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Rhinolaryngoscopy for the Allergist
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Jerald W Koepke, William K Dolen
The torus tubarius is located on the lateral wall of the nasopharynx, defining and protecting the Eustachian tube orifice (Fig. 11.5). Rosenmueller’s fossa is a vertical cleft, a potential space, between the posterior lip of the torus tubarius and the adenoidal pad. Many of the insidious malignancies of the pharynx have their origin in this space. The adenoid or pharyngeal tonsil, is a primary lymph node of first line defense for inflammation involving the upper airway.
Imaging in head and neck surgery
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
The anterior margin is demarcated by the posterior choanae. The posterior wall contains the adenoids as part of Waldeyer's lymphatic ring. This regresses with age. Posterolaterally, the pharyngeal recesses, also known as the fossa of Rosenmuller, can be a difficult region for clinical evaluation due to obscuration by the cartilaginous torus tubarius. However, this area can be readily reviewed by radiological cross-sectional evaluation. Anterolateral to the torus tubarius will be the opening of the Eustachian tube. Laterally are the veli palatini muscles, which are important demarcators for staging of nasopharyngeal tumours.
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The internal aspect of the pharynx is shown in Plates 3.36 and 3.37. The nasopharynx lies posterior to the nasal cavity, and specifically to the choana, which is the transition region from the nasal cavity to the nasopharynx. The choanae of the two sides are separated by the posterior end of the nasal septum (Plate 3.38). The nasopharynx includes the opening of the pharyngotympanic tube (auditory tube or Eustachian tube, connecting the nasopharynx to the tympanic cavity, also called the middle ear cavity), the torus tubarius (cartilage of the auditory tube that is covered by mucosa), the salpingopalatine fold (mucous membrane containing the levator veli palatini muscle), the salpingopharyngeal fold (mucous membrane containing the salpingopharyngeal muscle), the pharyngeal recess, and the pharyngeal tonsil (adenoid), that is located in the mucous membrane of this recess.
Tubarial gland involvement in IgG4-related diseases
Published in Acta Oto-Laryngologica, 2022
Kenichi Takano, Makoto Kurose, Ryuta Kamekura, Masatoshi Kanda, Motohisa Yamamoto, Hiroki Takahashi
Valstar et al. found a collection of salivary glands overlying the torus tubarius, at both macroscopic and microscopic levels, and identified these glands as TGs [1]. A cohort of patients with head and neck cancer, who received radiation treatment, was observed to assess the clinical relevance of TGs. They described that the TGs were associated with xerostomia and dysphagia after radiation therapy [1]. Although studies have described the collections of minor salivary glands around the Eustachian tube nasopharyngeal orifice [9], these glands have not been interpreted as localised and organised macroscopic glandular structures, similar to the major salivary glands [10]. In contrast, Li W et al. proposed that the TGs are better classified as minor salivary glands because the TGs, in comparison to the SMGs, have only one layer of glandular tissue underneath the mucous membrane of the torus tubarius and lack main ducts such as Wharton’s duct [11]. In addition, the term ‘tubarial gland’ would be appropriate because of its location [11]. The salivary glands are one of the most frequently affected organs in patients with IgG4-RD [5,6]. Specifically, patients with IgG4-RD present with (1) elevated serum IgG4 levels, (2) dense lymphoplasmacytic infiltration and fibrosis of affected organs, and (3) enlargement of the affected organs [5,6]. The clinical findings of the patients’ TGs in this study are consistent with these characteristics.
Efficacy of balloon Eustachian tuboplasty on the quality of life in children with Eustachian tube dysfunction
Published in Acta Oto-Laryngologica, 2020
The BET procedure was preferred as the first-line treatment for otitis media with effusion in children. The BET procedure was performed under general anesthesia using endoscopic visualization of the nasopharynx. Before surgery, adenoidectomy procedures were performed in all patients. In most pediatric patients, adenoid tissue pushes the torus tubarius laterally or closes its orifis. Therefore, exposition of the torus tubarius is increased with adenoidectomy and a safer surgery can be performed. After the nasal cavity was decongested with xylometazoline, via its applicator system (Spiggle & Theiss, Germany), the balloon catheter was transnasally inserted into the nasopharyngeal ostium of the ET using a 2.5 mm/0° or 45° endoscope. Next, a saline solution was injected into balloon at a pressure of 10 bar for 2 min, thereby causing the balloon to inflate. Two minutes later, the process was repeated while the catheter was inserted via the nasal passage using a 0° endoscope.
Impact of nasal conditions on chronic otitis media: a cross-sectional study in Koreans
Published in Acta Oto-Laryngologica, 2018
Kyung Wook Heo, Min Jae Kim, Jun Ho Lee
Given this background, we hypothesized that pathological nasal conditions may affect these pathological processes. Infected nasal drainage from chronic sinusitis could run posteriorly through the torus tubarius. Additionally, hypertrophied nasal mucosa and septal deviation (SD) could affect nasal airflow. The degree of inferior turbinate hypertrophy affects the nasal flow velocity. However, the exact pathological change that affected developing of middle ear pathologies has not been evaluated.