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The Laryngoscope Sep 2021Transoral surgery (TOS) has become increasingly popular for patients with superficial hypopharyngeal squamous cell carcinoma (SCC). However, the number of patients in... (Comparative Study)
Comparative Study
OBJECTIVES/HYPOTHESIS
Transoral surgery (TOS) has become increasingly popular for patients with superficial hypopharyngeal squamous cell carcinoma (SCC). However, the number of patients in whom metachronous multiple SCC of the head and neck (HNSCC) occurs has also increased. In this study, we investigated whether multiple lugol-voiding lesions (LVLs) in the pharyngeal background mucosa observed during TOS would be a biomarker of metachronous HNSCC.
STUDY DESIGN
Retrospective study.
METHODS
We examined 362 patients who underwent TOS for superficial hypopharyngeal carcinoma. Endoscopic images were reviewed in a blinded fashion by two endoscopists. LVLs in the pharyngeal mucosa were graded as follows: A, no lesions; B, 1 to 4 lesions; and C, ≥5 lesions per endoscopic view.
RESULTS
Cumulative incidence curves of secondary HNSCC in the groups of grades A, B, and C revealed 3-year incidence rates of 14.4%, 18.8%, and 29.3%, respectively (P = .001 for A vs. C and P = .002 for B vs. C). Cumulative incidence curves of third HNSCC in the groups of grades A, B. and C revealed 5-year incidence rates of 3.9%, 9.8%, and 19.6%, respectively (P = .001 for A vs. C and P = .006 for B vs. C). Cumulative incidence curves of fourth HNSCC in the groups of grades A, B, and C revealed 7-year incidence rates of 0%, 2.3%, and 13.2%, respectively (P = .025 for A vs. C and P = .009 for B vs. C).
CONCLUSIONS
Multiple LVLs in the pharyngeal mucosa increase the risk of development of metachronous multiple HNSCC.
LEVEL OF EVIDENCE
3 (nonrandomized, controlled cohort/follow-up study) Laryngoscope, 131:2036-2040, 2021.
Topics: Aged; Endoscopy; Female; Follow-Up Studies; Humans; Hypopharyngeal Neoplasms; Incidence; Iodides; Male; Middle Aged; Mucous Membrane; Natural Orifice Endoscopic Surgery; Neoplasm Staging; Neoplasms, Second Primary; Oral Surgical Procedures; Pharynx; Prognosis; Retrospective Studies; Risk Assessment; Squamous Cell Carcinoma of Head and Neck
PubMed: 33729575
DOI: 10.1002/lary.29524 -
International Journal of... 2010The Eustachian tube (ET) is divided in 3 portions: a bony portion, a cartilaginous portion, and a junctional portion. From an anatomical-functional point of view, the... (Review)
Review
The Eustachian tube (ET) is divided in 3 portions: a bony portion, a cartilaginous portion, and a junctional portion. From an anatomical-functional point of view, the bony portion of ET is the region of ventilation and clearance of secretions, and is lined by pseudostratified, ciliated, columnar epithelium, with an anti-gravitational direction of the drainage. The ET in the bony portion is in a state of forced opening. The cartilaginous portion is instead the heart of this dynamic system tube, because the mechanism of opening and closing of the tube is at this level. ET is normally closed, and it opens only during swallowing, being essential for good functioning of the middle ear, because it provides ventilation from the nasopharynx to the middle ear, and, at the same time, clearance of secretions from the middle ear-mastoid unit to the nasopharynx. Moreover, the ET protects the middle ear against nasopharyngeal pressure variations, ascending secretions, and microorganisms. The ability to develop all these functions makes the tube a complex organ.
Topics: Cartilage; Eustachian Tube; Humans; Mucous Membrane; Nasopharynx
PubMed: 20152070
DOI: No ID Found -
Voprosy Onkologii 2006
Review
Topics: Antineoplastic Agents; Humans; Mucositis; Pharynx; Radiotherapy; Severity of Illness Index; Stomatitis
PubMed: 17024807
DOI: No ID Found -
The Journal of Laryngology and Otology Apr 1972
Topics: Barium Sulfate; Chronic Disease; Cineradiography; Epithelium; Female; Gastroesophageal Reflux; Humans; Hyperplasia; Keratosis; Laryngitis; Male; Middle Aged; Mucous Membrane; Pharynx
PubMed: 5021719
DOI: 10.1017/s0022215100075356 -
Archives of Otolaryngology--head & Neck... Mar 1995
Topics: Climate; Humans; Inhalation; Laryngeal Mucosa; Mucous Membrane; Nasal Mucosa; Nose; Pharynx; Pulmonary Ventilation; Rheology; Turbinates
PubMed: 7873153
DOI: 10.1001/archotol.1995.01890030078013 -
The Laryngoscope Dec 1984Pathophysiological aspects of the nasal and pharyngeal airways are discussed with particular reference to breathing disorders in sleep. Hypotonus of dilator muscles in... (Review)
Review
Pathophysiological aspects of the nasal and pharyngeal airways are discussed with particular reference to breathing disorders in sleep. Hypotonus of dilator muscles in sleep permits the pharynx to comply with inspiratory pressures. If airflow resistances are increased by nasal disease, complete inspiratory obstructive closure of the pharynx and apnea can result from nasal breathing in sleeping subjects. Recumbency increases resistive swelling of inflamed nasal mucosa. Furthermore in patients with normal mucosa and unilateral nasal obstruction, contralateral recumbency induces contralateral obstruction which increases resistance to nasal breathing; and in either dorsal or lateral recumbency the congestive phase of the spontaneous nasal cycle acts in a similar way. Examples of breathing disorders in sleep and impaired quality of sleep in patients with obstructive mucosal disease and both bilateral and unilateral structural abnormalities are cited.
