China
Africa
Explore chapters and articles related to this topic
Head and Neck
Published in Adnan Darr, Karan Jolly, Jameel Muzaffar, ENT Vivas, 2023
Hannah Nieto, Theofano Tikka, Adnan Darr, Karan Jolly, Paul Pracy, Vinidh Paleri
Background: Reflux of stomach contents into larynx and pharynxMulti-factorial (with gastro-oesophageal reflux association)Can remain symptomatic despite optimal reflux therapyMucosal irritation secondary to pepsin, proteolytic enzymes, bacteria and bile salts Pepsin may damage extra-gastric tissues with a pH of up to 6, hence PPI therapy may not halt mucosal damageImplicated in: Subglottic stenosisVocal cord nodulesLaryngeal SCCMucosal ulcers
Oropharynx
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
The pharynx is divided into three parts: the nasopharynx, oropharynx, and hypopharynx. The oropharynx is bounded superiorly by the soft palate, inferiorly by the lingual surface of the epiglottis, anteriorly by the palatoglossal arches and vallate papillae of the tongue, and laterally by the pharyngoepiglottic folds. The section of posterior pharyngeal wall included in the oropharynx lies anterior to the vertebral bodies of C2/C3 and extends from a horizontal line drawn through the hard palate cranially to a horizontal line drawn through the hyoid bone caudally.
The spectrum of voice disorders – classification
Published in Stephanie Martin, Working with Voice Disorders, 2020
Irritation to the larynx may also be the result of acute or chronic inflammation, which may be secondary to upper respiratory infection or caused by allergy or the presence of irritants in the environment such as fumes, airborne particles or cigarette smoke. Laryngeal irritation may be caused by acid repeatedly refluxing from the stomach into the oesophagus alone, known as gastroesophageal reflux disease (GORD). However, if the stomach acid travels up the oesophagus and spills into the pharynx and larynx, even on occasion into the back of the nasal airway, leading to inflammation in areas not protected against gastric acid exposure, such as the vocal folds, it is known as laryngopharyngeal reflux (LPR). With LPR, you may not have the classic symptoms of GORD, such as a burning sensation in your lower chest (heartburn). That’s why it can be difficult to diagnose and why it is often called ‘silent reflux’. Both LPR and GORD are frequently described as the cause of laryngeal irritation and proton pump inhibitors (PPIs) prescribed to treat the GORD/LPR. Khidr et al. (2003) report significant reduction in hoarseness and throat clearing after two months of such treatment, which reinforces the view that if the root of the irritation is correctly diagnosed and treated, the problem may resolve spontaneously and relatively quickly. However, there still remains some ambivalence about the side effects of long-term PPI use (British Medical Journal, 2012; Ambizas and Etzel, 2017).
Targets for obstructive sleep apnea pharmacotherapy: principles, approaches, and emerging strategies
Published in Expert Opinion on Therapeutic Targets, 2023
The mechanical properties of the upper airspace have been well characterized [23–25] and only the key points relevant to this review focussing on therapeutic targets are identified here. Ultimately, the pharynx is the collapsible region of the upper airway situated between two non-collapsible regions above and below. Contraction of the diaphragm and other primary respiratory muscles creates the driving sub-atmospheric airway pressures necessary for airflow into the lungs (Figure 1). The resulting pressure gradient along the conducting airways from nose to lung includes sub-atmospheric airway pressures in the pharynx that constitute an airway narrowing force (PAirway, Figure 1). The positive pressure applied on the collapsible airway by the surrounding tissue also constitutes a closing force (PTissue, Figure 1). PTissue results from the tissue and bony structures that surround the airspace, with the tissues constrained within those bony structures and compartment (i.e. the mandible and spinal vertebrae).
Canned Fish Consumption and Upper Digestive Tract Cancers
Published in Nutrition and Cancer, 2023
Barbara D’Avanzo, Ilaria Ardoino, Eva Negri, Diego Serraino, Anna Crispo, Attilio Giacosa, Werner Garavello, Francesca Bravi, Federica Turati, Cristina Bosetti, Elena Fattore, Carlo La Vecchia, Carlotta Franchi
Results from the model in strata according to socio-demographic factors (sex, age and years of education), lifestyle habits (smoking and alcohol drinking) and fresh fish consumption in cancer of the oral cavity and pharynx and of the stomach are shown in Table 3. The findings were consistent with the overall results. However, an appreciable effect modification was found for stomach cancer according to smoking habits (p-value for heterogeneity = 0.038), where current smokers showed a significant reduction in cancer risk (OR = 0.22, 95% CI: 0.09–0.52). Borderline significant heterogeneity was also found for cancer of the oral cavity and pharynx across strata of alcohol consumption (p-value = 0.09), with a significant risk reduction of about 40% among subjects with lower alcohol intake. The association of canned fish with cancers of oral cavity and pharynx and stomach was confirmed also in strata of people who consumed one or more portions of fresh fish per week, in the absence of significant heterogeneity across strata.
Botulinum toxin A injection using ultrasound combined with balloon guidance for the treatment of cricopharyngeal dysphagia: analysis of 21 cases
Published in Scandinavian Journal of Gastroenterology, 2022
Lielie Zhu, Jiajun Chen, Xiangzhi Shao, Xinyu Pu, Jinyihui Zheng, Jiacheng Zhang, Xinming Wu, Dengchong Wu
As part of the upper oesophageal sphincter (UES), normally, the cricopharyngeal muscle maintains tension and contraction during breathing, preventing air from entering the oesophagus and protecting the airway from retrograde reflux from the stomach [1–3]. During swallowing, food is pushed from the mouth to the pharynx under the contraction of masticatory muscles, tongue muscles and pharyngeal muscles; then, the hyoid–laryngeal complex moves upwards and forwards, and the cricopharyngeal muscle relaxes physiologically to allow food to pass through [38]. This swallowing motor sequence is regulated by the medulla oblongata swallowing central pattern generator (CPG) [39]. Brain lesions of many causes, especially brainstem stroke, could damage this regulatory mechanism, which then cannot distribute the swallowing impulse to the relevant motor nucleus, resulting in cricopharyngeal muscle achalasia [38,39]. Therefore, patients with stroke were selected as the participants in this study, which has important clinical significance because of its high incidence and the high incidence of cricopharyngeal muscle achalasia after stroke [5–7,23]. In addition, with good administration, stroke can reach a relatively stable clinical state compared with other progressive neurogenic or neuromuscular diseases, which might hinder patients from gaining permanent therapeutic effects.