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BMJ Paediatrics Open Apr 2023Adenoids (nasopharyngeal tonsils), being part of Waldeyer's ring, are masses of lymphoid tissues located at the junction of the roof and the posterior wall of the... (Review)
Review
Adenoids (nasopharyngeal tonsils), being part of Waldeyer's ring, are masses of lymphoid tissues located at the junction of the roof and the posterior wall of the nasopharynx. Adenoids play an important role in the development of the immune system and serve as a defence against infections, being the first organs that come into contact with respiratory and digestive antigens. The causes of adenoid hypertrophy are not fully known. They are most likely associated with aberrant immune reactions, infections, environmental exposures and hormonal or genetic factors. The aim of this review is to summarise the current knowledge of adenoid hypertrophy in children and associated diseases. Adenoid hypertrophy has many clinical manifestations that are frequent in the paediatric population and is accompanied by various comorbidities.
Topics: Humans; Child; Adenoids; Clinical Relevance; Nasopharynx; Lymphoid Tissue; Hypertrophy
PubMed: 37045541
DOI: 10.1136/bmjpo-2022-001710 -
Journal of Medical Microbiology Jun 2021The nasopharyngeal microbiome is a dynamic microbial interface of the aerodigestive tract, and a diagnostic window in the fight against respiratory infections and... (Review)
Review
The nasopharyngeal microbiome is a dynamic microbial interface of the aerodigestive tract, and a diagnostic window in the fight against respiratory infections and antimicrobial resistance. As its constituent bacteria, viruses and mycobacteria become better understood and sampling accuracy improves, diagnostics of the nasopharynx could guide more personalized care of infections of surrounding areas including the lungs, ears and sinuses. This review will summarize the current literature from a clinical perspective and highlight its growing importance in diagnostics and infectious disease management.
Topics: Drug Resistance, Microbial; Environment; Humans; Microbiota; Mycobacterium; Nasopharynx; Otitis Media; Virome
PubMed: 34165422
DOI: 10.1099/jmm.0.001368 -
Anatomical Record (Hoboken, N.J. : 2007) Aug 2022The process by which upper respiratory tract structures have changed over deep evolutionary time is, in part, reflected in the process of embryologic development. The...
The process by which upper respiratory tract structures have changed over deep evolutionary time is, in part, reflected in the process of embryologic development. The nasopharynx in particular is a centrally located space bounded by components of the respiratory portion of the nasal cavity, cranial base, soft palate, and Eustachian tube. The development of these components can be understood both in terms of embryologic structures such as the branchial arches and paraxial mesoderm and through fossil evidence dating as far back as the earliest agnathan fish of the Cambrian Period. Understanding both the evolution and development of these structures has been an immeasurable benefit to the otolaryngologist seeking to model disease etiology of both common and rare conditions. This discussion is a primer for those who may be unfamiliar with the central importance of the nasopharynx both in terms of our evolutionary history and early embryological development of vital cranial and upper respiratory tract structures.
Topics: Animals; Biological Evolution; Branchial Region; Developmental Biology; Mesoderm; Nasopharynx; Skull
PubMed: 35665451
DOI: 10.1002/ar.24950 -
Current Allergy and Asthma Reports Dec 2012Acute otitis media (AOM) is a polymicrobial disease, which usually occurs as a complication of viral upper respiratory tract infection (URI). While respiratory viruses... (Review)
Review
Acute otitis media (AOM) is a polymicrobial disease, which usually occurs as a complication of viral upper respiratory tract infection (URI). While respiratory viruses alone may cause viral AOM, they increase the risk of bacterial middle ear infection and worsen clinical outcomes of bacterial AOM. URI viruses alter Eustachian tube (ET) function via decreased mucociliary action, altered mucus secretion and increased expression of inflammatory mediators among other mechanisms. Transient reduction in protective functions of the ET allows colonizing bacteria of the nasopharynx to ascend into the middle ear and cause AOM. Advances in research help us to better understand the host responses to viral URI, the mechanisms of viral-bacterial interactions in the nasopharynx and the development of AOM. In this review, we present current knowledge regarding viral-bacterial interactions in the pathogenesis and clinical course of AOM. We focus on the common respiratory viruses and their established role in AOM.
