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At least 847 records · Page 47Linked to original sources

PubMed2005

Penetrating pharyngeal injuries in children: trivial trauma leading to devastating complications.

Pharyngeal perforations are uncommon in children and are usually secondary to instrumentation or external penetrating injuries. A delay in management can lead to life-threatening complications such as retropharyngeal abscess, mediastinitis, and airway compromise. We report three children who had pharyngeal perforation due to apparently innocuous injury and who developed serious complications. A high index of suspicion for a significant pharyngeal injury, use of lateral soft-tissue x-ray films of the neck, and flexible endoscopy in the emergency room can assist in early diagnosis when evaluating patients with oropharyngeal and penetrating neck injury. Prompt administration of broad-spectrum antibiotics, local drainage, and debridement can avert life-threatening complications.

Abscess↗

PubMed2003

An audit of pharyngeal pouch surgery using endoscopic stapling. The patient's viewpoint.

We report an audit designed to assess patient satisfaction resulting from pharyngeal pouch surgery using an endoscopic stapler. A personal series of 16 patients all operated on by the senior author over a 3-year period is reported. Information was gathered using a retrospective telephone questionnaire to establish pre- and postoperative symptoms, complications of surgery and patient satisfaction. This showed endoscopic pharyngeal pouch surgery to be successful in the majority of cases. Eighty-seven percent of patients felt better as a result of surgery. Seventy-five percent had no symptoms postoperatively. This series shows that surgery on pharyngeal pouches results in significant improvement in patient symptoms with minimal morbidity and mortality.

Adult↗

PubMed2004

An SXP/RAL-2 protein produced by the subventral pharyngeal glands in the plant parasitic root-knot nematode Meloidogyne incognita.

Meloidogyne incognita is a major parasite of numerous plant families, including many crop species. Upon infection of the plant root, it induces several multinucleate giant cells by the injection of pharyngeal gland secretions into the root cells. In order to obtain a better understanding of the nematode-plant interaction, characterization of the pharyngeal gland secretions is a necessity. By differential display, a nematode gene was identified that encodes a new member of the SXP/RAL-2 protein family. The gene is specifically expressed in the subventral pharyngeal glands and the protein is most likely secreted.

Amino Acid Sequence↗

PubMed2004

Common medical conditions in the elderly: impact on pharyngeal bolus transit.

Deglutition in the elderly may be impacted by the sequelae of medical diseases. It is unknown if the long-term presence of common medical diseases, such as arthritis and hypertension, leads to changes in neurologic and muscular function and thus swallowing ability. The aim of this project was to determine if the duration of bolus pharyngeal transit in nondysphagic elderly individuals with chronic medical problems is longer than that measured in nondysphagic elderly individuals without medical problems. Videofluoroscopic swallowing studies were performed on 63 elderly subjects with a variety of well-controlled medical problems and on 23 elderly subjects with no medical problems. The mean timing of pharyngeal bolus transit was compared between the two groups. The relationship between the presence of medical problems and the likelihood of transit times prolonged beyond two standard deviations of the mean transit time found in 60 younger normal controls was also analyzed. Findings included significantly prolonged pharyngeal transit time in the group of subjects with medical problems compared with those subjects without medical problems for a small bolus size. Those individuals with hypertension demonstrated the most significant delays in bolus transit. The presence of medical problems did correlate with an increased likelihood of prolonged transit times. This preliminary study indicates that medical problems common in elderly populations are associated with a deterioration of swallowing function and that changes identified in elderly individuals may not be due to aging alone.

Age Factors↗

PubMed2005

Temporal measurements of pharyngeal swallowing in normal populations.

The purpose of this investigation was to examine the temporal differences among three measures of pharyngeal stage transition in 40 normal subjects. The measures were (1) Pharyngeal Delay Time (PDT), (2) Stage Transition Duration (STD), and (3) Delayed Pharyngeal Swallow (DPS). Results showed a significant difference between younger and older subjects for PDT and STD but not for DPS. No gender differences were observed. These data on normal subjects will be used for comparisons with stroke patients in future research.

Adult↗

PubMed2002

Sudden onset pharyngeal pain associated with dissecting vertebral artery aneurysm.

BACKGROUND AND PURPOSE: We report a case of sudden onset pharyngeal pain due to dissection of the vertebral artery. CASE DESCRIPTION: A 65-year-old patient presented with sudden onset of unilateral pharyngeal pain, which was first, diagnosed as idiopathic glossopharyngeal neuralgia. Magnetic resonance image and cerebral angiography revealed a dissecting vertebral artery aneurysm. The anatomical site of the aneurysm may explain this complication. CONCLUSIONS: Sudden onset of pharyngeal pain, although rare, should be considered as a complication of dissection of the vertebral artery even though there are no other general or neurological symptoms.

