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Objective: Persistent buccopharyngeal membrane (PBM) is a rare anomaly associated with failure of ecto-endodermal resorption of the buccopharyngeal membrane on the 26th day of intrauterine life. The current literature has insufficient information about PBM. Design: Systematic Review. Patients, Participants: Online electronic databases such as PubMed-MEDLINE, Embase, and Scopus were searched using appropriate keywords from the earliest available data until 30th August 2022, with no language restriction. Additional sources such as Google Scholar, major journals, gray literature, conference proceedings, and cross-referencing were also explored. Main Outcome Measures: The present systematic review evaluated and analysed the data available on PBM along with its treatment options and clinicopathological findings, prevalence, and prognosis of the patient. Results: Thirty-four publications with 37 reported cases were included in this systematic review. The majority of patients had dyspnea (n = 18), followed by dysphagia (n = 10). Approximately 16 patients suffering from PBM reported orofacial abnormalities. Seventeen patients reported complete PBM, and 18 patients had partial PBM. The treatment modality followed by most patients (n = 15) was surgical excision of the membrane, along with stent placement in four patients. Oropharyngeal reconstruction was performed in four cases. The overall prognosis and survival rate of this rare condition is good. Conclusion: This review suggests that PBM is poorly understood, and the diagnosis of partial PBM is confirmed only when the patient complains of difficulty in breathing or eating. In-depth analysis and follow-up of the reported cases should be performed to diagnose the disease early so that clinicians can provide adequate treatment to the patients. [ABSTRACT FROM AUTHOR]

Objective: Accidental pharyngeal fishbone ingestion is a common complaint in ear, nose, and throat clinics. Approximately two-thirds of the accidentally ingested fishbones can be removed using tongue depressors and indirect laryngoscopy. However, the remaining third is challenging to identify and remove using these methods. These difficult fishbones require identification and removal via more advanced approaches. Video-guided laryngoscope is used to deal with difficult fishbones in our center. This study aimed to explore the risk factors for difficult fishbones. Methods: A prospective study was performed at a teaching hospital on 2080 patients. Univariate and multivariate analyses were performed to identify the risk factors. Results: The common fishbone locations were the tonsils (39.8%; defined as STEP-I), tongue base (37.1%), vallecula (13.3%; STEP-II), and hypopharynx (9.8%; STEP-III). With increasing STEP level, the ratio of difficult fishbones correspondingly increased (Z = 13.919, P <.001), and the proportions were 21.1%, 41.9%, and 70% in STEP-I, II, and III, respectively. In particular, fishbones in STEP-III (vs STEP-I) had a higher risk of difficult fishbones (odds ratio [OR]: 11.573, 95% CI: 7.987-16.769). Complaints of neck pain (yes vs no), foreign body sensation (yes vs no), and shorter length of fishbones always had a lower risk of difficult fishbones (OR: 0.455, 95% CI: 0.367-0.564; OR: 0.284, 95% CI: 0.191-0.422; OR: 0.727, 95% CI: 0.622-0.85). Missing teeth (yes vs no), swallowing behavior after fishbone ingestion (yes vs no), and male patients (vs female) had a higher risk of difficult fishbones (OR: 1.9, 95% CI: 1.47-2.456; OR: 1.631, 95% CI: 1.293-2.059; OR: 1.278, 95% CI: 1.047-1.56). Conclusions: Neck pain, foreign body sensation, fishbone length, patient age and sex, tooth status, and swallowing behavior after fishbone ingestion are independent risk factors for difficult fishbones. [ABSTRACT FROM AUTHOR]

The nasopharyngeal disease is common in felines. Nasopharyngeal stenosis is uncommonly a congenital problem, with most cases being secondary to other diseases. An 8-month-old male neutered domestic shorthair presented with a chief complaint of chronic nasal congestion, open-mouth breathing, and discharge. CT was performed, and palatal dysgenesis resulting in complete nasopharyngeal obstruction, secondary nasopharyngitis, and rostral nasal turbinate lysis were found. This was confirmed by an endoscopic evaluation of the nasopharynx region, which demonstrated a lack of connection between the nasopharynx and oropharynx. This is the first CT report documenting congenital palate dysgenesis resulting in complete obstruction of the nasopharynx., (© 2024 American College of Veterinary Radiology.)

