Newly Revealed Cricothyropharyngeus Muscle in the Human Laryngopharynx

Abstract

Humans have a uniquely curved pharynx and tongue that is believed to have evolved for speech. The most inferior part of the pharynx consists of the laryngopharynx, the critical crossroad where swallowing, breathing, and phonation overlap. We hypothesized that the human laryngopharynx has unique neuromuscular specializations that may be speech related. Laryngopharynx specimens from 15 humans and 20 nonhuman mammals (dog, pig, rabbit, and rat) were studied. Microdissection revealed that only human specimens had a muscle originating from the anterior arch of the cricoid cartilage, and coursing between the inferior pharyngeal constrictor and cricopharyngeus muscles to insert into the median raphe at the posterior midline of the pharynx. On the basis of these anatomic features, we termed it the "cricothyropharyngeus" (CTP). The structure, innervation, and muscle fiber types of the human CTP were further investigated by histological methods, Sihler's stain, and myosin heavy chain (MHC) immunocytochemistry. The innervation and muscle fiber types of the CTP were found to differ from those of neighboring muscles. The laryngeal portion of the CTP was innervated by the external superior laryngeal nerve, whereas the pharyngeal portion of the muscle was supplied by the pharyngeal plexus. Most notable was that the CTP contained specialized muscle fibers expressing some unusual MHC isoforms (i.e., slow-tonic, alpha-cardiac, neonatal, and embryonic). In conclusion, the CTP appears to be a newly described and uniquely human muscle with characteristics suggesting a specialized function that may be speech related.