The ascending palatine artery arises from the facial artery near its origin and ascends along the superior pharyngeal constrictor to reach the soft palate and the superior palatine tonsil. It supplies the soft palate musculature, the tonsillar bed, the Eustachian tube, and the posterior nasal wall. It anastomoses with the descending palatine artery from the maxillary system to form a palatal arcade.
The ascending palatine artery is relevant in palatal cleft surgery, where it must be identified and preserved in pharyngoplasty flap elevation from the posterior pharyngeal wall and soft palate. In palatopharyngeus flap procedures for velopharyngeal incompetence, the ascending palatine artery is the flap pedicle. It is also encountered during uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnoea, where palatal mucosal bleeding during palatoplasty originates from this artery.
The ascending palatine artery provides the pedicle for the posterior pharyngeal wall flap used in sphincter pharyngoplasty for velopharyngeal incompetence after cleft palate repair; the flap is elevated on the lateral pharyngeal walls with the bilateral ascending palatine artery pedicles preserved as the central flap attachment.
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