Objective: Persistent buccopharyngeal membrane (PBM) is a rare anomaly associated with failure of ecto-endodermal resorption of the buccopharyngeal membrane on the 26 th day of intrauterine life. The current literature has insufficient information about PBM., Design: Systematic Review., Patients, Participants: Online electronic databases such as PubMed-MEDLINE, Embase, and Scopus were searched using appropriate keywords from the earliest available data until 30 th August 2022, with no language restriction. Additional sources such as Google Scholar, major journals, gray literature, conference proceedings, and cross-referencing were also explored., Main Outcome Measures: The present systematic review evaluated and analysed the data available on PBM along with its treatment options and clinicopathological findings, prevalence, and prognosis of the patient., Results: Thirty-four publications with 37 reported cases were included in this systematic review. The majority of patients had dyspnea (n = 18), followed by dysphagia (n = 10). Approximately 16 patients suffering from PBM reported orofacial abnormalities. Seventeen patients reported complete PBM, and 18 patients had partial PBM. The treatment modality followed by most patients (n = 15) was surgical excision of the membrane, along with stent placement in four patients. Oropharyngeal reconstruction was performed in four cases. The overall prognosis and survival rate of this rare condition is good., Conclusion: This review suggests that PBM is poorly understood, and the diagnosis of partial PBM is confirmed only when the patient complains of difficulty in breathing or eating. In-depth analysis and follow-up of the reported cases should be performed to diagnose the disease early so that clinicians can provide adequate treatment to the patients., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective(s): Previous literature has established a high prevalence of upper airway obstruction in children with craniofacial abnormalities. This study aims to perform quantitative airway volume measurements in patients with craniofacial abnormalities and compare them to age and sex-matched controls., Methods: We performed a retrospective review of the records of all children with craniofacial abnormalities who underwent head-and-neck computed tomography (CT) imaging at a single tertiary-care center between 1/1/13 and 12/31/20 using the ICD-10 codes Q75.1, Q75.4, and Q87.0. These patients were then matched by age and sex to patients with isolated craniosynostosis (Q75.0). CT scans were imported into Dolphin Imaging software, and airway volumes were measured for the nasal cavity, nasopharynx, oropharynx, and hypopharynx. The primary outcome was the total airway volume, defined as the sum of these measurements., Results: Thirty subjects with craniofacial syndromes were matched to 30 patients with isolated craniosynostosis (controls). In both groups, 18 subjects (60%) were male (p = 0.99). The average ages for syndromic patients and controls were 12.1 and 12.9 months, respectively (p = 0.84). On average, the total airway volumes of syndromic patients were 25% lower than those of controls (p = 0.02). Syndromic patients had 39% smaller nasal cavity volumes (p < 0.001) and 32% smaller nasopharyngeal volumes (p < 0.01). Significant volume differences were not observed for the oropharynx or hypopharynx., Conclusion: We present a unique technique to measure airway volumes in patients with craniofacial abnormalities. These findings will help practitioners to further understand the anatomy and pathophysiology of disturbed breathing in children with craniofacial syndromes., Level of Evidence: III Laryngoscope, 134:2915-2921, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)

Background: Hairy polyps are the most common congenital deformity of the oral-nasopharynx/oral cavity in infants, which may lead to severe complications in the newborns. However, few studies have been published with respect to their radiological features, and most are case reports. Objective: This study aimed to analyze radiological features of the oral‑nasopharyngeal hairy polyps and to identify the radiological features with the highest diagnostic value. Materials and methods: From 2014 to 2019, pediatric cases pathologically diagnosed as hairy polyps and having received radiological examination at the Children's Hospital Affiliated to Zhejiang University were retrospectively analyzed. Radiological evaluations were conducted on tumor size, location, morphology, density or signal features as well as the enhancement pattern. Results: A total of six infants were recruited. Clinical features observed in these cases included choking on milk with cyanosis, intermittent dyspnea, oropharyngeal mass, and snoring. Lesions were derived from the left tubal torus in three out of six cases, from the left lateral aspect of soft palate in one, from the left lateral pharyngeal wall in one, and from the right tubal torus in one. They were shown as pedicled polyp-like well-circumscribed mass with fat density or signal as well as a stalk on CT or MRI. In the contrast-enhanced scan, the fat components were not enhanced, while the stalk was mildly enhanced. Conclusion: Hairy polyps had typical radiological features. Hairy polyps should be considered for pedicled polyp-like well-circumscribed mass in the oral-nasopharynx of infants with fat density or signal as well as a stalk. [ABSTRACT FROM AUTHOR]

Background: Pharyngeal arch anomalies are the second most common form of head and neck congenital defect. The second arch anomalies are the most common, and compromise 95% of cases. Little is known about the 3rd and 4th arch anomalies as they are extremely rare. They most commonly present in childhood with sudden severe left lateral neck infection and abscess formation with considerable tendency to recur, contributing to significant mortality and morbidity in those patients. Case presentation: Here we present four cases finally diagnosed as third or fourth pharyngeal arch anomalies, with more than 20 years of follow-up following their definitive surgery. The possibility that they are thymopharyngeal duct remnants is discussed. Conclusion: Meticulous open radical surgical excision of all involved paralaryngeal, parapharyngeal and thyroid tissue, with preservation of the superior and recurrent laryngeal nerves, is required for cure of recurrent cases. [ABSTRACT FROM AUTHOR]

In the speech of many Hebrew speakers, the distinction between the voiceless pharyngeal fricative /ħ/ and its non-pharyngeal counterpart is neutralized, with the non-pharyngeal production becoming increasingly common. Although this is a well-studied phenomenon, little attention has been given so far to the possibility of meaningful variation in the non-pharyngeal forms. In this paper I demonstrate that the non-pharyngeal dorsal variant is not always a fricative, but rather, is often realized as a trill. Using data from sociolinguistic interviews conducted in two field sites in Israel, I show that the rate of trilling varies among speakers, and is sensitive to both social and linguistic factors. A key finding is that speakers who do not produce pharyngeals are more likely to produce the trill variant, but only in one of the two communities studied, in which the loss of the pharyngeals is considerably more advanced. While retention of the pharyngeals is strongly associated with Mizrahi (Middle Eastern and North African) descent, variation in trill rates interacts with ethnicity in complex ways, which shed light on the social and linguistic dynamics underlying the spread of the non-pharyngeal forms. [ABSTRACT FROM AUTHOR]

