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Upper airway bronchoscopic approach and diagnostic procedures
Published in Don Hayes, Kara D. Meister, Pediatric Bronchoscopy for Clinicians, 2023
At the oropharynx, the anatomy and dynamic configurations of the velum, retropalatal space, uvula, and lateral pharyngeal walls should be described. Size of the palatine tonsils and the degree (none, partial, complete) and pattern (circular, anterior-posterior, mixed, etc.) of collapse at the level of the tonsils is described. The tongue is evaluated for macroglossia, glossoptosis, or hypertrophy of the lingual tonsils.
Oropharynx
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Finally, incidental asymmetric tonsillar uptake on PET-CT scan is a regular referral to an ear, nose and throat clinic. Retrospective studies have suggested the risk of malignancy in the absence of clinical symptoms or if signs are low, and may be managed along the lines of an asymmetric palatine tonsil [17]. This of course excludes patients being investigated for carcinoma of unknown primary (CUP), in whom panendoscopy and bilateral tonsillectomy is recommended as first line.
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
The palatine tonsils (‘tonsils’) are a large collection of lymphoid tissue that project into the oropharynx from the tonsillar fossa, between the palatoglossal arch (in front) and the palatopharyngeal arch (behind). They are most prominent in early life and regress in later years as the lymphoid tissue atrophies. The surface marking is medial to the lower masseter. The palatine, lingual, pharyngeal (‘adenoids’), and tubal tonsils collectively form an interrupted circle of protective lymphoid tissue at the upper end of the respiratory and alimentary tracts known as Waldeyer’s ring. This area has a role in the priming of lymphocytes for antigens during the early years of life.
Forget-me-not: Lemierre’s syndrome, a case report
Published in Journal of American College Health, 2023
Benjamin Silverberg, Melinda J Sharon, Devan Makati, Mariah Mott, William D Rose
The great majority of cases follow infection of the palatine tonsils or peritonsillar tissue,16,17 and there may be an association with other bacterial and viral infections such as Strep throat and Epstein-Barr mononucleosis, though this has yet to be proved conclusively.7,11,16–18,23,28 Less than 2% of cases result from ear or dental infections (e.g., otitis media, sinusitis, mastoiditis, sialadenitis).13,20 These infections are thought to cause immunosuppression and disruption of mucosal barriers, spurning the gram-negative bacillus Fusobacterium necrophorum (an obligate anaerobe previously known as Bacillus fundiliformis) to become pathogenic.9,11,31 High-grade bacteremia and septic seeding of vital organs ensues.
Impact of tonsillectomy on COVID–19 pandemic: an observational study of the incidence and prognosis
Published in Acta Oto-Laryngologica, 2021
Ahmet Kara, Halil Elden, Engin Okur, Mahmut Sinan Yilmaz, Fuldem Mutlu, Mehmet Guven, Deniz Demir
Palatine tonsils, which are parts of the Waldeyer ring, have an important role in the formation of the first and rapid response of both B and T–cell–mediated immune system against microorganisms coming from the external environment due to its special location [1]. Following tonsillectomy, alterations in both humoral and cellular immunity may be observed, due to potential effect of tonsillectomy operation on immune response [2–4]. It was concluded that tonsillectomy didn’t affect the immunity especially in adults in most of the studies. Besides, there were some publications that showed the effect of tonsillectomy on immunosuppression [5]. Although it is the most common surgical procedure performed in childhood, a possible immunosuppression effect after tonsillectomy still poses suspicion for both some of families and ENT surgeons.
Transoral robotic surgery: a 4-year learning experience in a single Danish Cancer Centre
Published in Acta Oto-Laryngologica, 2020
Asher Lou Isenberg, Hani Ibrahim Channir, Christian von Buchwald, Niclas Rubek, Jeppe Friborg, Katalin Kiss, Birgitte Wittenborg Charabi
Since 2000, a continuous increase in the incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been documented in Denmark, which is attributed to the rising prevalence of human papillomavirus (HPV)-positive tumours [6,7]. HPV-positive OPSCC has distinct clinical and morphological characteristics [8]. They typically present as a small or occult primary tumour in the lingual or palatine tonsils and a large nodal metastasis in level II or III on the ipsilateral neck [9]. Patients with HPV-positive OPSCC are predominantly younger males [9] with a substantial better overall survival [10]. Traditionally, OPSCCs regardless of HPV status have been treated using radiation with intensity-modulated radiation therapy (IMRT) and concurrent chemo- and radiation therapy (CRT) for advanced stages. These treatments are associated with considerable short and long-term toxicity [11]. Since HPV-positive OPSCC comprise a younger patient group with a better prognosis this has led to an increasing interest in a de-escalated treatment approach as well as alternative treatment modalities. TORS is still considered an experimental approach in the primary treatment of head and neck cancer. Several ongoing phase II/III randomized clinical trials are currently accruing patients with OPSCC including ECOG 3311, EORTC-1420-HNCG-ROG and PATHOS.