Aged↗

PubMed2004

Rapid Detection and Diagnosis of Group A Streptococcal Pharyngitis.

This article reviews techniques of rapid testing and the effective diagnosis of streptococcal pharyngitis. Despite 50 years' study of streptococcal pharyngitis and 20 years' experience with rapid tests for its diagnosis, the subject continues to evolve. Rapid diagnostic tests have become more sensitive. Experts now consider not if but when they may replace throat cultures. Highly accurate rapid tests will still challenge clinicians to screen the right patients. The improvement of clinical diagnosis will require an understanding of the clinical spectrum of pharyngitis and questions relating to disease prevalence, test performance, and medical decision making. Implications for diagnostic strategies are discussed.

Journal Article↗

PubMed1992

Mimicking low amniotic pressure by chronic pharyngeal drainage does not impair lung development in fetal sheep.

OBJECTIVE: The etiology of oligohydramnios-related pulmonary hypoplasia is not understood but is known to involve chronic lung liquid loss. We tested the hypothesis that low amniotic pressure in oligohydramnios disturbs the normal tracheal-amniotic pressure gradient to increase lung liquid loss and impair lung development. STUDY DESIGN: Chronic pharyngeal catheterization with drainage to the exterior was used in 15 fetal sheep to mimic reduced amniotic pressure at the upper airway in the presence of normal amniotic fluid volume. RESULTS: Pharyngeal pressures relative to amniotic pressures were negative in all drained fetuses (mean +/- SE -3.0 +/- 0.6 mm Hg), in contrast to positive pressures in controls (0.7 +/- 0.1 mm Hg). There was no significant difference in lung weight or deoxyribonucleic acid relative to body weight, or in lung morphometry, between 10 fetuses drained for 10 to 21 days and their control cotwins. CONCLUSION: Mimicking low amniotic pressure in the upper airway by chronic fetal pharyngeal drainage does not impair lung development in fetal sheep.

Amniotic Fluid↗

PubMed1995

Phenotypic plasticity in the lower pharyngeal jaw dentition of Astatoreochromis alluaudi (Teleostei: Cichlidae).

The potentially molluscivorous cichlid fish Astatoreochromis alluaudi is known to exhibit a pronounced phenotypic plasticity in its pharyngeal jaw apparatus. Two phenotypes (wild-caught snail-eating specimens and specimens raised on soft food) were examined for differences in the number, size, shape, spacing and wear of functional teeth on the lower pharyngeal jaw. During growth, snail-eating specimens maintain tooth numbers but invest in teeth of a larger size (width and depth). In contrast, specimens fed a soft diet invest in more teeth, their size remaining unchanged except for the central, most posterior teeth. All changes in the dentition must be achieved through successive tooth generations. Serial microradiographs in the caudal area of the lower pharyngeal jaw, a region that is most significant in food processing, indicated that functional teeth in hard-food specimens more often show a successor below. This may be due to more time needed for larger replacement teeth to form and possibly to a shorter replacement cycle linked to the greater wear of the functional teeth. It is hypothesized that maintenance of tooth numbers and increase of tooth size in hard-food specimens is achieved by a one-for-one replacement and expansion of the tooth-bearing region and possibly by closer spacing of the teeth. Increase of tooth numbers in the soft-food specimens is probably achieved through the establishment of new tooth loci at the margins of the dentigerous area in addition to a one-for-one replacement.

Africa, Eastern↗

PubMed1976

A simple and rapid determination of the lecithin/sphingomyelin (LS) ratio in amniotic fluids and in pharyngeal aspirates of newborn infants.

A simple, rapid method for the routine determination of the lecithin/sphingomyelin (L/S) ratio in amniotic fluid and/or in pharyngeal aspirate of the newborn has been developed. In 33 samples of amniotic fluid at various gestational ages, an L/S ratio corresponding to the fetal age was found: in 16 samples of biochemically immature amniotic fluid (gestation age less than 34 weeks) the mean of the ratio was 1.26 and in 17 samples of mature amniotic fluid (gestation age greater than 35 weeks) the mean value was 3.02. Pharyngeal aspirates of 55 non-selected newborn were examined by the same method. The L/S ratio of 39 infants (gestation age greater than 38 weeks) gave a mean value of 7.3 and that of 16 premature infants (gestation age less than 37 weeks) a mean value of 5.5. In none of these cases did RDS develop after birth. The results suggest that the method is useful for the determination in both amniotic fluid and pharyngeal aspirate.

Amniotic Fluid↗

PubMed1992

Development and immunophenotyping of the pharyngeal tonsil (adenoid) in cattle.

