasopharyngeal lumen is air-filled, appearing hypodense (black), providing contrast against the fold

  • Surrounding cartilages (torus tubarius, pharyngeal wall) are soft tissue density; calcifications or ossifications are hyperdense

  • Pathological changes such as thickening, masses, or mucosal lesions are visible as soft tissue density within the air-filled nasopharynx

  • CT is particularly useful for preoperative planning and assessing airway patency

MRI images

Salpingopalatine fold mri axial image -img-00000-00000