Purpose: The field lacks consensus about preferred metrics for capturing pharyngeal residue on videofluoroscopy. We explored four different methods, namely, the visuoperceptual Eisenhuber scale and three pixel-based methods: (a) residue area divided by vallecular or pyriform sinus spatial housing ("%-Full"), (b) the Normalized Residue Ratio Scale, and (c) residue area divided by a cervical spine scalar (%(C2-4²). Method: This study involved retrospective analysis of an existing data set of videofluoroscopies performed in 305 adults referred on the basis of suspected dysphagia, who swallowed 15 boluses each (six thin and three each of mildly, moderately, and extremely thick 20% w/v barium). The rest frame at the end of the initial swallow of each bolus was identified. Duplicate measures of pharyngeal residue were made independently by trained raters; interrater reliability was calculated prior to discrepancy resolution. Frequency distributions and descriptive statistics were calculated for all measures. Kendall's tb tests explored associations between Eisenhuber scale scores and pixel-based measures, that is, %-Full and %(C2-4)². Cross-tabulations compared Eisenhuber scale scores to 25% increments of the %-Full measure. Spearman rank correlations evaluated relationships between the %-Full and %(C2-4)²measures. Results: Complete data were available for 3,545 boluses: 37% displayed pharyngeal residue (thin, 36%; mildly thick, 41%; moderately thick, 35%; extremely thick, 34%). Eisenhuber scale scores showed modest positive associations with pixel-based measures but inaccurately estimated residue severity when compared to %-Full measures with errors in 20.6% of vallecular ratings and 14.2% of pyriform sinus ratings. Strong correlations (p < .001) were seen between the %-Full and %(C2-4)² measures, but the %-Full measures showed inflation when spatial housing area was small. Conclusions: Generally good correspondence was seen across different methods of measuring pharyngeal residue. Pixel-based measurement using an anatomical reference scalar, for example, (C2-4)² is recommended for valid, reliable, and precise measurement. [ABSTRACT FROM AUTHOR]

The integration of distinct sensory modalities is essential for behavioural decision making. In Caenorhabditis elegans, this process is coordinated by neural circuits that integrate sensory cues from the environment to generate an appropriate behaviour at the appropriate output muscles. Food is a multimodal cue that impacts the microcircuits to modulate feeding and foraging drivers at the level of the pharyngeal and body wall muscle, respectively. When food triggers an upregulation in pharyngeal pumping, it allows the effective ingestion of food. Here, we show that a C. elegans mutant in the single gene orthologous to human neuroligins, nlg-1, is defective in food-induced pumping. This was not due to an inability to sense food, as nlg-1 mutants were not defective in chemotaxis towards bacteria. In addition, we found that neuroligin is widely expressed in the nervous system, including AIY, ADE, ALA, URX and HSN neurons. Interestingly, despite the deficit in pharyngeal pumping, neuroligin was not expressed within the pharyngeal neuromuscular network, which suggests an extrapharyngeal regulation of this circuit. We resolved electrophysiologically the neuroligin contribution to the pharyngeal circuit by mimicking food-dependent pumping and found that the nlg-1 phenotype is similar to mutants impaired in GABAergic and/or glutamatergic signalling. We suggest that neuroligin organizes extrapharyngeal circuits that regulate the pharynx. These observations based on the molecular and cellular determinants of feeding are consistent with the emerging role of neuroligin in discretely impacting functional circuits underpinning complex behaviours. [ABSTRACT FROM AUTHOR]

Background: Parapharyngeal space abscesses (PPSA) are deep-space neck infections that are associated with significant morbidity and, rarely, mortality if not promptly diagnosed and treated. The diagnosis is often difficult, as the clinical presentation can mimic peritonsillar abscesses (PTA). Transoral point-of-care ultrasound (POCUS) may be a useful tool to help distinguish PTAs from other deep-space infections such as PPSAs.Case Report: A woman presented to the Emergency Department (ED) with fever, sore throat, trismus, and unilateral tonsillar swelling from a walk-in clinic with a preliminary diagnosis of PTA for drainage. A POCUS performed by the emergency medicine resident in the ED demonstrated normal tonsils. However, it revealed evidence of a PPSA. A computed tomography scan was performed, which confirmed the diagnosis. The patient was admitted to the otolaryngology service for antibiotics and steroids, with subsequent improvement and discharge home. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: In this case, the use of POCUS in the ED avoided an unnecessary invasive procedure, and facilitated the correct diagnosis of an uncommon condition. [ABSTRACT FROM AUTHOR]

Background: Reconstruction of the clivus and posterior cranial base defects following endoscopic skull‐base surgery can be particularly challenging. Commonly, defects in this region are repaired with pedicled mucoperichondrial flaps from the sinonasal cavity. Complex and large defects often require regional or free flaps, particularly when intranasal flaps have been exhausted. While there are no primary barriers to routing flaps into the clivus or nasopharynx in large open approaches, secondary surgical corridors are necessary during endoscopic cases for routing of free flaps. Routing of free‐flap pedicles for endoscopic cranial base reconstruction has been described through secondary surgical corridors created through the maxillary sinus and infratemporal fossa. Here we describe the technique of a more direct pedicle route to the clivus through the retropharyngeal space. Methods: A patient with frank cerebrospinal fluid (CSF) rhinorrhea and extensive osteoradionecrosis of the clivus and craniocervical junction presented for treatment. Due to the size and location of the defect and previous exhaustion of candidate mucoperichondrial flaps, free‐flap reconstruction was performed. A radial forearm free flap was tunneled through the prevertebral space into the nasopharynx and clivus and inserted with endoscopic‐assisted techniques. The flap pedicle coursed through the retropharyngeal space to the neck vessels where arterial and venous anastomosis was established. Results: The CSF leak and clival defect were successfully repaired with this technique. Postoperative imaging demonstrated appropriate positioning of the flap as well as the location of the free‐flap pedicle and anastomosis. Endoscopic evaluation at 6 months showed complete resurfacing of the previously exposed cranial base. In cadaveric dissection in 3 adult specimens, the pedicle length necessary to reach the inferior clivus and craniocervical junction from the closest recipient pedicle through a retropharyngeal route was an average of 6.5 cm vs an average of 16 cm through the transmaxillary approach. Conclusion: The retropharyngeal space offers a direct route for tunneling free flaps for the repair of large clival defects during endoscopic skull‐base surgery. Several advantages include a less circuitous pedicle route, mucosalization of the fascial flap, avoidance of midfacial degloving, and avoidance of potential disruption of the maxillary sinus. [ABSTRACT FROM AUTHOR]

