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The pharyngeal plexus: an anatomical review for better understanding postoperative dysphagia

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Abstract

The pharyngeal plexus is an essential anatomical structure, but the contributions from the glossopharyngeal and vagus nerves and the superior cervical ganglion that give rise to the pharyngeal plexus are not fully understood. The pharyngeal plexus is likely to be encountered during various anterior cervical surgical procedures of the neck such as anterior cervical discectomy and fusion. Therefore, a detailed understanding of its anatomy is essential for the surgeon who operates in and around this region. Although the pharyngeal plexus is an anatomical structure that is widely mentioned in literature and anatomy books, detailed descriptions of its structural nuances are scarce; therefore, we provide a comprehensive review that encompasses all the available data from this critical structure. We conducted a narrative review of the current literature using databases like PubMed, Embase, Ovid, and Cochrane. Information was gathered regarding the pharyngeal plexus to improve our understanding of its anatomy to elucidate its involvement in postoperative spine surgery complications such as dysphagia. The neural contributions of the cranial nerves IX, X, and superior sympathetic ganglion intertwine to form the pharyngeal plexus that can be injured during ACDF procedures. Factors like surgical retraction time, postoperative hematoma, surgical hardware materials, and profiles and smoking are related to postoperative dysphagia onset. Thorough anatomical knowledge and lateral approaches to ACDF are the best preventing measures.

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Author information

Authors and Affiliations

  1. Pontificia Universidad Javeriana, Bogotá, Colombia

    Santiago Gutierrez

  2. Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA

    Joe Iwanaga, Aaron S. Dumont & R. Shane Tubbs

  3. Department of Anatomy, Jagiellonian University, Kraków, Poland

    Przemyslaw Pekala

  4. Department of Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany

    Emre Yilmaz

  5. Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA

    William E. Clifton

  6. Department of Anatomical Sciences, St. George’s University, St. George’s, West Indies, Grenada

    R. Shane Tubbs

  7. Department of Neurosurgery, Ochsner Health System, Ochsner Neuroscience Institute, New Orleans, LA, USA

    R. Shane Tubbs

  8. Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA

    R. Shane Tubbs

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  1. Santiago Gutierrez
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Correspondence to Joe Iwanaga.

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The protocol of the study did not require approval by the ethical committees or informed consent. The study followed the Declaration of Helsinki (64th WMA General Assembly, Fortaleza, Brazil, October 2013).

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Gutierrez, S., Iwanaga, J., Pekala, P. et al. The pharyngeal plexus: an anatomical review for better understanding postoperative dysphagia. Neurosurg Rev 44, 763–772 (2021). https://doi.org/10.1007/s10143-020-01303-5

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  • DOI: https://doi.org/10.1007/s10143-020-01303-5

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