pterygomandibular raphe pterygomandibular raphe the pterygomandibular raphe (pterygomandibular ligament) is a ligamentous band of the buccopharyngeal fascia. it is attached superiorly to the pterygoid hamulus of the medial pterygoid plate, and inferiorly to the posterior end of the mylohyoid line of the mandible. it connects the buccinator muscle in front to the superior pharyngeal constrictor muscle behind. pterygomandibular raphemuscles of the pharynx and cheek. (pterygo-mandibular ligament labeled at center, vertically.)detailspart ofbuccopharyngeal fasciaoriginpterygoid hamulus of the medial pterygoid plateinsertionmylohyoid line of the mandibleidentifierslatinraphe pterygomandibularista98a05.3.01.102ta22178fma55618anatomical terminology structure open mouth, view from front. the pterygomandibular ligaments are marked with arrows. note that in this mouth the lower wisdom teeth have been removed, slightly changing the shape of the pterygomandibular ligaments that usually curve and attach to the mandible around them. the pterygomandibular raphe is a ligament that forms from the buccopharyngeal fascia. it is a paired structure, with one on each side of the mouth. superiorly, it is attached to the pterygoid hamulus of the medial pterygoid plate of the sphenoid bone. inferiorly, it is attached to the posterior end of the mylohyoid line of the mandible. its medial surface is covered by the mucous membrane of the mouth. its lateral surface is separated from the ramus of the mandible by a quantity of adipose tissue. its posterior border gives attachment to the superior pharyngeal constrictor muscle. its anterior border attaches to the posterior edge of the buccinator muscle. variation in foetuses, the pterygomandibular raphe is always very prominent. however, in adults, it may become less distinctive. it is very large and distinctive in around 36% adults. it is fairly small, and only an upper triangular portion visible, in around 36% of adults. it is not visible in around 28%, making the superior pharyngeal constrictor muscle and the buccinator muscle continuous. this may vary by ethnic group. function the pterygomandibular raphe is the common meeting point of the superior pharyngeal constrictor muscle and the buccinator muscle. it holds them together, forming part of the mouth. clinical significance when the mandible is splinted for gradual realignment (such as to treat sleep apnea), the pterygomandibular ligament slightly resists the realignment. history the pterygomandibular ligament was first noted in 1784.