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At least 199 records · Page 11Linked to original sources

PubMed2000

The endoderm plays an important role in patterning the segmented pharyngeal region in zebrafish (Danio rerio).

The development of the vertebrate head is a highly complex process involving tissues derived from all three germ layers. The endoderm forms pharyngeal pouches, the paraxial mesoderm gives rise to endothelia and muscles, and the neural crest cells, which originate from the embryonic midbrain and hindbrain, migrate ventrally to form cartilage, connective tissue, sensory neurons, and pigment cells. All three tissues form segmental structures: the hindbrain compartmentalizes into rhombomeres, the mesoderm into somitomeres, and the endoderm into serial gill slits. It is not known whether the different segmented tissues in the head develop by the same molecular mechanism or whether different pathways are employed. It is also possible that one tissue imposes segmentation on the others. Most recent studies have emphasized the importance of neural crest cells in patterning the head. Neural crest cells colonize the segmentally arranged arches according to their original position in the brain and convey positional information from the hindbrain into the periphery. During the screen for mutations that affect embryonic development of zebrafish, one mutant, called van gogh (vgo), in which segmentation of the pharyngeal region is absent, was isolated. In vgo, even though hindbrain segmentation is unaffected, the pharyngeal endoderm does not form reiterated pouches and surrounding mesoderm is not patterned correctly. Accordingly, migrating neural crest cells initially form distinct streams but fuse when they reach the arches. This failure to populate distinct pharyngeal arches is likely due to the lack of pharyngeal pouches. The results of our analysis suggest that the segmentation of the endoderm occurs without signaling from neural crest cells but that tissue interactions between the mesendoderm and the neural crest cells are required for the segmental appearance of the neural crest-derived cartilages in the pharyngeal arches. The lack of distinct patches of neural crest cells in the pharyngeal region is also seen in mutants of one-eyed pinhead and casanova, which are characterized by a lack of endoderm, as well as defects in mesodermal structures, providing evidence for the important role of the endoderm and mesoderm in governing head segmentation.

Animals↗

PubMed2006

Upper and lower pharyngeal airways in subjects with Class I and Class II malocclusions and different growth patterns.

INTRODUCTION: Associations of Class II malocclusions and vertical growth pattern with obstruction of the upper and lower pharyngeal airways and mouth breathing have been suggested. This implies that these malocclusion characteristics have a predisposing anatomical factor for these problems. Therefore, the purpose of this study was to compare upper and lower pharyngeal widths in patients with untreated Class I and Class II malocclusions and normal and vertical growth patterns. METHODS: The sample comprised 80 subjects divided into 2 groups: 40 Class I and 40 Class II, subdivided according to growth pattern into normal and vertical growers. The upper and lower pharyngeal airways were assessed according to McNamara's airways analysis. The intergroup comparison of the upper and lower airways was performed with 1-way ANOVA and the Tukey test as a second step. RESULTS: The results showed that the upper pharyngeal width in the subjects with Class I and Class II malocclusions and vertical growth patterns was statistically significantly narrower than in the normal growth-pattern groups. CONCLUSIONS: Subjects with Class I and Class II malocclusions and vertical growth patterns have significantly narrower upper pharyngeal airways than those with Class I and Class II malocclusions and normal growth patterns. However, malocclusion type does not influence upper pharyngeal airway width, and malocclusion type and growth pattern do not influence lower pharyngeal airway width.

Airway Obstruction↗

PubMed2006

Pharyngeal anesthesia during sedated EGDs: is "the spray" beneficial? A meta-analysis and systematic review.