Rehabilitation of the glossectomy patient is one of the most difficult and challenging problems for the prosthodontist and speech pathologist. The tongue plays an important role in articulation, control of secretions, formation of a bolus, propulsion of the bolus toward the pharynx, clearing the palate, and initiation of the swallow reflex. This paper presents speech and prosthodontic considerations for a patient who underwent a glossectomy and had the additional problem of reduced oral opening. [ABSTRACT FROM AUTHOR]

The article presents a discussion on the condition of congenital facial paralysis, associated with palato-pharyngeal insufficiency. Three patients who have palato pharyngeal insufficiency are discussed, for an understanding of the Möbius syndrome. The first patient was diagnosed with the syndrome and is reported to have a similar record in his family. The second patient, is a 12-year-old patient of the first patient with a typical mask-like appearance and an inability to make bilabial sounds. The third patient is a 21-year-old female, referred to, for the treatment of velo-pharyngeal insufficiency.

Iatrogenic injuries to the upper gastrointestinal tract in neonates are rare but may lead to significant morbidity and mortality if undiagnosed. The clinical presentation of such injuries is usually nonspecific and symptoms may be overlooked, particularly in sick preterm neonates. Therefore, it is important to recognize the findings on plain chest radiographs obtained regularly in neonatal intensive care units (NICUs) on intubated patients. The purpose of this pictorial essay is to describe the imaging findings of various iatrogenic injuries to the pharynx and esophagus in the neonatal period in a cohort of seven cases. [ABSTRACT FROM AUTHOR]

Globus is a non-painful sensation of a lump or a foreign body in the throat, and it frequently improves with eating. Although globus is a common symptom, only little is known about the etiology, and the causes have remained controversial. Previously, globus was labelled as a hysterical symptom. However, nowadays, the research has been mainly focused on somatic causes and it is suspected that the etiology is complex. Because of the unclear etiology, the diagnostics and treatment are varying, predisposing patients to possible unnecessary investigations. This review presents the current literature of globus: its etiology, diagnostics, and treatment. In addition, a special aim is to discuss the rational investigation methods in globus diagnostics and present a diagnostic algorithm based on recent researches. [ABSTRACT FROM AUTHOR]

Craniofacial development is a complex progression that necessitates the assimilation of numerous dedicated embryological processes. This review provides an integration of the genetic underpinnings, craniofacial development, and clinical features related to deficiencies of the first and second pharyngeal arches. A focus on Pierre Robin Sequence (PRS) is presented. Review of the literature included searches of Medline, PubMed, Google Scholar, and online sources using search terms related to craniofacial development, specific gene patterns, neural crest development, and pharyngeal arch malformations. Associated terms in craniofacial biology, craniofacial physiology, and syndromic conditions were also used. This review serves as an introduction to current research regarding the genetic basis of craniofacial development and its relationship to pharyngeal arch development and PRS. Given the substantial influence of genetics in the development of the pharyngeal arches, craniofacial anomalies can frequently be traced to embryological deviations within these structures. Interruption in the embryological processes secondary to chromosomal abnormalities, genetic disorders, teratogenic effects, or mechanical factors can result in the mandibular deficits and subsequent lingual, airway, and palatal issues observed in pharyngeal arch malformations. [ABSTRACT FROM AUTHOR]

This article discusses the extraesophageal manifestations of gastroesophageal reflux disease, focusing primarily on the gamut of pharyngeal abnormalities that can be detected on barium swallows. Abnormalities of pharyngeal swallowing caused by gastroesophageal reflux are illustrated. We particularly emphasize how pharyngoesophageal relationships can guide the radiologist for performing tailored barium swallows to optimally evaluate pharyngeal abnormalities in patients with underlying gastroesophageal reflux disease. [ABSTRACT FROM AUTHOR]

Introduction: The tongue flap is a surgical option to stop oroantral communication (OAC). Observation: An OAC secondary to a palatal cystic adenoid carcinoma was treated with a tongue flap. The intervention consisted of creating a pedicle flap to close the gap, which was then used to close the communication 3 weeks after the first procedure. Discussion: The tongue flap allows for the closure of the relatively large OAC, it has the advantage of being reliable and easy to perform; however, its main disadvantage is the need for two separate surgical interventions. Between the two procedures, the patient's diet must be exclusively mixed. [ABSTRACT FROM AUTHOR]

Abstract: Polymorphic populations are often considered as intermediate stages of speciation. Bluegill sunfish (Lepomis macrochirus) from Lake Waban, Wellesley, MA have diverged into two ecomorphs based on their diet, occupied habitat and morphology. Littoral bluegills are generalist feeders that consume a variety of aquatic invertebrates. Pelagic bluegills feed primarily on Daphnia. We aimed to understand if suction pressure generation, prey capture behaviors and pharyngeal jaw morphology differed between the littoral and pelagic ecomorphs feeding on three prey types. Littoral and pelagic bluegills showed similar feeding kinematics and peak pressure, however, significant differences were observed among prey types within an ecomorph. Feeding events on brine shrimp were slower and accompanied by less negative pressure for both ecomorphs. Littoral bluegills varied their use of ram among prey types, however, pelagic bluegills (zooplankton specialists) did not. Similar to previous studies, when presented with different prey items both dietary generalists and specialists varied equally in most aspects of their feeding behaviors. However, pelagic bluegills (dietary specialists) did not vary in their approach behaviors. Despite the lack of differences in trophic morphology among the individuals sampled here, the prey approach behaviors of dietary specialists appears to be fixed in pelagic bluegills. This result deemphasizes the importance of suction during feeding and places more importance on prey approach behaviors. [ABSTRACT FROM AUTHOR]