Immunoperoxidase staining and electron and light microscopy were used to characterize the development of the pharyngeal tonsil in 98 cattle aged between 30 days of gestation and 12 years. The rugae of the pharyngeal tonsil were poorly formed before 95 days of gestation. Microvillous (M) cells associated with intra-epithelial leucocytes (lympho-epithelium) were scattered among ciliated and goblet cells covering most of the surface in post-natal animals. Intra-epithelial leucocytes were rare in fetuses, but ciliated and M cells could be distinguished. Leucocytes of the lamina propria started to accumulate at approximately 120 days of gestation. A loose accumulation of mononuclear cells progressed into a B-cell rich upper and T-cell rich lower layer, with typical lymphoid tissue organization in post-natal animals and lymphoid involution in aged cattle. Primary lymphoid follicles formed at 5 months of gestation, but germinal centres did not form until 2 to 4 weeks after birth. Except for null cells, the relative number of cells staining for each leucocyte phenotype or MHC class II antigen increased with age, especially during the neonatal period. The early development, strategic location and specialized structure of the pharyngeal tonsil suggest an important role in modulating inhaled antigens in cattle. Fetal and neonatal calves had minimal lymphoid tissue priming, as indicated by lack of secondary follicles, low MHC class II expression and few intra-epithelial leucocytes. The phenotypic differences may be relevant to the increased susceptibility of calves to infectious diseases shortly after birth.

Animals↗

PubMed1992

Bovine herpesvirus-1-induced pharyngeal tonsil lesions in neonatal and weanling calves.

The potential involvement of the pharyngeal tonsil in the pathogenesis of bovine herpesvirus-1 (BHV-1) infection was examined in neonatal and weanling calves infected by intranasal aerosol. Calves were monitored from days 1 to 5, and on day 6 (neonates) or 8 (weanlings) and, in a second trial at day 4.5, by histology, electron microscopy, immunocytochemistry and virus isolation. Mucosal lesions of neonates were similar to, but less extensive than, those of weanling calves. Loss of microvilli and goblet cells, with minimal epithelial erosions as early as day 1, progressed to necrosis of epithelium and adjacent lymphoid tissue, and leucocyte exudation. Lesions and clinical disease were progressive up to and including day 6 in neonates, but resolving in weanlings on days 5 and 8. By transmission electron microscopy, the physical characteristics of the phagocytic cells appeared similar in both age groups, and viral replication was not identified in leucocytes. Virus was isolated from, or found by immunocytochemistry in, the pharyngeal tonsil of all calves examined, except for two weanlings on days 1 and 8. Virus as detected by immunocytochemistry was restricted to epithelium and superficial lymphoid tissue in neonates, but was found in deep lymphoid tissue around germinal centres in weanlings. The study showed that the pharyngeal tonsil is readily infected with BHV-1 and may be an important lymphoid tissue for early anti-viral responses. The delayed inflammatory response and reduced viral clearance may contribute to the increased susceptibility of neonatal calves to fatal BHV-1 infections.

Animals↗

PubMed1987

Pharyngeal structure and function as a determinant of sleep-related breathing disorders: a unifying hypothesis.

We propose a hypothesis which relates the pathogenesis of various sleep-related breathing disorders such as snoring, obstructive sleep apnea, and central sleep apnea to pharyngeal structure and function, i.e. pharyngeal area and compliance; these easily measured mechanical properties of the pharynx reflect the complex integrated response of upper airway muscles to changes in neural drive. Our arguments, although hypothetical, are based on the already existing measurements of pharyngeal dynamics in patients with sleep-related breathing disorders. If confirmed, this hypothesis would allow to predict a particular breathing disorder occurring during sleep from simple mechanical measurements performed in an awake subject, and furthermore it would help us to understand the effect of recent therapeutic modalities used in treatment of sleep apnea.

Humans↗

PubMed2005

Relationship between the pharyngeal airway space and craniofacial morphology, taking into account head posture.

This study assessed the relationship between craniofacial characteristics and the size of the pharyngeal airway space (PAS), taking into account head posture. Sixty dental students 25-30 years of age (30 men and 30 women) were examined by lateral cephalometry. The data were corrected with the use of appropriate regression equations for the PAS. The PAS significantly correlated with hyoid position, maxillary and mandibular size, maxillary and mandibular prognathism, and mandibular inclination. A large, anteriorly positioned mandible was associated with a large PAS-TP (the most proximal distance between the posterior pharyngeal wall and the tongue base). Uvula length and PNS-Ba (the distance between the most posterior point of the hard palate and the most inferior point of the anterior foramen magnum) correlated with PAS-UP (the most proximal distance between the posterior pharyngeal wall and uvula). Our results suggest that the anteroposterior dimension of the PAS is substantially affected by the size of the enclosure surrounding the PAS, including the maxilla, mandible and soft palate.

Adult↗

PubMed2005

Long-term changes of hyoid bone position and pharyngeal airway size following mandibular setback by sagittal split ramus osteotomy.