BACKGROUND: Pharyngeal anesthesia is widely used as an adjunct to sedation during upper endoscopy. Methemoglobinemia and anaphylactic reactions are rare but serious complications of topical anesthetic agents. Individual studies produce variable results about the effectiveness of pharyngeal anesthesia in improving patient tolerance. OBJECTIVE: A systematic review was performed to evaluate the effectiveness of pharyngeal anesthesia in improving patient tolerance and ease of endoscopy during sedated upper endoscopy. DESIGN: A MEDLINE search, an EMBASE search, and manual searches were performed to identify pertinent English language articles. Randomized controlled trials (RCT) comparing the efficacy of pharyngeal anesthesia to placebo or no treatment were identified. Duplicate data extraction about patient tolerance of the procedure and endoscopist assessment regarding the ease of endoscopy was performed. RESULTS: From a pool of 53 studies, 5 RCTs evaluated a total of 491 patients and provided interpretable data. Patients who rated their discomfort during the sedated procedure as none/minimal were more likely to have received pharyngeal anesthesia (odds ratio [OR] 1.88, 95% confidence interval [CI] 1.13-3.12). Endoscopists were more likely to rate the procedure as "not difficult" for patients who received pharyngeal anesthesia (OR 2.60, 95% CI 1.63-4.17). LIMITATIONS: Lack of standardized outcome measurements and standardized sedation strategies led to heterogeneity in the patient-tolerance portion of the meta-analysis. CONCLUSIONS: Pharyngeal anesthesia before upper endoscopy improves ease of endoscopy and also improves patient tolerance.

Anesthesia, Local↗

PubMed2006

Sonic hedgehog in the pharyngeal endoderm controls arch pattern via regulation of Fgf8 in head ectoderm.

Fgf8 signalling is known to play an important role during patterning of the first pharyngeal arch, setting up the oral region of the head and then defining the rostral and proximal domains of the arch. The mechanisms that regulate the restricted expression of Fgf8 in the ectoderm of the developing first arch, however, are not well understood. It has become apparent that pharyngeal endoderm plays an important role in regulating craniofacial morphogenesis. Endoderm ablation in the developing chick embryo results in a loss of Fgf8 expression in presumptive first pharyngeal arch ectoderm. Shh is locally expressed in pharyngeal endoderm, adjacent to the Fgf8-expressing ectoderm, and is thus a candidate signal regulating ectodermal Fgf8 expression. We show that in cultured explants of presumptive first pharyngeal arch, loss of Shh signalling results in loss of Fgf8 expression, both at early stages before formation of the first arch, and during arch formation. Moreover, following removal of the endoderm, Shh protein can replace this tissue and restore Fgf8 expression. Overexpression of Shh in the non-oral ectoderm leads to an expansion of Fgf8, affecting the rostral-caudal axis of the developing first arch, and resulting in the formation of ectopic cartilage. Shh from the pharyngeal endoderm thus regulates Fgf8 in the ectoderm and the role of the endoderm in pharyngeal arch patterning may thus be indirectly mediated by the ectoderm.

Animals↗

PubMed2003

Acoustic reflectance of pharyngeal structures in children.

The aim of this study was to examine whether Eccovision Reflectance Pharyngometer could assess the anatomical structure of the upper airway in young children. Secondary aims were to assess changes in pharyngeal volume in children with tonsillar (Group A, n=13) and adenoidal hypertrophy (Group B, n=17) at pre- and post- surgical procedures, respectively and further compare them to children who underwent myringotomy (Control Group C, n=10). In all 40 children (aged 3-9 years, median 6 years) enrolled in this pilot prospective study, six recordings (equally dispersed at pre- and 3 month post- operation per subject) of the pharyngeal cavity along with demographic (age, gender), somatic (standing and sitting height, body weight, head and neck circumference) and anatomic (bimaxilliary and bregma) characteristics, were captured. No significant intra-subject variability was noted within the multiple measurements of the pharyngeal volume at pre- as well as post-incision (ANOVA, P>0.1) in all groups. However, in Group A there was a marked increase from pre- to post-pharyngeal volumes in males (P=0.007), which was not observed in females (P=0.13). In Group B pharyngeal volumes decreased from pre- to post- in both males (P=0.87) and females (P=0.34). On the contrary, in Group C there was no change in pharyngeal volumes. These findings contradicted the visual evaluation of the size of the removed tonsillar and/or adenoidal mass in the first two groups and thus suggested that Eccovision Pharyngometer does not reliably assess pharyngeal volumes in a pediatric population.

Adenoidectomy↗

PubMed2000

Assessment of the pharyngeal airway space after mandibular setback surgery.

