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Neurogastroenterology and Motility Nov 2017Eating and drinking are enjoyable activities that positively impact on an individual's quality of life. The ability to swallow food and fluid is integral to the process... (Review)
Review
BACKGROUND
Eating and drinking are enjoyable activities that positively impact on an individual's quality of life. The ability to swallow food and fluid is integral to the process of eating. Swallowing occupies a dual role being both part of the enjoyment of eating and being a critically important utilitarian activity to enable adequate nutrition and hydration. Any impairment to the process of swallowing can negatively affect a person's perception of their quality of life. The process of swallowing is highly complex and involves muscles in the mouth, pharynx, larynx, and esophagus. The oropharynx is the anatomical region encompassing the oral cavity and the pharynx. Food must be masticated, formed into a bolus and transported to the pharynx by the tongue whereas fluids are usually held within the mouth before being transported ab-orally. The bolus must then be transported through the pharynx to the esophagus without any matter entering the larynx. The muscles needed for all these steps are coordinated by swallowing centers within the brainstem which are supplied with sensory information by afferent nerve fibers from several cranial nerves. The swallowing centers also receive modulatory input from higher centers within the brain. Hence, a swallow has both voluntary and involuntary physiologic components and the term dysphagia is given to difficult swallowing while oropharyngeal dysphagia is difficult swallowing due to pathology within the oropharynx.
PURPOSE
Problems affecting any point along the complex swallowing pathway can result in dysphagia. This review focuses on the anatomy and physiology behind normal and abnormal oropharyngeal swallowing. It also details the common diseases and pathology causing oropharyngeal dysphagia.
Topics: Animals; Brain; Deglutition; Deglutition Disorders; Esophagus; Humans; Laryngeal Nerves; Larynx; Mastication; Masticatory Muscles; Mouth; Neurons; Pharynx
PubMed: 28547793
DOI: 10.1111/nmo.13100 -
The Medical Clinics of North America Nov 2014Patients often present to their physician with complaints of dental and/or oral pain. It is important for physicians to understand the complexities of oral anatomy and... (Review)
Review
Patients often present to their physician with complaints of dental and/or oral pain. It is important for physicians to understand the complexities of oral anatomy and how to perform a basic clinical examination of this area to evaluate and potentially manage patients with these complaints. This article discusses anatomic structures of the oral cavity and systematic clinical examination of this area.
Topics: Dentition; Diagnosis, Oral; Humans; Mouth; Mouth Mucosa; Pharynx; Primary Health Care; Salivary Glands
PubMed: 25443674
DOI: 10.1016/j.mcna.2014.08.001 -
Sleep Medicine Reviews Feb 2018People develop obstructive sleep apnoea (OSA) for different reasons. The ability to understand these reasons, easily identify them in individual patients, and develop... (Review)
Review
People develop obstructive sleep apnoea (OSA) for different reasons. The ability to understand these reasons, easily identify them in individual patients, and develop therapies that target one or more of these reasons are the keys to unlocking new approaches for the treatment of OSA. In line with this approach, recent advances in OSA pathogenesis using upper airway and respiratory phenotyping techniques have identified four key causes of OSA. A narrow or collapsible upper airway ('impaired anatomy') is the primary cause. However, the anatomical contribution to OSA varies substantially. Indeed, impairment in pharyngeal anatomy can be modest and in many patients (∼20%), pharyngeal collapsibility asleep is not different to people without OSA. Thus, non-anatomical factors or 'phenotypes' that modulate pharyngeal patency are crucial determinants of OSA for many people. These include impairment in pharyngeal dilator muscle control and function during sleep, increased propensity for awakening during airway narrowing (low respiratory arousal threshold) and respiratory control instability (high loop gain). Each phenotype is a potential therapeutic target. This review summarises the recent advances in the understanding of OSA pathogenesis according to a phenotypic approach, emerging tools to identify the phenotypes, and potential new therapeutic pathways and interventions to treat this common disorder.
Topics: Arousal; Continuous Positive Airway Pressure; Humans; Pharynx; Phenotype; Precision Medicine; Sleep; Sleep Apnea, Obstructive
PubMed: 28110857
DOI: 10.1016/j.smrv.2016.12.003 -
Neuroimaging Clinics of North America Feb 2022Cancers of the pharynx and larynx are treated using a combination of chemotherapeutic, radiation, and surgical techniques, depending on the cancer type, biology,... (Review)
Review
Cancers of the pharynx and larynx are treated using a combination of chemotherapeutic, radiation, and surgical techniques, depending on the cancer type, biology, location, and stage, as well as patient and other factors. When imaging in the postsurgical setting, the knowledge of the type of tumor, preoperative appearance, and type of surgery performed is essential for accurate interpretation. Surgical anatomic changes, surgical implants/devices, and potential postsurgical complications must be differentiated from suspected recurrent tumors.
