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Anesthesia and Analgesia for Donkeys, Mules and Foals
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
Tomas Williams, Michele Barletta
Endotracheal intubation can be more difficult in donkeys than in horses. The pharynx opens into the larynx with a greater angle, which tilts caudally. The pharyngeal recess is more developed than in horses. Full extension of the neck should help guide the endotracheal tube into the trachea (Figure 13.3).
Nasal Obstruction
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Tornwaldt's cyst Cystic transformation of pharyngeal recess midline of posterior nasopharyngeal wall.Inflammation can cause nasal obstruction, occipital pain, aural fullness, and discharge.Endoscopy is diagnostic, while CT/MRI is used to assess cervical vertebral adhesion.Rarely cause significant obstruction. Tornwaldt's cysts can be incised or excised, but need palatal approach for total clearance.
Tumours of the oral cavity and pharynx
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Kunwar S S Bhatia, Ann D King, Robert Hermans
The nasopharynx lies behind the nasal cavity and above the oropharynx, the soft palate forming the inferior wall. NPC is confined to the nasopharynx when it involves the roof (containing the centrally placed adenoid), posterior wall, and lateral walls, including the pharyngeal recesses, eustachian tube entrance, torus tubarius, and levator palatini muscle attached to the tube (Figure 1.17a and b). The pharyngeal recess is a common site for NPC (Figure 1.17a), and small tumours deep in the recess can be identified easily on MRI but may be undetectable on nasoendoscopy because of angulation of the recess and the fact that the walls of the recess are often collapsed.
Treatment of intractable epistaxis in patients with nasopharyngeal cancer
Published in Annals of Medicine, 2023
Xiaojing Yang, Hanru Ren, Minghua Li, Yueqi Zhu, Weitian Zhang, Jie Fu
Based on the anatomy of the nasopharynx, it can be concluded that the main arterial blood supply comes from the internal maxillary arteries. When the lesion in the pharyngeal recess is deep, it can invade the foramen lacerum and the ICA, resulting in uncontrolled carotid blowout, which can be harmful to patients. During DSA examination, internal maxillary angiography can reveal small blood vessels and a few bleeding points [39]. This may be due to the existence of the pharyngeal recess that is adjacent to the cervical segment of the ICA. Since the ICA extends to the skull via the foramen lacerum, rupture of its walls can lead to fatal bleeding. The pharyngeal recess and the areas outside the sphenoid sinus are considered the apical regions of the ICA. High-dose radiotherapy can cause blood vessels to become hard and fibrotic, with stage IV patients often experiencing skull-base bone destruction. Regeneration of tumor tissues and nasopharyngeal ulcers compresses the bone and surrounding tissues in the apical region of the ICA, which can cause the formation of a pseudoaneurysm (PSA) if the invaded ICA ruptures initially [40]. The rupture of PSA can cause nasopharyngeal hemorrhage due to increased blood pressure. In case of a major hemorrhage, temporary hemostasis may be observed clinically after the blood pressure drops. However, when the blood pressure returns to normal, blood volume recovery can lead to fatal hemorrhage. The apical vessels of the ICA are considered nasopharyngeal hemorrhage-prone areas after radiotherapy in patients with NPC [41]. Lesions in the pharyngeal recess area that invade the foramen lacerum and ICA often result in uncontrolled major bleeding. In addition, bleeding caused by PSA in the neck vessels after NPC radiotherapy can be fatal if left untreated or mistreated, accounting for approximately 1% of patients with significant bleeding.