PURPOSE: This retrospective study evaluated the change in pharyngeal airway space associated with surgical mandibular setback. PATIENTS AND METHODS: Lateral cephalograms of 14 adult patients taken preoperatively, immediately postoperatively, and at long-term follow-up were traced, and the width of the pharyngeal airway space and the pharyngeal airway space area were calculated and compared. RESULTS: At long-term follow-up, the mean amount of mandibular setback was 9.7 mm. The mean reduction in the distance from the tongue base to the posterior pharyngeal wall was 4.77 mm (28% decrease). The mean reduction in pharyngeal airway space area was 1.52 cm2, which corresponded to a 12.8% reduction. There was a strong correlation between the amount of mandibular setback and the decrease in pharyngeal airway space area. CONCLUSION: Mandibular setback surgery causes a long-term decrease in pharyngeal airway space area. In patients who have other risk factors, for example, overweight, short necks, or large tongues, a mandibular setback procedure could possibly predispose to the development of sleep apnea syndrome.

Adolescent↗

PubMed2003

Posterior pharyngeal wall position in the production of speech.

The posterior pharyngeal wall has been assumed to be stationary during speech. The present study examines this assumption in order to assess whether midsagittal widths in the pharyngeal region can be inferred from measurements of the anterior pharyngeal wall. Midsagittal magnetic resonance images and X-ray images were examined to determine whether the posterior pharyngeal wall from the upper oropharynx to the upper laryngopharynx shows anterior movement that can be attributed to variables in speech: vowel quality in both English and Japanese; vowels versus consonants as classes of speech sounds; sustained versus dynamically produced speech; and isolated words versus sentences. Measurements were made of the distance between the anterior portion of the vertebral body and the pharyngeal wall. The first measurement was on a line traversing the junction between the dens and the body of the second cervical vertebra (C2). The next three measurements were on lines at the inferior borders of the bodies of C2, C3, and C4. The measurements showed very little movement of the posterior pharyngeal wall, none of it attributable to speech variables. Therefore, the position of the posterior pharyngeal wall in this region can be eliminated as a variable, and the anterior portion of the pharynx alone can be used to estimate vocal cavities.

Adult↗

PubMed1998

[Acid esophago-pharyngeal reflux as etiology of hoarseness].

BACKGROUND: Gastroesophageal reflux has been implicated in otolaryngologic problems, particularly chronic hoarseness that cannot be attributed to other causes. PATIENTS AND METHODS: To study this relationship between gastroesophageal reflux and chronic hoarseness we used 24-h dual-site ambulatory pH-recordings in 68 patients with chronic hoarseness and laryngeal lesions suggestive of acid irritation. RESULTS: Thirty-eight patients (56%) had evidence of at least one esophago-pharyngeal reflux episode. The mean number of esophago-pharyngeal episodes was 6.7 +/- 12 within 24 hours (range: 1-34 episodes). The mean duration of these episodes was 201 +/- 28 seconds (range: 6 seconds-19.6 minutes). Most patients with esophago-pharyngeal reflux had no evidence of pathologic gastroesophageal reflux. Only 28.9% of the patients with esophago-pharyngeal reflux episodes also had pathologic gastroesophageal phageal reflux, whereas 23.3% of the patients without esophago-pharyngeal reflux had no gastroesophageal reflux disease. The esophago-pharyngeal reflux occurred mainly in the upright position. CONCLUSIONS: Occult esophago-pharyngeal reflux, predominantly in the upright position, appears to be common and severe in patients with chronic hoarseness. Gastroesophageal reflux may be an important factor in the pathogenesis of chronic hoarseness. The causative mechanisms are not clear.

Adult↗

PubMed1995

Interacting genes required for pharyngeal excitation by motor neuron MC in Caenorhabditis elegans.

