pharyngeal mucosal space

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The pharyngeal (or superficial) mucosal space is a deep compartment of the head and neck, located between the fascia of the pharyngeal constrictor muscles (buccopharyngeal or visceral fascia) and the mucosal surface of the nasopharynx, oropharynx, and hypopharynx.

Terminology

Not a true anatomic fascial space, the pharyngeal mucosal space was coined in the radiology literature to complete the spatial map of the neck . The concept may be confusing in two ways. First, pathology involving the pharyngeal "mucosal space" is not limited to the mucosa and can be primarily submucosal . Second, the proximal and distal limits are unclear: various authors have arbitrarily expanded or limited the pharyngeal mucosal space to include the oral cavity and/or exclude all or part of the hypopharynx as it is inferior to the hyoid bone . In the latter definitions, the visceral space is the infrahyoid continuation that includes most of the hypopharynx .

Rather than citing the pharyngeal mucosal space in radiology reporting and communications with surgeons, a practical alternative is localizing pathology to the "nasopharynx", "oropharynx", or "hypopharynx" and their anatomic subsites.

Gross anatomy

The pharyngeal mucosal space is the deepest compartment (closest to the airway) of the head and neck, circumscribed by the middle (visceral, buccopharyngeal, pretracheal, pharyngomucosal) layer of the deep cervical fascia . It extends from the base of the skull to the cricoid cartilage .

Relations

medial to the parapharyngeal space
anterior to the retropharyngeal space
includes the peritonsillar space

Boundaries

The pharyngeal mucosal space is internal to the middle layer of deep cervical fascia:

superior margin: merging of the middle layer of deep cervical fascia with the aponeurosis of the superior pharyngeal constrictor muscle
inferior margin: cricoid cartilage