INTRODUCTION: The purpose of this study was to determine long-term changes in hyoid bone position and pharyngeal airway size after mandibular setback osteotomies. MATERIAL AND METHODS: Serial cephalograms of 12 patients who underwent mandibular setback surgery were evaluated preoperatively, at 1 week, 6 months, and 14 months postoperatively, and finally after an average of 12 years. RESULTS: A mean setback of 5.6 mm was associated with a posterior and inferior movement of the hyoid bone. At long-term follow-up, the hyoid bone adapted horizontally to a position about 1.6 mm more posterior than its preoperative location. Immediately after surgery, the length of suprahyoid muscles correlated significantly with skeletal movements: suprahyoid muscles shortened by 4 mm but started lengthening after 1 year. Thereafter, it tended to correlate with the change of hyoid bone position rather than with skeletal relapse. Following the initial decrease after surgery, the size of the lower pharyngeal airway remained almost unchanged. The upper and middle pharyngeal airway sizes continued to decrease over the postoperative period of 12 years, and ultimately were smaller than their preoperative sizes by about 1.5 and 3 mm, respectively.

Adaptation, Physiological↗

PubMed2004

A peroxiredoxin specifically expressed in two types of pharyngeal neurons is required for normal growth and egg production in Caenorhabditis elegans.

A family of antioxidant proteins, the peroxiredoxins, serve two purposes, detoxification of reactive oxygen species and cellular signaling. Among the three peroxiredoxins of Caenorhabditis elegans (CePrx1-3), CePrx2 was found to have a very unusual expression pattern, restricted to only two types of pharyngeal neurons; namely, the single pharyngeal interneuron I4 and the sensory interneuron I2. CePrx1 and CePrx3-depleted worms showed no obvious phenotypic alterations, whereas worms devoid of CePrx2 were retarded developmentally and had a significantly reduced brood size. Other features, such as lifespan, pharyngeal activity or defecation rates were indistinguishable from those of wild-type worms. Recombinant CePrx2 revealed antioxidant activity, as it was able to detoxify hydrogen peroxide and butylhydroperoxide (t-BOOH), and to protect glutamine synthetase from inactivation by thiol-dependent metal-catalyzed oxidation. In addition, the molecule was able to act as a terminal peroxidase in the thioredoxin system. Expression of ceprx2 in C.elegans was induced after short-term exposure of worms to t-BOOH but survival of ceprx2 knockout mutants in the presence of reactive oxygen or nitrogen species was not impaired. Thus, CePrx2 may protect specifically the two types of neurons from oxidative damage or, more likely, plays a critical role in peroxide signaling in this nematode.

Animals↗

PubMed2006

Mechanical effects of genioglossus muscle stimulation on the pharyngeal airway by MRI in cats.

To examine the regional mechanical effects of selective genioglossus muscle activation on pharyngeal airway size and function, magnetic resonance images of the pharyngeal airway were obtained in five paralyzed, anesthetized cats over a range of positive and negative pressures in an isolated, sealed upper airway. When all results across pressure levels and pharyngeal regions were analyzed, genioglossus stimulation significantly increased the cross-sectional area (CSA) of the nasopharyngeal airway. Within specific regions, stimulation tended toward significantly increasing cross-sectional airway area in the mid-nasopharynx. Despite its dilating effect, genioglossus muscle stimulation did not alter compliance in the nasopharyngeal airway, as evidenced by the similar slopes of the pressure versus cross-sectional area relationships with and without stimulation. Finally, airway shape in the mid pharynx became more circular with either increased airway pressure or genioglossus stimulation. The results indicate that selective stimulation of the genioglossus muscle dilates the nasopharynx and provide evidence that stimulation of the genioglossus alone does not alter airway compliance.

Anatomy, Cross-Sectional↗

PubMed2006

Traumatic pseudoaneurysm of the pharyngeal artery: An unusual cause of hematemesis and hematochezia after craniofacial trauma.

BACKGROUND: Traumatic aneurysms of the internal maxillary artery are extremely rare. We report a case of traumatic pseudoaneurysm of the pharyngeal artery, a branch of the internal maxillary artery, presenting with hematemesis and hematochezia. CASE DESCRIPTION: An 18-year-old man presented with deep drowsy consciousness after a motor vehicle accident, in which he had a severe craniofacial injury. Three days later, he had hematemesis and hematochezia with a marked decrease in circulating hemoglobin level. External carotid arteriography performed to rule out vascular injury revealed active leakage from a false aneurysm of the pharyngeal artery. The lesion was successfully obliterated by superselective endovascular embolization. CONCLUSIONS: In patients with craniofacial injury associated with multiple traumas, traumatic pseudoaneurysm of the pharyngeal artery should be suspected as one of the possible causes of hematemesis and hematochezia. Selective endovascular embolization with cerebral angiography is an effective modality for the treatment and diagnosis of this lesion.

Accidents, Traffic↗