The Musculus Uvulae Muscle and the Effect of Furlow’s Palatoplasty on It

The musculus uvulae (m. uvulae) is an often overlooked, albeit crucial anatomic structure within the human soft palatal musculature. It is one of 5 paired muscles that contribute to a variety of physiological functions, including speech, deglutination, and prevention of nasal regurgitation. Over the previous 60 years, there has been contention among surgeons and anatomists as to the functional anatomy of the musculus uvulae and its contribution to the competence of the velopharyngeal sphincter, both actively and passively. Furlow's palatoplasty is widely used in repair of both primary and secondary clefts, with generally good outcomes. Although its restoration of certain velar muscles orientation has positive effects on velar function, it inherently disrupts the action of the musculus  uvulae, which may account for certain cases of postoperative velopharyngeal insufficiency (VPI). Here, the authors review the anatomy of the musculus uvulae and provide videographic evidence of the detrimental effect of Furlow's palatoplasty upon it.