Objectives: To compare the outcomes of endoscopic repair of bilateral congenital choanal atresia using a flap technique without stenting versus endoscopic repair using stenting without a flap. Methods: A prospective randomised controlled study was conducted, comprising 72 patients with bilateral congenital choanal atresia. The patients were randomised into two groups. Group A (42 patients) underwent endoscopic repair using a mirrored L-shaped flap without stenting, and group B (30 patients) underwent endoscopic repair using stenting without a flap. Results: At a mean follow-up period of 18.2 months, endoscopic assessment revealed a patent posterior choana in 81 per cent and 83.33 per cent of patients in group A and group B respectively. Choanal stenosis occurred in 21.40 per cent and 33.33 per cent of patients in group A and group B respectively. Granulation tissue was observed in 28.6 per cent and 53.3 per cent of patients in group A and group B respectively. Conclusion: The endoscopic approach utilising a flap without stenting is safe and effective, with a high success rate. [ABSTRACT FROM AUTHOR]

The present study demonstrates the scale-eating behavior of a siluroid catfish, Pachypterus khavalchor , and the role of its oral structure and bacterial endosymbionts in shaping this lepidophagous habit. Scale-eating behavior in P. khavalchor was studied using a series of behavioral experiments. P. khavalchor was found to feed only on the scales of live fish and never of dead fish, even after 72 h of starvation. It was nocturnal in habit and attacked all species that were used as prey. Attacking behavior showed extensive chasing of prey species followed by a powerful random strike at the flank or close to the caudal region in posterior oblique position. After a strike, P. khavalchor was found to immediately turn back and pick up the falling dislodged scales. SEM analysis of oral structures of P. khavalchor revealed three different types of teeth arranged in specific order on the upper jaw, lower jaw and pharyngeal region that could facilitate their lepidophagous habit. Teeth of upper and lower jaws are likely to help in dislodging the scales and pharyngeal teeth may help to engulf the scales. Gut microflora analysis and enzyme assay revealed two isolates, namely Bacillus pumilus and Bacillus licheniformis , which were positive for chitinase production. These two isolates were found to be capable of producing chitinase indicating that they are likely to be involved in the digestion of chitin-rich scales in the host fish gut. An in vitro scale degradation assay further strengthens the results since both isolates were found to be efficient in chitinase production and degradation of scales. [ABSTRACT FROM AUTHOR]

Branchial apparatus anomalies usually manifest in teenage or early adult life. Infection complicates second branchial pouch anomalies usually presented as a neck lump or discharging sinus. It is the most common form of anomalies compared to another branchial pouch aberrant. However, it is extremely rare to find a complete branchial fistula with both internal and external openings. Misdiagnosis usually occurs leading to inappropriate and suboptimal treatment. Here, we report of a case of complete second branchial pouch fistula and discuss the clinical presentation and surgical management of such lesion. [ABSTRACT FROM AUTHOR]

Tornwaldt (Thornwaldt) or nasopharyngeal cyst is a cyst occurred at the connection site of pharyngeal endoderm and notochord remnant, usually located in the midline postero-superior wall of nasopharynx. Nasopharynx's obstruction, recurrent infection or trauma may exacerbate mucous secretion by the potential space lining. Although rare and is usually symptomless, it is not uncommon for the patients to have some nasal, ear, cervical or oral symptoms. We report a case of Tornwaldt cyst with rare associated dental symptoms. The patient's initial presentations were dry mouth, cheek biting, post nasal drip and few nasal symptoms including frequent snoring, sleep apnoea, mouth breathing, sneezing, sore throat and itchiness. These symptoms were tremendously and immediately relieved once the cyst was surgically removed. [ABSTRACT FROM AUTHOR]

The genetic basis of earlobe attachment has been a matter of debate since the early 20 th century, such that geneticists argue both for and against polygenic inheritance. Recent genetic studies have identified a few loci associated with the trait, but large-scale analyses are still lacking. Here, we performed a genome-wide association study of lobe attachment in a multiethnic sample of 74,660 individuals from four cohorts (three with the trait scored by an expert rater and one with the trait self-reported). Meta-analysis of the three expert-rater-scored cohorts revealed six associated loci harboring numerous candidate genes, including EDAR , SP5 , MRPS22 , ADGRG6 ( GPR126 ), KIAA1217 , and PAX9 . The large self-reported 23andMe cohort recapitulated each of these six loci. Moreover, meta-analysis across all four cohorts revealed a total of 49 significant (p < 5 × 10 −8 ) loci. Annotation and enrichment analyses of these 49 loci showed strong evidence of genes involved in ear development and syndromes with auricular phenotypes. RNA sequencing data from both human fetal ear and mouse second branchial arch tissue confirmed that genes located among associated loci showed evidence of expression. These results provide strong evidence for the polygenic nature of earlobe attachment and offer insights into the biological basis of normal and abnormal ear development. [ABSTRACT FROM AUTHOR]