Topics: Airway Resistance; Humans; Nasal Mucosa; Nose; Nose Diseases; Pharynx; Posture; Respiration Disorders; Rhinitis; Sleep
PubMed: 6390041
DOI: No ID Found -
Chemical Senses Sep 2013Signs of pharyngeal neurodegeneration have been detected in patients with obstructive sleep apnea (OSA). Along with this neurodegeneration, a decreased pharyngeal...
Signs of pharyngeal neurodegeneration have been detected in patients with obstructive sleep apnea (OSA). Along with this neurodegeneration, a decreased pharyngeal sensitivity to mechanical stimulation has been described. The decreased sensitivity may play a role in the pathophysiology of this disease. The aim of the study was to investigate the chemosensitivity of the pharyngeal mucosa in patients with OSA compared with controls. Healthy controls and patients with OSA (age: 30-60 years) were included. Testing of oropharyngeal chemosensitivity was performed with subjective intensity ratings of capsaicin (SIR, visual analogue scale 0-10), air puffs (presented with an olfactometer), and stimulation with CO2 at the posterior pharyngeal wall. A 2-point discrimination test at the soft palate, an intensity rating of capsaicin at the tongue, and a nasal lateralization test were performed. Twenty-six patients with OSA and 18 healthy controls were included. No differences were detected in the SIR of capsaicin at the tongue or in the nasal lateralization test. At the pharynx, a decreased sensitivity to capsaicin (OSA: 6.8 ± 2.3; healthy control: 8.6 ± 1.3), air puffs (OSA: 2.8 ± 1.9; healthy control: 4.2 ± 1.6), and stimulation with CO2 (OSA: 1.5 ± 1.7; healthy control: 2.8 ± 1.8) were demonstrated in patients with OSA (all P < 0.05). Two-point discrimination at the soft palate was reduced with statistical significance in the OSA group (OSA: 11.5 ± 5.4 mm; healthy control: 5.0 ± 2.4 mm). The results suggest reduced pharyngeal chemosensitivity in OSA patients in addition to the reduced mechanical pharyngeal sensitivity shown with 2-point discrimination. This demonstrates peripheral neurodegeneration in the context of this disease.
Topics: Adult; Capsaicin; Carbon Dioxide; Case-Control Studies; Female; Humans; Male; Middle Aged; Oropharynx; Palate, Soft; Pharynx; Reference Values; Respiratory Mucosa; Sleep Apnea, Obstructive; Stimulation, Chemical; Taste; Tongue
PubMed: 23821728
DOI: 10.1093/chemse/bjt031 -
The American Review of Respiratory... Nov 1991Phenylephrine, an alpha-adrenergic agonist, increases pharyngeal cross-sectional area when applied topically to the nasal and pharyngeal mucosa, as determined by...
