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American Family Physician Jan 2021Dysphagia is common but may be underreported. Specific symptoms, rather than their perceived location, should guide the initial evaluation and imaging. Obstructive... (Review)
Review
Dysphagia is common but may be underreported. Specific symptoms, rather than their perceived location, should guide the initial evaluation and imaging. Obstructive symptoms that seem to originate in the throat or neck may actually be caused by distal esophageal lesions. Oropharyngeal dysphagia manifests as difficulty initiating swallowing, coughing, choking, or aspiration, and it is most commonly caused by chronic neurologic conditions such as stroke, Parkinson disease, or dementia. Symptoms should be thoroughly evaluated because of the risk of aspiration. Patients with esophageal dysphagia may report a sensation of food getting stuck after swallowing. This condition is most commonly caused by gastroesophageal reflux disease and functional esophageal disorders. Eosinophilic esophagitis is triggered by food allergens and is increasingly prevalent; esophageal biopsies should be performed to make the diagnosis. Esophageal motility disorders such as achalasia are relatively rare and may be overdiagnosed. Opioid-induced esophageal dysfunction is becoming more common. Esophagogastroduodenoscopy is recommended for the initial evaluation of esophageal dysphagia, with barium esophagography as an adjunct. Esophageal cancer and other serious conditions have a low prevalence, and testing in low-risk patients may be deferred while a four-week trial of acid-suppressing therapy is undertaken. Many frail older adults with progressive neurologic disease have significant but unrecognized dysphagia, which significantly increases their risk of aspiration pneumonia and malnourishment. In these patients, the diagnosis of dysphagia should prompt a discussion about goals of care before potentially harmful interventions are considered. Speech-language pathologists and other specialists, in collaboration with family physicians, can provide structured assessments and make appropriate recommendations for safe swallowing, palliative care, or rehabilitation.
Topics: Deglutition; Deglutition Disorders; Esophagus; Family Practice; Female; Humans; Male; Pharynx; Physical Examination
PubMed: 33448766
DOI: No ID Found -
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 -
Oral and Maxillofacial Surgery Clinics... May 2021Uvulopalatopharyngoplasty is a generally safe and widely accepted surgical procedure for the treatment of obstructive sleep apnea. Unfortunately,... (Review)
Review
Uvulopalatopharyngoplasty is a generally safe and widely accepted surgical procedure for the treatment of obstructive sleep apnea. Unfortunately, uvulopalatopharyngoplasty does not always result in success, and patients who initially experienced improvement in the severity of their obstructive sleep apnea may relapse. Proper patient selection and performing uvulopalatopharyngoplasty in conjunction with other surgical procedures that are directed at other sites of upper airway collapsibility may yield favorable outcomes.
Topics: Humans; Pharynx; Sleep Apnea, Obstructive; Uvula
PubMed: 33581977
DOI: 10.1016/j.coms.2021.01.001 -
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 -
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 -
BMJ Case Reports Dec 2022No part of the human body is immune to tuberculosis, the most common site being the lungs. We report a rare case of primary nasopharyngeal tuberculosis without cervical...
No part of the human body is immune to tuberculosis, the most common site being the lungs. We report a rare case of primary nasopharyngeal tuberculosis without cervical lymphadenopathy nor pulmonary involvement. The only presenting symptom was an intermittent discomfort in the neck and throat. Several biopsies were performed to exclude nasopharyngeal carcinoma and to reach the final diagnosis of tuberculosis. The patient made full recovery following 6 months of treatment with antibiotics. A multidisciplinary approach by ear, nose and throat, radiology, pathology, and infectious disease colleagues was crucial in reaching the diagnosis and managing the patient.
Topics: Humans; Nasopharynx; Tuberculosis; Pharynx; Neck; Nasopharyngeal Neoplasms
PubMed: 36593611
DOI: 10.1136/bcr-2022-251927 -
MMW Fortschritte Der Medizin May 2021
Topics: Foreign Bodies; Humans; Neck; Pharynx
PubMed: 33961234
DOI: 10.1007/s15006-021-9883-x -
Chest Mar 2021
Topics: Humans; Pharynx; Polysomnography
PubMed: 33678276
DOI: 10.1016/j.chest.2020.11.031