Recently, there has been increased interest in chronotypes and clinical differences between them. However, there is limited information about the potential influence of the chronotypes on clinical manifestations and symptom intensity of somatic diseases. The aim of this study is to evaluate the impact of biological rhythm differences and sleep quality on benign paroxysmal positional vertigo (BPPV) and larengo pharyngeal reflux (LPR) severity. Forty-four LPR patients, 43 BBPV patients and 42 controls were included in the study. The morningness–eveningness questionnaire was used to determine chronotypes, and the Pittsburgh Sleep Quality Index was used to assess subjective sleep quality. Both patient groups reported a significantly greater tendency to eveningness diurnal preferences compared to healthy controls. As with the circadian preferences, patients with BPPV or LPR characterized by poorer sleep quality and worse insomnia than non-patient individuals. It can be concluded that the circadian rhythm and sleep quality are related to the severity of LPR and BPPV. [ABSTRACT FROM PUBLISHER]

Patients A 53-year-old institutionalized male patient with a history of postoperative bilateral hypoglossal nerve injury was admitted for treatment of dysphagia. He experienced dysphagia involving oral cavity-to-pharynx bolus transportation because of restricted tongue movement and was treated with a palatal augmentation prosthesis (PAP), which resulted in improved bolus transportation, pharyngeal swallowing pressure, and clearance of oral and pharyngeal residue. The mean pharyngeal swallowing pressure at tongue base with the PAP (145.5 ± 7.5 mmHg) was significantly greater than that observed immediately after removal of the PAP (118.3 ± 10.1 mmHg; p < 0.05; independent t-test). Dysphagia rehabilitation with the PAP was continued. Approximately 1 month after PAP application, the patient could orally consume three meals, with the exception of foods particularly difficult to swallow. Discussion The supporting contact between the tongue and palate enabled by the PAP resulted in improvement of bolus transportation, which is the most important effect of a PAP. The increase in pharyngeal swallowing pressure at the tongue base because of PAP-enabled tongue–palate contact might play an important role in this improvement. Since a PAP augments the volume of the palate, it enables easy contact between the tongue and palate, resulting in the formation of an anchor point for tongue movement during swallowing. Thus, application of a PAP increases the tongue force, especially that of the basal tongue. Conclusion A palatal augmentation prosthesis helps improve pharyngeal swallowing pressure at the basal tongue region and might contribute to the decrease of oral as well as pharyngeal residue. [ABSTRACT FROM AUTHOR]

Importance Oesophageal inlet stenosis can promote dysphagia and aspiration. We report the cases of syndromic children with congenital pharyngeal webs successfully treated with endoscopic CO2 laser. Observations Pharyngeal webs were excised with CO2 laser (Ultrapulse mode) and resurfaced using mucosal advancement flaps to avoid restenosis and/or formation of secondary synechia. This led to a significant enlargement of the oesophageal inlet, which was documented immediately postoperatively and the clinical improvement of dysphagia and decreased aspiration persisted at distant follow-up. Conclusion and relevance Pharyngeal webs are congenital anomalies that can be safely and effectively corrected with endoscopic treatment. [ABSTRACT FROM AUTHOR]

Background: Mandibular setback osteotomies potentially lead to narrowing of the pharyngeal airways, subsequently resulting in post-surgical obstructive sleep apnea (OSA). Objective: To summarize current evidence from systematic reviews that has evaluated pharyngeal airway changes after mandibular setback with or without concomitant upper jaw osteotomies. Methodology: PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched with no restriction of language or date. Systematic reviews studying changes in pharyngeal airway dimensions and respiratory parameters after mandibular setback with or without concomitant upper jaw osteotomies have been identified, screened for eligibility, included and analyzed in this study. Results: Six systematic reviews have been included. While isolated mandibular setback osteotomies result in reduced oropharyngeal airway dimensions, the reduction is lesser in cases with concomitant upper jaw osteotomies. Only scarce evidence exists currently to what happens to naso- and hypo-pharyngeal airways. There is no evidence for post-surgical OSA, even though some studies reported reduced respiratory parameters after single-jaw mandibular setback with or without concomitant upper jaw osteotomies. Conclusion: Although mandibular setback osteotomies reduce pharyngeal airway dimensions, evidence confirming post-surgical OSA was not found. Nevertheless, potential post-surgical OSA should be taken into serious consideration during the treatment planning of particular orthognathic cases. As moderate evidence exists that double-jaw surgeries lead to less compromised post-surgical pharyngeal airways, they should be considered as the method of choice especially in cases with severe dentoskeletal Class III deformity. Study registration: PROSPERO (registration number: ). [ABSTRACT FROM AUTHOR]

Background: Upper airway analysis is an often-cited use of cone beam computed tomography (CBCT) imaging in orthodontics. However, the reliability of this process in a clinical setting is largely unknown. Objective: Our objective was to systematically review the literature to evaluate the reliability of upper pharyngeal airway assessment using dental CBCT. Search methods: MEDLINE, EMBASE, Web of Science, and Google Scholar were searched through June 2015. Selection criteria: Human studies that measured reliability of upper airway assessment in patients using CBCT as part of the study protocol were considered. Data collection and analysis: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was followed. Data were collected on overall study characteristics and measurements, CBCT unit and machine settings used, and examination characteristics of the included studies. Methodological quality of the included studies was evaluated. Results: Forty-two studies were evaluated, representing the CBCT scans of 956 patients. Studies included a wide variety of patients and CBCT machines with various scan settings. Only five studies were deemed high quality. The available evidence indicates that under specific restricted conditions there is moderate to excellent intra- and inter-examiner reliability. Airway volume demonstrated greater intra- and inter-examiner reliability than did minimum cross-sectional area. However, significant methodological limitations of the current literature, most importantly a lack of manual orientation of the images and selection of threshold sensitivity in study protocols, suggest that reliability has not been adequately established. Conclusions: The current literature reports moderate to excellent reliability, with airway volume having higher reliability than minimum cross-sectional area. However, only limited aspects of the process of airway analysis have been evaluated, indicating that further research is required to adequately establish the reliability of upper pharyngeal airway assessment of patients using dental CBCT. Registration: None. [ABSTRACT FROM AUTHOR]