Topics: Acute Disease; Adenoviridae; Adult; Bacterial Vaccines; Child; Disease Progression; Eustachian Tube; Humans; Microbial Interactions; Nasopharynx; Orthomyxoviridae; Otitis Media; Respiratory Mucosa; Respiratory Syncytial Viruses; Respiratory Tract Infections; Rhinovirus
PubMed: 22968233
DOI: 10.1007/s11882-012-0303-2 -
Plastic and Reconstructive Surgery Jan 2018A number of textbooks, review articles, and case reports highlight the potential comorbidity of choanal atresia in craniosynostosis patients. However, the lack of a... (Review)
Review
A number of textbooks, review articles, and case reports highlight the potential comorbidity of choanal atresia in craniosynostosis patients. However, the lack of a precise definition of choanal atresia within the current craniosynostosis literature and widely varying methods of detection and diagnosis have produced uncertainty regarding the true coincidence of these conditions. The authors review the anatomy and embryologic basis of the human choanae, provide an overview of choanal atresia, and analyze the available literature that links choanal atresia and craniosynostosis. Review of over 50 case reports that describe patients diagnosed with both conditions reveals inconsistent descriptions of choanal atresia and limited use of definitive diagnostic methodologies. The authors further present preliminary analysis of three-dimensional medical head computed tomographic scans of children diagnosed with craniosynostosis syndromes (e.g., Apert, Pfeiffer, Muenke, and Crouzon) and typically developing children and, although finding no evidence of choanal atresia, report the potentially reduced nasal airway volumes in children diagnosed with Apert and Pfeiffer syndromes. A recent study of the Fgfr2c Crouzon/Pfeiffer syndrome mouse model similarly found a significant reduction in nasal airway volumes in littermates carrying this FGFR2 mutation relative to unaffected littermates, without detection of choanal atresia. The significant correlation between specific craniosynostosis syndromes and reduced nasal airway volume in mouse models for craniosynostosis and human pediatric patients indicates comorbidity of choanal and nasopharyngeal dysmorphologies and craniosynostosis conditions. Genetic, developmental, and epidemiologic sources of these interactions are areas particularly worthy of further research.
Topics: Abnormalities, Multiple; Animals; Choanal Atresia; Craniosynostoses; Genetic Markers; Humans; Mice; Mutation; Nasopharynx; Receptor, Fibroblast Growth Factor, Type 2; Syndrome
PubMed: 29280877
DOI: 10.1097/PRS.0000000000003928 -
The Journal of International Medical... Dec 2022Amyloidosis is a disease caused by amyloid deposition in tissues or organs. According to the extent of the lesion, it can be divided into systemic amyloidosis and...
Amyloidosis is a disease caused by amyloid deposition in tissues or organs. According to the extent of the lesion, it can be divided into systemic amyloidosis and localized amyloidosis. Amyloidosis originating in the larynx accounts for approximately 0.5% to 1.0% of benign lesions of the larynx; such lesions are relatively rare and mostly localized. Nasopharyngeal amyloidosis combined with laryngeal amyloidosis is even rarer. We herein present a case involving a patient with amyloidosis in the nasopharynx and larynx who presented with a foreign body sensation and hoarseness in the pharynx. Electronic fiber laryngoscopy revealed a smooth neoplasm in the left nasopharynx and left vocal cord. The patient underwent surgical treatment, and the postoperative pathologic examination results suggested amyloidosis. Special staining performed using Congo red and crystal violet was positive, confirming amyloidosis. The patient recovered after surgery, and no recurrence was present at the 3- and 6-month follow-ups.