Topics: Humans; Laryngeal Neoplasms; Laryngectomy; Larynx; Pharyngectomy; Pharynx; Postoperative Complications
PubMed: 34809843
DOI: 10.1016/j.nic.2021.08.009 -
The British Journal of Radiology Sep 2023The pharynx plays a significant role in swallowing and speech, and this is reflected in both its complex anatomy and degree of physiological motility. Patients who... (Review)
Review
The pharynx plays a significant role in swallowing and speech, and this is reflected in both its complex anatomy and degree of physiological motility. Patients who present with pharynx-related symptoms such as sore throat, globus, dysphagia or dysphonia will usually undergo visual and nasal endoscopic examination in the first instance. Imaging is frequently required to supplement clinical assessment and this typically involves MRI and CT. However, fluoroscopy, ultrasound and radionuclide imaging are valuable in certain clinical situations. The aforementioned complexity of the pharynx and the myriad of pathologies which may arise within it often make radiological evaluation challenging. In this pictorial review, we aim to provide a brief overview of cross-sectional pharyngeal anatomy and present the radiological features of a variety of pharyngeal pathologies, both benign and malignant.
Topics: Humans; Pharynx; Cross-Sectional Studies; Deglutition Disorders; Deglutition; Fluoroscopy
PubMed: 37334795
DOI: 10.1259/bjr.20230046 -
Neuroimaging Clinics of North America Nov 2022The pharynx is a complex muscular structure allowing breathing, swallowing, as well speech through common airspace. The normal imaging appearance of the pharynx and... (Review)
Review
The pharynx is a complex muscular structure allowing breathing, swallowing, as well speech through common airspace. The normal imaging appearance of the pharynx and cervical esophagus can be challenging given the numerous interleaved surrounding muscles and numerous connections. This article presents the imaging anatomy of the pharynx and cervical esophagus and also discusses the clinical relevance of selected anatomical structures that have important significance in disease development and extension.
Topics: Esophagus; Humans; Hypopharynx; Neck; Pharynx
PubMed: 36244724
DOI: 10.1016/j.nic.2022.07.022 -
Seminars in Ultrasound, CT, and MR Apr 2019Pharyngeal emergencies, which can be subdivided into traumatic versus nontraumatic, are a common cause of Emergency Department visits. Patients often present to... (Review)
Review
Pharyngeal emergencies, which can be subdivided into traumatic versus nontraumatic, are a common cause of Emergency Department visits. Patients often present to Emergency Department with a wide variety of pharyngeal symptoms, for which computed tomography imaging has become the first line imaging modality. Familiarity with these conditions enables a radiologist to make a prompt diagnosis, assess the extent of disease, and evaluate for potential complications. In this chapter, we present a brief overview of nontraumatic pharyngeal emergencies based on anatomic subdivisions (nasopharynx, oropharynx, and hypopharynx), discuss their etiologies, clinical presentations, computed tomography imaging findings, and management options. We will also discuss differential diagnoses based on imaging findings.
Topics: Emergencies; Humans; Pharyngeal Diseases; Pharynx; Tomography, X-Ray Computed
PubMed: 31030737
DOI: 10.1053/j.sult.2018.10.009 -
Laryngo- Rhino- Otologie Jan 2023
Topics: Humans; Pharynx; Palatine Tonsil; Tongue Neoplasms; Neck; Tongue
PubMed: 36580933
DOI: 10.1055/a-1981-8474 -
Laryngo- Rhino- Otologie Feb 2023
Topics: Humans; Pharynx; Pharyngeal Neoplasms; Palatine Tonsil
PubMed: 36750115
DOI: 10.1055/a-1992-1037 -
European Annals of Otorhinolaryngology,... Apr 2019Based on a review of the medical literature, the authors document the key technical points, variants, technical errors to avoid and main functional results of lateral...
Based on a review of the medical literature, the authors document the key technical points, variants, technical errors to avoid and main functional results of lateral pharyngotomy for resection of cancers originating from the lateral oro and/or hypopharynx.
Topics: Anatomic Landmarks; Humans; Medical Illustration; Pharyngeal Neoplasms; Pharynx
PubMed: 30482706
DOI: 10.1016/j.anorl.2018.10.011