We studied the control of pharyngeal excitation in Caenorhabditis elegans. By laser ablating subsets of the pharyngeal nervous system, we found that the MC neuron type is necessary and probably sufficient for rapid pharyngeal pumping. Electropharyngeograms showed that MC transmits excitatory postsynaptic potentials, suggesting that MC acts as a neurogenic pacemaker for pharyngeal pumping. Mutations in genes required for acetylcholine (ACh) release and an antagonist of the nicotinic ACh receptor (nAChR) reduced pumping rates, suggesting that a nAChR is required for MC transmission. To identify genes required for MC neurotransmission, we screened for mutations that cause slow pumping but no other defects. Mutations in two genes, eat-2 and eat-18, eliminated MC neurotransmission. A gain-of-function eat-18 mutation, ad820sd, and a putative loss-of-function eat-18 mutation, ad1110, both reduced the excitation of pharyngeal muscle in response to the nAChR agonists nicotine and carbachol, suggesting that eat-18 is required for the function of a pharyngeal nAChR. Fourteen recessive mutations in eat-2 fell into five complementation classes. We found allele-specific genetic interactions between eat-2 and eat-18 that correlated with complementation classes of eat-2. We propose that eat-18 and eat-2 function in a multisubunit protein complex involved in the function of a pharyngeal nAChR.

Animals↗

PubMed1996

Lateral pharyngeal fat pad pressure during breathing.

The purpose of this study was to test whether pressure in tissue lateral to the upper airway, the lateral pharyngeal fat pad, differs from atmospheric and pharyngeal pressure and whether it changes with breathing. We studied five male pigs by inserting a transducer-tipped catheter into their fat pad space using computed tomography (CT) scan guidance. We measured airflow with a pneumotachograph attached to a face mask and pharyngeal pressure with a balloon catheter. Fat pad pressure correlated positively with airflow and with pharyngeal pressure, decreasing during inspiration and increasing during expiration. Pressure in the fat pad differed from atmospheric pressure, generally exceeding it, and from pharyngeal pressure. We conclude that lateral pharyngeal fat pad pressure differs from atmospheric and pharyngeal pressure and that it changes with breathing.

Adipose Tissue↗

PubMedDate not supplied

Increase of IgA in pharyngeal washings from patients with IgA nephropathy.

The levels of IgA and total proteins in pharyngeal washings were examined in patients with IgA nephropathy and other glomerular diseases in order to determine whether secretory IgA, IgA1 and IgA2 were increased in these patients. Thirty patients with IgA nephropathy, 21 patients with other glomerular diseases and 15 healthy adults were examined. The levels of IgA were quantitated by radial immunodiffusion and laser nephelometry. The levels of total proteins in pharyngeal washings were quantitated by Tonein-TP. It was demonstrated that the levels of IgA in pharyngeal washings were significantly increased in patients with IgA nephropathy compared to those with other glomerular diseases and healthy adults. The levels of total proteins in pharyngeal washings were increased in patients with IgA nephropathy, and the ratio of IgA and total proteins in the washings from patients with IgA nephropathy was not significantly different from those healthy adults. There was a significant correlation between the levels of IgA in pharyngeal washings and those of IgA in sera from patients with IgA nephropathy. The IgA observed in pharyngeal washings contained secretory components, IgA1 and IgA2, in patients with IgA nephropathy. It is suggested that the increase of IgA in the pharyngeal washings in parallel with the increase of total proteins might be associated with local inflammation.

Humans↗

PubMed1996

Primary closure of pharyngeal remnant after total laryngectomy and partial pharyngectomy: how much residual mucosa is sufficient?

After total laryngectomy with or without partial pharyngectomy, the remaining pharyngeal defect can be repaired either by primary closure or with additional tissue, depending on the amount of pharyngeal tissue remnant available. The aim of this study was to determine the minimum width of the pharyngeal remnant that could be safely closed primarily without causing difficulty in swallowing. A total of 52 consecutive patients who underwent total laryngectomy were entered into the study. The relaxed and stretched widths of the pharyngeal remnant were measured after removal of the specimen. The widths of the pharyngeal mucosa ranged from 1.5 to 5.0 cm relaxed (mean, 3.24 cm) and from 2.5 to 8.0 cm stretched (mean, 4.83 cm). All neopharynx was reconstructed by closing the pharynx primarily. Seven of the 52 patients developed recurrent tumor with concomitant dysphagia. Two of the 45 patients without recurrence presented with acute dysphagia from food bolus obstruction, and 1 patient developed benign inflammatory stricture following an episode of fish-bone impaction. The narrowest widths of the pharyngeal remnant in this group of 45 were 1.5 cm relaxed and 2.5 cm stretched. As these patients do not have swallowing difficulty, we conclude that in the absence of tumor recurrence, this amount of residual pharyngeal tissue is sufficient both for primary closure of the pharynx and in restoring swallowing function.