Topics: Humans; Larynx; Amyloidosis; Laryngeal Diseases; Immunoglobulin Light-chain Amyloidosis; Nasopharynx
PubMed: 36539964
DOI: 10.1177/03000605221144151 -
International Journal of Molecular... Jul 2021Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as with the influenza virus, has been shown to spread more rapidly during winter. Severe coronavirus... (Review)
Review
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as with the influenza virus, has been shown to spread more rapidly during winter. Severe coronavirus disease 2019 (COVID-19), which can follow SARS-CoV-2 infection, disproportionately affects older persons and males as well as people living in temperate zone countries with a tropical ancestry. Recent evidence on the importance of adequately warming and humidifying (conditioning) inhaled air in the nasal cavity for reducing SARS-CoV-2 infectivity in the upper respiratory tract (URT) is discussed, with particular reference to: (i) the relevance of air-borne SARS-CoV-2 transmission, (ii) the nasal epithelium as the initial site of SARS-CoV-2 infection, (iii) the roles of type 1 and 3 interferons for preventing viral infection of URT epithelial cells, (iv) weaker innate immune responses to respiratory viral infections in URT epithelial cells at suboptimal temperature and humidity, and (v) early innate immune responses in the URT for limiting and eliminating SARS-CoV-2 infections. The available data are consistent with optimal nasal air conditioning reducing SARS-CoV-2 infectivity of the URT and, as a consequence, severe COVID-19. Further studies on SARS-CoV-2 infection rates and viral loads in the nasal cavity and nasopharynx in relation to inhaled air temperature, humidity, age, gender, and genetic background are needed in this context. Face masks used for reducing air-borne virus transmission can also promote better nasal air conditioning in cold weather. Masks can, thereby, minimise SARS-CoV-2 infectivity and are particularly relevant for protecting more vulnerable persons from severe COVID-19.
Topics: Age Factors; Air; COVID-19; Humans; Humidity; Inhalation; Nasopharynx; SARS-CoV-2; Sex Factors; Temperature
PubMed: 34360686
DOI: 10.3390/ijms22157919 -
Trends in Microbiology Mar 2013Streptococcus pneumoniae (the pneumococcus) is a common commensal inhabitant of the nasopharynx and a frequent etiologic agent in serious diseases such as pneumonia,... (Review)
Review
Streptococcus pneumoniae (the pneumococcus) is a common commensal inhabitant of the nasopharynx and a frequent etiologic agent in serious diseases such as pneumonia, otitis media, bacteremia, and meningitis. Multiple pneumococcal strains can colonize the nasopharynx, which is also home to many other bacterial species. Intraspecies and interspecies interactions influence pneumococcal carriage in important ways. Co-colonization by two or more pneumococcal strains has implications for vaccine serotype replacement, carriage detection, and pneumonia diagnostics. Interactions between the pneumococcus and other bacterial species alter carriage prevalence, modulate virulence, and affect biofilm formation. By examining these interactions, this review highlights how the bacterial ecosystem of the nasopharynx changes the nature and course of pneumococcal carriage.
Topics: Carrier State; Coinfection; Humans; Microbial Interactions; Nasopharynx; Pneumococcal Infections; Streptococcus pneumoniae
PubMed: 23273566
DOI: 10.1016/j.tim.2012.11.005 -
Ear, Nose, & Throat Journal Dec 2020Upper airway foreign body is one of the most encountered clinical situations in otolaryngology practice. In rare conditions, a living organism may be a foreign body in...
PURPOSE
Upper airway foreign body is one of the most encountered clinical situations in otolaryngology practice. In rare conditions, a living organism may be a foreign body in the upper airway. In this study, we demonstrate 19 patients with leech infestations in nose, nasopharynx, and larynx.
METHODS
This study was enrolled with 19 patients between 2012 and 2016 in a regional state hospital. All of the patients were admitted to clinic with these complaints: epistaxis, hemoptysis, coughing, foreign body sensation, and bloody stool.
RESULTS
There were 12 male and 7 female patients. The leech was in the nose in 12 patients, in nasopharynx in 6 patients, and in the larynx in only 1 patient. All leeches are removed under local anesthesia (except laryngeal presentation). No bleeding and complication were seen after extraction of leech.
CONCLUSION
Leech can be easily diagnosed and managed in the upper aero-digestive tract without any complication and leech-associated disease.
Topics: Adolescent; Adult; Airway Obstruction; Animals; Child; Child, Preschool; Female; Foreign Bodies; Humans; Larynx; Leeches; Male; Middle Aged; Nasopharynx; Nose; Retrospective Studies; Young Adult
PubMed: 31266401
DOI: 10.1177/0145561319860527 -
Pediatrics and Neonatology Oct 2013
Topics: Carrier State; Female; Humans; Male; Nasopharynx; Streptococcus pneumoniae
PubMed: 23856426
DOI: 10.1016/j.pedneo.2013.06.001