Phenylephrine, an alpha-adrenergic agonist, increases pharyngeal cross-sectional area when applied topically to the nasal and pharyngeal mucosa, as determined by magnetic resonance imaging. In this study, we examined the possibility that the increase in area results from either a decrease in transmural collapsing pressure, as a result of a decrease in upstream (nasal) resistance, or an increase in upper airway muscle activity. In eight normal, awake men we measured inspiratory pharyngeal and nasal resistance and the electrical activity of the genioglossus (EMGGG) and alae nasi (EMG(AN) before and after pharyngeal and nasal + pharyngeal instillation of 1 ml of either 0.25% phenylephrine or normal saline; phenylephrine and saline were tested on separate days. Under control eucapnic conditions, pharyngeal resistance was 0.43 +/- 0.03 cm H2O/L/s, and nasal resistance was 2.43 +/- 0.14 cm H2O/L/s. Pharyngeal resistance was 0.29 +/- 0.03 cm H2O/L/s after nasal + pharyngeal instillation of phenylephrine and 0.98 +/- 0.13 cm H2O/L/s after saline; nasal resistance was 2.18 +/- 0.13 cm H2O/L/s after nasal + pharyngeal instillation of phenylephrine and 3.15 +/- 0.21 cm H2O/L/s after saline. Thus, phenylephrine decreased both nasal and pharyngeal inspiratory resistance. The change in pharyngeal resistance was not dependent on the change in nasal resistance. Eucapnic EMGGG and EMGAN activities did not change after phenylephrine or saline. We conclude that phenylephrine decreased pharyngeal resistance independent of a change in nasal resistance of upper airway muscle activity, and we believe that the changes in resistance we observed reflect a direct effect of phenylephrine on the pharyngeal mucosa and a consequent enlargement of pharyngeal size.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Administration, Topical; Adult; Airway Resistance; Catheterization; Electromyography; Humans; Male; Mucous Membrane; Nasal Mucosa; Nose; Pharyngeal Muscles; Pharynx; Phenylephrine; Reference Values; Vasoconstriction
PubMed: 1952430
DOI: 10.1164/ajrccm/144.5.1048 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2021Intensive studies on properties of synthetic compounds are simultaneously conducted with studies on the effectiveness and safety of drugs derived from natural compounds.... (Review)
Review
Intensive studies on properties of synthetic compounds are simultaneously conducted with studies on the effectiveness and safety of drugs derived from natural compounds. These drugs have been effectively used for years in dentistry, in treatment of inflammatory conditions of the oral cavity and in laryngology, in treatment of pharyngeal inflammatory conditions. The subject of this article is a compilation of studies conducted on medicinal products containing composed ethanolic extract as an active substance, and obtained from: chamomile capitulum (Matricaria recutita L.), oak bark (Quercus spp.), sage leaf (Salvia officinalis L.), arnica herb (Arnica spp.), calamus rhizome (Acorus calamus L.), peppermint herb (Mentha piperita L.), thyme herb (Thymus spp.) Preclinical studies confirmed that a particular tested plant extract exhibits antimicrobial (antibacterial, antifungal and antiprotozoal) as well as anti-inflammatory, immunomodulatory and astringent properties. Under clinical conditions, it was confirmed that drugs containing the analysed extract used in periodontology, in prevention and complex treatment of gingivitis, periodontitis as well as diseases of oral mucosa (but also the throat) of viral, bacterial, fungal and protozoal aetiology significantly improved the effectiveness of therapy, shortened the treatment and improved the patients' quality of life. The above preparations used in dental surgery contributed to faster tissue regeneration, more quickly relieved pain and swelling after a surgery or difficult dentition. Furthermore, drugs containing the above-mentioned extract can also be successfully used for oral cavity decontamination in the case of various diseases of teeth or the oral and pharyngeal mucosa. The tested composed herbal extract (CHE), applied in the form of a mouthwash and in the form for topical application with benzocaine content (CHEB), is a component of drugs which are great alternatives to widely used synthetic drugs. They are characterised with high effectiveness, comparable to that of synthetic agents, and a higher safety profile. Results of pharmacological and clinical studies justify their use in both prevention and treatment of inflammatory diseases of the gums, periodontium, oral cavity and pharynx.
Topics: Gingivitis; Humans; Mucous Membrane; Pharynx; Plant Extracts
PubMed: 34459780
DOI: No ID Found -
Vestnik Otorinolaringologii 2023The relevance of the problem of chronic inflammatory diseases of the pharynx is due to the significant prevalence of this pathology. Among all forms of chronic... (Review)
Review
The relevance of the problem of chronic inflammatory diseases of the pharynx is due to the significant prevalence of this pathology. Among all forms of chronic pharyngitis, the most adverse effect on the quality of life is observed in chronic athrophic pharyngitis. According to the literature, in this category of patients there are no clear criteria for assessing the functional state and morphological picture of the mucous membrane of the posterior pharyngeal wall. Most of the described signs of atrophic pharyngitis are insufficienyly informative, which necessitates further improvement of existing and possible search for new diagnostic methods. Many of the modern methods of treatment do not provide a lasting effect due to the presence of only a local effect on the altered mucous membrane of the posterior pharyngeal wall, without taking into account the changes that are caused by a violation of trophic processes in the tissue, which necessitates the search for new effective methods of treating this disease.The review article outlines modern ideas about the methods of diagnosis and treatment of chronic pharyngitis, presents promising areas in the treatment of patients with atrophic pharyngitis. In foreign countries, the term «chronic tonsillopharyngitis» is most often used. Due to the existing difference in terminology, the predominant part of the material on the problem of chronic pharyngitis is presented by domestic literature sources.
Topics: Humans; Quality of Life; Pharyngitis; Pharynx; Mucous Membrane; Chronic Disease
PubMed: 37450392
DOI: 10.17116/otorino20228803156