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Journal of Applied Physiology... Dec 2005The pathogenesis of obstructive sleep apnea (OSA) has been under investigation for over 25 years, during which a number of factors that contribute to upper airway (UA)... (Review)
Review
The pathogenesis of obstructive sleep apnea (OSA) has been under investigation for over 25 years, during which a number of factors that contribute to upper airway (UA) collapse during sleep have been identified. Structural/anatomic factors that constrict space for the soft tissues surrounding the pharynx and its lumen are crucial to the development of OSA in many patients. Enlargement of soft tissues enveloping the pharynx, including hypertrophied tonsils, adenoids, and tongue, is also an important factor predisposing to UA collapse, inasmuch as this can impinge on the pharyngeal lumen and narrow it during sleep. Other factors, including impairment of UA mechanoreceptor sensitivity and reflexes that maintain pharyngeal patency and respiratory control system instability, have also been identified as possible mechanisms facilitating UA instability. This suggests that OSA may be a heterogeneous disorder, rather than a single disease entity. Therefore, the extent to which various pathogenic factors contribute to the phenomenon of repetitive collapse of the UA during sleep probably varies from patient to patient. Further elucidation of specific pathogenic mechanisms in individuals with OSA may facilitate the development of new therapies that can be tailored to individual patient needs according to the underlying mechanism(s) of their disease.
Topics: Animals; Humans; Lung; Models, Biological; Pharyngeal Muscles; Pharynx; Pulmonary Ventilation; Sleep Apnea, Obstructive
PubMed: 16288102
DOI: 10.1152/japplphysiol.00772.2005 -
Comprehensive Physiology Jul 2012The importance of the upper airway (nose, pharynx, and larynx) in health and in the pathogenesis of sleep apnea, asthma, and other airway diseases, discussed elsewhere... (Review)
Review
The importance of the upper airway (nose, pharynx, and larynx) in health and in the pathogenesis of sleep apnea, asthma, and other airway diseases, discussed elsewhere in the Comprehensive Physiology series, prompts this review of the biomechanical properties and functional aspects of the upper airway. There is a literature based on anatomic or structural descriptions in static circumstances, albeit studied in limited numbers of individuals in both health and disease. As for dynamic features, the literature is limited to studies of pressure and flow through all or parts of the upper airway and to the effects of muscle activation on such features; however, the links between structure and function through airway size, shape, and compliance remain a topic that is completely open for investigation, particularly through analyses using concepts of fluid and structural mechanics. Throughout are included both historically seminal references, as well as those serving as signposts or updated reviews. This article should be considered a resource for concepts needed for the application of biomechanical models of upper airway physiology, applicable to understanding the pathophysiology of disease and anticipated results of treatment interventions.
Topics: Airway Resistance; Animals; Biomechanical Phenomena; Humans; Larynx; Nose; Pharynx; Respiratory Physiological Phenomena
PubMed: 23723026
DOI: 10.1002/cphy.c110053 -
Wiley Interdisciplinary Reviews.... 2014The Caenorhabditis elegans pharynx is a rhythmically pumping organ composed initially of 80 cells that, through fusions, amount to 62 cells in the adult worm. During the... (Review)
Review
The Caenorhabditis elegans pharynx is a rhythmically pumping organ composed initially of 80 cells that, through fusions, amount to 62 cells in the adult worm. During the first 100 min of development, most future pharyngeal cells are born and gather into a double-plate primordium surrounded by a basal lamina. All pharyngeal cells express the transcription factor PHA-4, of which the concentration increases throughout development, triggering a sequential activation of genes with promoters responding differentially to PHA-4 protein levels. The oblong-shaped pharyngeal primordium becomes polarized, many cells taking on wedge shapes with their narrow ends toward the center, hence forming an epithelial cyst. The primordium then elongates, and reorientations of the cells at the anterior and posterior ends form the mouth and pharyngeal-intestinal openings, respectively. The 20 pharyngeal neurons establish complex but reproducible trajectories using 'fishing line' and growth cone-driven mechanisms, and the gland cells also similarly develop their processes. The genetics behind many fate decisions and morphogenetic processes are being elucidated, and reveal the pharynx to be a fruitful model for developmental biologists.