Objective: To correlate the pharyngeal airway subregions with the positioning of the hyoid bone. Material and Methods: The study examined 107 lateral cephalometric (LC) and cone beam computed tomography (CBCT) images. Linear and volumetric measurements of the pharyngeal subregions were made and correlated to linear measurements using hyoid triangle analysis on images of LC and multiplanar (MPR) and three-dimensional (3D) reconstructions of CBCT. Results: There was significant correlation between linear measurements of the pharyngeal subregions and hyoid bone position in LC images and in MPR and 3D reconstructions of the CBCT. Correlations were more frequent in the oropharynx and hypopharynx, especially for LC images. No correlations were observed between LC images or CBCT reconstructions and the volumetric measurements of the pharyngeal subregions and the position of the hyoid bone. Conclusion: The hyoid bone position showed more correlations with oropharynx and hypopharynx airway measurements. The hyoid triangle method was not applicable to 3D images, since it showed a smaller number of measures correlated to the hyoid bone position. [ABSTRACT FROM AUTHOR]

Unusual enlargement of nasopharynx can disrupt air flow through the nose. The aim of this study was to investigate the cephalometric parameters in the upper airways. This retrospective descriptive study was conducted on 32 adults with Class II malocclusion without the history of night apnea in Qazvin. The radiographs were obtained from the archives in Qazvin Orthodontics Department and private clinics. The selected radiographs were entered into the computer and measured by two observers using Foxit reader version 3. Then, according to the criteria in the Lieberg analysis, the average size of the variables related to the upper airways was determined as the final size. Coefficient of variations and Pearson correlation were calculated in SPSS. There was a significant positive correlation between tongue length and height and soft palate length and also between tongue length and vertical position of the vallecula (P<0.01). But there was a significant negative correlation between nasopharyngeal air space and hypopharyngeal air space, vertical and horizontal position of vallecula (P<0.01). Nasopharyngeal air space showed a significant positive correlation with posterior air space but a negative correlation with soft palate length (P<0.001). There was also a significant positive correlation between soft palate length and maximum thickness of soft palate, while the length of contact between the dorsal surface of the tongue and soft palate showed a significant negative correlation with vertical position of the vallecula (P<0.004). Cephalometric parameters of upper airways were not significantly different in adults with CLII malocclusion in Qazvin. [ABSTRACT FROM AUTHOR]

Congenital salivary gland anlage tumor (SGAT) is a benign nasopharyngeal mass that presents with respiratory distress in infancy. Prior case reports have characterized SGAT as a lesion of the nasopharynx without intracranial extension. We report a unique case of SGAT extending through the anterior skull base and discuss the differential diagnosis and management of this unusual entity. [ABSTRACT FROM AUTHOR]

Objectives: To examine the influence of negative pressure of the pharyngeal airway on mandibular retraction during inspiration in children with nasal obstruction using the computational fluid dynamics (CFD) method.Setting and Sample Population: Sixty-two children were divided into Classes I, II (mandibular retrusion) and III (mandibular protrusion) malocclusion groups.Material and Methods: Cone-beam computed tomography data were used to reconstruct three-dimensional shapes of the nasal and pharyngeal airways. Airflow pressure was simulated using CFD to calculate nasal resistance and pharyngeal airway pressure during inspiration and expiration.Results: Nasal resistance of the Class II group was significantly higher than that of the other two groups, and oropharyngeal airway inspiration pressure in the Class II (-247.64 Pa) group was larger than that in the Class I (-43.51 Pa) and Class III (-31.81 Pa) groups (P<.001). The oropharyngeal airway inspiration-expiration pressure difference in the Class II (-27.38 Pa) group was larger than that in the Class I (-5.17 Pa) and Class III (0.68 Pa) groups (P=.006).Conclusion: Large negative inspiratory pharyngeal airway pressure due to nasal obstruction in children with Class II malocclusion may be related to their retrognathia. [ABSTRACT FROM AUTHOR]

Superior laryngeal artery (SLA) is one of the main branches of the superior thyroid artery that its main function is to supply blood to the larynx. This artery is accompanied by the internal branch of superior laryngeal nerve; this relation has anatomical and surgical significance. In this paper, a case of anomalous origin of the superior laryngeal artery is reported. Abnormal origin of SLA from the common carotid artery was observed in about 2cm before its branching point during dissection of the anterolateral region of the neck of a 70-year-old male cadaver through performing standard Grant`s method. The SLA was traced until it passed through thyrohyoid membrane and entered the larynx. The abnormal origin of this artery from the lingual artery, external carotid artery, the facial and ascending pharyngeal artery had been previously reported. A good understanding of the variation in origin of the SLA is necessary to avoid bleeding during surgery and also to avoid damage to the internal branch of the superior laryngeal nerve. [ABSTRACT FROM AUTHOR]