Adult↗

PubMed1998

Pharyngeal acid reflux events in patients with vocal cord nodules.

OBJECTIVE: Gastroesophageal reflux has been implicated in the pathogenesis of vocal cord nodules. However, a cause-and-effect relationship has not been established. Because documentation of pharyngeal acid reflux events makes this correlation more plausible, the aim of the present study was to determine the frequency of pharyngeal acid reflux events in patients with vocal cord nodules. METHODS: Eleven patients with vocal cord nodules (mean age, 42 +/- 6 years) and eleven healthy volunteers (mean age, 45 +/- 6 years) were studied. Patients underwent barium esophagram and ambulatory 24-hour simultaneous three-site pharyngoesophageal pH monitoring. Controls only had ambulatory 24-hour simultaneous three-site pH monitoring. In the ambulatory pH monitoring studies, pH was recorded from the manometrically determined sites of pharynx (2 cm above upper esophageal sphincter), proximal esophagus (10 cm distal to pharyngeal site), and distal esophagus (5 cm above the lower esophageal sphincter). Pharyngeal acid reflux event was deemed acceptable if all three sites recorded a decrease in pH below 4 which was not related to meal or drinking. RESULTS: Pharyngeal acid reflux events occurred in seven of 11 patients with vocal cord nodules (1-4 episodes) and two of 11 controls (1-2 episodes) (P < .05). In both groups all pharyngeal acid reflux events occurred in upright position and were not associated with belching or coughing. Barium studies documented hiatal hernia in two patients and gastroesophageal reflux in five of 11 patients. However, none of the esophageal reflux events reached the pharynx on barium esophagram. CONCLUSIONS: Prevalence of pharyngeal acid reflux events is significantly higher in patients with vocal cord nodules compared with normal controls and suggests a contributory role for gastroesophagopharyngeal acid reflux in the pathogenesis of some vocal cord nodules.

Adolescent↗

PubMed2006

Function of a key morphological innovation: fusion of the cichlid pharyngeal jaw.

The pharyngeal jaw of cichlids may represent a key innovation that facilitated their unparalleled trophic divergence. In cichlids, 'fusion' of the lower pharyngeal jaw (LPJ) results from suturing between the two lower ceratobranchials. To examine, what novel abilities a more extensively fused pharyngeal jaw may confer, the function of LPJ suturing was examined in Heroine cichlids. Greater LPJ suturing, pharyngeal jaw splitting under compression and the forces used to crush molluscs in the wild suggest increased LPJ fusion in the trophically polymorphic Herichthys minckleyi operates to strengthen the pharyngeal jaw. Among Heroine cichlid species, the presence of an external LPJ suture and feeding specialization on molluscs was evolutionarily quite variable, but greater LPJ fusion estimated from the amount of external suturing was highly correlated with molluscivory. Throughout cichlid diversification, increased pharyngeal jaw fusion via suturing has likely helped to reinforce the LPJ during pharyngeal processing thereby facilitating the ability of cichlids to exploit durable prey.

Animals↗

PubMed1979

Pharyngeal colonisation by Neisseria gonorrhoeae and Neisseria meningitidis in black and white patients attending a venereal disease clinic.

Pharyngeal colonisation by Neisseria gonorrhoeae and Neisseria meningitidis was studies in 2000 patients attending a venereal disease clinic. Of these patients, 64% were white and 36% were black. The incidence of gonococcal infections was highest in the period from June to August. The incidence of genital or rectal infections or both was higher in the black patients. Pharyngeal colonisation by gonococci was present in 1.3% of the patients. There was no significant associations between pharyngeal colonisation and the pharyngeal symptoms, race, sex, or marital state of the patients. Pharyngeal colonisation was more frequent in patients with gonococcal infections at other sites. However, in 40.7% of the patients with pharyngeal colonisation, the pharynx was the only culture-positive site. There was no significant difference in the auxotypes or in the antibiotic susceptibility of the pharyngeal and the rectal-genital isolates except in the susceptibility to spectinomycin. Our findings do not indicate that gonococci isolated from the pharynx differ significantly from gonococci isolated from rectal or genital sites. It was notable that meningococcal colonisation of the pharynx was significantly more frequent in the white patients. This may be a genetically determined phenomenon.