Topics: Animals; Caenorhabditis elegans; Cell Differentiation; Gene Expression Regulation, Developmental; Pharynx
PubMed: 25262818
DOI: 10.1002/wdev.139 -
Frontiers in Cellular and Infection... 2019, or Group A Streptococcus (GAS), is a human-restricted pathogen most commonly found in the posterior oropharynx of the human host. The bacterium is responsible for 600... (Review)
Review
, or Group A Streptococcus (GAS), is a human-restricted pathogen most commonly found in the posterior oropharynx of the human host. The bacterium is responsible for 600 million annual cases of pharyngitis globally and has been found to asymptomatically colonize the pharynxes of 4-30% of the population. As such, many studies have utilized animals as models in order to decipher bacterial and host elements that contribute to the bacterial-pharyngeal interaction and determine differences between acute infection and asymptomatic colonization. The aim of this review is to first describe both bacterial and host factors that are important for the pharyngeal persistence of GAS in humans, then to detail the bacterial and host factors that are important for colonization in murine model, and finally to compare the two in order to evaluate the strength of murine pharyngeal colonization as a model for the human-GAS pharyngeal interaction.
Topics: Animals; Carrier State; Disease Models, Animal; Mice; Pharynx; Streptococcal Infections; Streptococcus pyogenes
PubMed: 31119108
DOI: 10.3389/fcimb.2019.00137 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Feb 2022The aim of this study is to explore the anatomy and surgical approach of retropharyngeal lymphadenectomy via endoscopic transoral approach. The retropharyngeal spaces...
The aim of this study is to explore the anatomy and surgical approach of retropharyngeal lymphadenectomy via endoscopic transoral approach. The retropharyngeal spaces were studied with three fresh frozen cadaver head (6 sides) in the anatomical laboratory of Eye, Ear, Nose and Throat Hospital of Fudan University through endoscopic transoral approach. The superior pharyngeal constrictor muscle, medial pterygoid muscle, tendon of tensor veli palatini muscle, fat of prestyloid space, ascending palatine artery and its branches, styloglossus, stylopharyngeus, stylohyoideus, external carotid artery, levator veli palatini, carotid sheath, ascending pharyngeal artery and longus capitis muscle were revealed in order. The above-mentioned structures were photographed with a 0° Karl Storz nasal endoscope and adjacent relationships were recorded. A case of metastatic retropharyngeal lymphadenopathy was reviewed and the surgical methods and techniques of retropharyngeal lymphadenectomy via endoscopic transoral approach were introduced in detail. The retropharyngeal space and related anatomical structures were exposed through endoscopic transoral approach in all specimens. The styloglossus, stylopharyngius and levator veli palatini are the markers of locating the internal carotid artery. The superior pharyngeal constrictor muscle, medial pterygoid muscle, styloid muscle group, longus capitis muscle and carotid sheath are the markers that can be used to locate the retropharyngeal lymph nodes. Ascending palatine artery, ascending pharyngeal artery and internal carotid artery are the main arteries involved in retropharyngeal lymphadenectomy via endoscopic transoral approach. Endoscopic transoral approach is a new surgical technique to perform retropharyngeal lymphadenectomy safely and completely.
Topics: Carotid Artery, Internal; Endoscopy; Humans; Lymph Node Excision; Pharyngeal Muscles; Pharynx
PubMed: 35172541
DOI: 10.13201/j.issn.2096-7993.2022.02.001 -
Dysphagia Feb 2017Determining intrabolus pressure (IBP) at the upper esophageal sphincter (UES) and in the esophagus has given compelling evidence that IBP can be a predictor for...
Determining intrabolus pressure (IBP) at the upper esophageal sphincter (UES) and in the esophagus has given compelling evidence that IBP can be a predictor for swallowing dysfunction. Studies have looked most superiorly at the low hypopharynx region but there has been no inquiry into what IBP measures throughout the entire pharynx can tell us. We present a study to describe the pressures within and surrounding the moving bolus throughout the pharynx and into the UES. Simultaneous high-resolution manometry (HRM) and videofluoroscopy were performed in ten healthy subjects swallowing ten 10 mL thin-liquid barium boluses. Three events surrounding bolus movement were tracked via videofluoroscopy, and two additional events were found using manometric measures. As the bolus passes through the pharynx, low pressure is created at and below the head of the bolus. A modest pressure increase is seen as the bolus passes through the pharynx, and finally, high pressure is observed at the bolus tail, followed by an even larger pressure generation of a clearance event. HRM allows for greater resolution in data collection in the pharynx and in this study, aided in identifying semi-unique characteristics around the hypopharynx and the UES which are consistent with the complex anatomy of the regions and the transition of the UES from active closure to relaxed opening. In the future, additional studies designed to look at aged and diseased populations may lead to better understanding of disease etiology, and treatment options.
Topics: Adult; Deglutition; Esophageal Sphincter, Upper; Female; Fluoroscopy; Healthy Volunteers; Humans; Male; Manometry; Middle Aged; Pharynx; Pressure; Young Adult
PubMed: 27565155
DOI: 10.1007/s00455-016-9743-5 -
Anesthesiology Feb 2013
Topics: Animals; Body Temperature; Brain; Humans; Pharynx
PubMed: 23340367
DOI: 10.1097/ALN.0b013e31827e3c53 -
WormBook : the Online Review of C.... Jan 2007The C. elegans foregut (pharynx) has emerged as a powerful system to study organ formation during embryogenesis. Here I review recent advances regarding cell-fate... (Review)
Review
The C. elegans foregut (pharynx) has emerged as a powerful system to study organ formation during embryogenesis. Here I review recent advances regarding cell-fate specification and epithelial morphogenesis during pharynx development. Maternally-supplied gene products function prior to gastrulation to establish pluripotent blastomeres. As gastrulation gets under way, pharyngeal precursors become committed to pharyngeal fate in a process that requires PHA-4/FoxA and the Tbox transcription factors TBX-2, TBX-35, TBX-37 and TBX-38. Subsequent waves of gene expression depend on the affinity of PHA-4 for its target promoters, coupled with combinatorial strategies such as feed-forward and positive-feedback loops. During later embryogenesis, pharyngeal precursors undergo reorganization and a mesenchymal-to-epithelial transition to form the linear gut tube. Surprisingly, epithelium formation does not depend on cadherins, catenins or integrins. Rather, the kinesin ZEN-4/MKLP1 and CYK-4/RhoGAP are critical to establish the apical domain during epithelial polarization. Finally, I discuss similarities and differences between the nematode pharynx and the vertebrate heart.
Topics: Animals; Caenorhabditis elegans; Caenorhabditis elegans Proteins; Cell Lineage; Epithelium; Humans; Models, Animal; Organogenesis; Pharynx; Trans-Activators; Transcription, Genetic
PubMed: 18050503
DOI: 10.1895/wormbook.1.129.1 -
Australian Journal of General Practice Oct 2018Patients with foreign bodies in their ear, nose or throat typically present to general practitioners. The safe and timely removal of foreign bodies ensures good patient... (Review)
Review
BACKGROUND
Patients with foreign bodies in their ear, nose or throat typically present to general practitioners. The safe and timely removal of foreign bodies ensures good patient outcomes and limits complications.
OBJECTIVES
The aim of this paper is to outline common foreign objects and review the associated anatomy that may make removal difficult. A description of instruments and indications for use is provided, along with circumstances where specialist referral is warranted.
DISCUSSION
The use of appropriate techniques for removal of foreign bodies reduces the complications of removal and associated distress, and limits the number of cases that require surgical input.
Topics: Ear; Foreign Bodies; Humans; Nose; Otorhinolaryngologic Diseases; Pharynx; Referral and Consultation; Therapeutic Irrigation
PubMed: 31195771
DOI: 10.31128/AJGP-02-18-4503 -
American Journal of Physiology.... Aug 2021Swallowing is a critical function for survival and development in human neonates and requires cross-system coordination between neurological, airway, and digestive... (Review)
Review
Swallowing is a critical function for survival and development in human neonates and requires cross-system coordination between neurological, airway, and digestive motility systems. Development of pharyngoesophageal motility is influenced by intra- and extrauterine development, pregnancy complications, and neonatal comorbidities. The primary role of these motility reflex mechanisms is to maintain aerodigestive homeostasis under basal and adaptive biological conditions including oral feeding, gastroesophageal reflux, and sleep. Failure may result in feeding difficulties, airway compromise, dysphagia, aspiration syndromes, and chronic eating difficulties requiring prolonged tube feeding. We review the integration of cross-systems physiology to describe the basis for physiological and pathophysiological neonatal aerodigestive functions.
Topics: Deglutition; Esophagus; Humans; Infant, Newborn; Pharynx; Reflex
PubMed: 34105355
DOI: 10.1152/ajpgi.00480.2020