Adult↗

PubMed2005

Quantification of pharyngeal patency in patients with sleep-disordered breathing.

Many techniques are available for the assessment of pharyngeal characteristics in sleep-disordered breathing (SDB). However, most of the reported techniques are invasive to some extent and/or hard to perform during sleep studies. The focus of this concept paper is on the forced oscillation technique (FOT) to quantify pharyngeal patency in patients with SDB. In a pilot study, the potential of FOT for non-invasive and continuous assessment of pharyngeal patency during different types of respiratory events was studied in 8 patients with an established diagnosis of a sleep apnea-hypopnea syndrome. During polysomnography, FOT was applied using a 5-Hz pressure oscillation signal. The respiratory impedance was determined and considered as a marker for pharyngeal patency. The results demonstrate that FOT allows detection of the complete pharyngeal occlusion during obstructive sleep apnea. In addition, we found that central sleep apnea can be associated with pharyngeal closure. We also demonstrated that during the flow-limited breath preceding obstructive apnea, almost complete upper airway closure can occur during either the expiratory or the inspiratory phase. FOT is a suitable method to assess pharyngeal patency continuously and non-invasively during sleep. Furthermore, this technique has the potential to contribute substantially to our knowledge of upper airway physiology in SDB.

Body Mass Index↗

PubMed1997

A fifth pharyngeal arch artery does not exist in rat.

The development of the caudal pharyngeal arch arteries was studied in perfused rat embryos in the interval of embryonic day 12 1/2 to embryonic day 13 3/4 using semithin serial sections and computer-aided 3-dimensional reconstructions. The fourth pharyngeal arch artery was already developed at embryonic day 12 1/2. The sixth developed from cystic enlarged vascular sprouts at embryonic day 13 1/4. A real fifth pharyngeal arch artery was not found between the fourth and sixth artery. Instead a vascular plexus was present at embryonic day 12 1/2 which was interposed between the epithelial sheets of the fourth pharyngeal pouch and the lower cervical sinus. At the onset of development this plexus arose ventrally and dorsally from the fourth pharyngeal arch artery only. Subsequent to the development of the sixth pharyngeal arch artery, vascular branches arose ventrally and dorsally from this artery, too. The plexus underwent incipient involution from embryonic day 13 1/4. It arose either from the fourth or the sixth pharyngeal arch artery only from embryonic day 13 3/4. It drained to the venous system. Branches of the plexus which ran towards the epithelial sheet of the lower cervical sinus became prominent.

Animals↗

PubMed1984

Lung volume dependence of pharyngeal cross-sectional area in patients with obstructive sleep apnea.

We examined the relationship between lung volume and pharyngeal cross-sectional area in 9 obese patients with obstructive sleep apnea and 10 age-matched, obese subjects without sleep apnea. Pharyngeal area was measured in the upright, seated posture using an acoustic reflection technique. Measurements were made at a rate of 5 per second during a slow exhalation from total lung capacity (TLC) to residual volume (RV). In the control subjects, the mean +/- SE pharyngeal area was 5.6 +/- 0.2 cm2 at TLC, and decreased by 30 +/- 5% over the vital capacity range to 3.9 +/- 0.3 cm2 at RV. In contrast to the control subjects, in patients with obstructive sleep apnea, pharyngeal area was 5.0 +/- 0.2 cm2 at TLC, and decreased by 54 +/- 6% over the vital capacity range to 2.3 +/- 0.3 cm2 at RV. The difference in pharyngeal area between the patients and control subjects was significant at all lung volumes below TLC, as was the difference in the magnitude of change in pharyngeal area with change in lung volume. The results indicate that in obese patients with obstructive sleep apnea, pharyngeal cross-sectional area is abnormally small, and varies considerably with changes in lung volume. The beneficial effects of weight reduction in such patients may relate to the coincident increase in functional residual capacity, causing an increase in upper airway size.

Adult↗