Introduction: Intracranial vascular, bone, and brain abnormalities might be observed in oculo-auriculo-vertebral spectrum (OAVS) patients even though these structures do not derive embryologically from the first and second pharyngeal arches. This neuroimaging study investigated their type, frequency and phenotype correlations among OAVS patients. Methods: Thirty-five OAVS patients (mean-age 4.8 ± 6.0 years; age range 0.3-30, 14 females) underwent head CT (all patients) and brain MRI (32 patients); 19 patients had a more severe phenotype (Goldenhar syndrome). Internal carotid artery hypoplasia/agenesia and abnormal course, brain abnormalities, internal acoustic canal stenosis/aplasia, cochlear-vestibular malformations, facial nerve bony canal anomalies, and oval window atresia were recorded. Results: Nine of 35 (26%) OAVS patients showed internal carotid artery anomalies; 18/32 (56%) had protean brain MRI abnormalities, ranging from tegmental cap anomaly to mild ventriculomegaly, which were associated with Goldenhar syndrome ( p < 0.001) and concomitant cranial nerve abnormalities ( p = 0.004); 11/35 (31%) disclosed cochlear-vestibular abnormalities including Michel deformity, common cavity, cochlear hypoplasia, and incomplete partition type-1 that were associated with Goldenhar syndrome ( p = 0.01) and ipsilateral VIII cranial nerve abnormalities ( p < 0.001); 16/35 (46%, 23 sides) presented facial nerve bony canal abnormalities that were associated with Goldenhar syndrome ( p < 0.001) and ipsilateral VII cranial nerve ( p < 0.001) and cochlear-vestibular ( p < 0.001) abnormalities; and 23/31 (74%, 31 sides) showed oval window atresia, always with concomitant ossicular chain dysplasia. Conclusions: Intracranial vascular, bone, and brain abnormalities in OAVS patients are strikingly common and heterogeneous. As their detection might impact significantly on clinical and surgical management of affected patients, accurate neuroimaging investigations should be included in the diagnostic work-up of OAVS. [ABSTRACT FROM AUTHOR]

Steinert syndrome, also called myotonic dystrophy type 1, is a genetic disorder with autosomal dominant transmission characterized by myotonia and a multisystemic clinical picture that affects several tissues of the human body. The most common systemic phenotypes are: muscular, cardiac, respiratory, CNS, ocular, gynecological, digestive, orthopedical, as well as cognitive and psychological symptoms (cognitive decline). Muscles involved in voluntary movement are highly affected by myotonia especially distal muscles of upper limbs. These patients also show changes in face, chewing and pharynx muscles that can lead to swallowing and speech problems, dysphagia and in most cases to food aspiration and suffocation. Poor oral hygiene resulting from reduced motor mobility and reduced saliva flux can lead to gingival inflammation and periodontal disease. Other oral manifestations include disturbances at the temporomandibular articulation, dental occlusion changes and reduction in teeth number as a result of caries. Main causes of death are pneumonia and cardiac arrhythmias. The etiopathogeny of this syndrome is still not clear, conditioning the existence of a specific treatment for this disease. Nowadays, treatments consist on the release of the existing symptoms, in an attempt to give a better life quality to patients. It is very important to implement actions that can prevent complications and consequently decrease death. Treatments should be applied in an early stage of the disease. Bronchoscopy and artificial respiration should be used to prevent pneumonia, and regular electrocardiographic monitoring should be done to evaluate defects in the conductive system. Several approaches have been applied to rehabilitate swallowing dysfunction and avoid aspiration like videofluoroscopy, postural techniques and adjustment of diet type. It is the aim of this paper to clarify the ethiology, diagnosis, systemic and oral characteristics of the syndrome, as well as to discuss treatments to be applied according to patients affected organs. [ABSTRACT FROM AUTHOR]

Objective: Mano-videoendoscopy (MVE) is a manometry technique with endoscopic confirmation of the pressure catheter. This study aimed to investigate the possibility of replacing a videofluorographic swallowing study (VFSS) with MVE for the precise evaluation of the pharyngeal contraction and the upper esophageal sphincter (UES) function.Methods: The data from 69 patients with dysphagia were retrospectively reviewed. All of the patients underwent both MVE and a VFSS for the evaluation of dysphagia. Manometry was performed with a transnasally inserted catheter (2.6-mm outer diameter and 4 pressure sensors) under endoscopic observation. The sensors were kept at the tongue base, upper pyriform sinus, apex of the pyriform sinus, and UES. We evaluated the pharyngeal contraction and UES function fluorographically and statistically compared the manometric parameters.Results: The fluorographic pharyngeal contraction was diagnosed as good in 28 patients and poor in 41 patients. The UES opening was diagnosed as good in 44 patients and poor in 25 patients. The highest pressure values at the tongue base (sensor 1), upper pyriform sinus (sensor 2), and apex of the pyriform sinus (sensor 3) were significantly larger in the good contraction group than in the poor contraction group. A stepwise logistic regression test revealed that the peak pressure of sensor 2 (upper pyriform sinus) was a robust predictor of fluorographic pharyngeal contraction, and the cut-off level for good fluorographic pharyngeal contraction was >81.5mmHg (specificity, 0.929; sensitivity, 0.870; area under the curve, 0.923). The nadir pressure, pressure drop, and pressure rise in the UES were significantly correlated with the fluorographic UES opening. A stepwise logistic regression test revealed that the pressure drop-the gap between the resting pressure and the nadir of the UES pressure-was a robust predictor of fluorographic UES opening, and the cut-off level to anticipate good fluorographic opening was ≥33.5mmHg (specificity, 0.853; sensitivity, 0.759).Conclusion: MVE can supplement the information obtained regarding the pharyngeal contraction and UES function, and overcomes the drawbacks of a videoendoscopic swallowing study (VESS). [ABSTRACT FROM AUTHOR]

To determine the factors inducing aspiration following esophagectomy with three-field lymph node dissection (3FL) and the effect of the chin-down maneuver combined with supraglottic swallow (CDSS). Retrospective analysis of a consecutive case series. Videofluoroscopic (VF) evaluations of 25 patients who consulted with our out-patient clinic from 2006 to 2012 for swallowing dysfunction following esophagectomy with 3FL without tracheostomy were reviewed. The penetration aspiration scale (PAS) was used for evaluation. The assessment parameters of VF examination were set as follows: laryngeal elevation, peristaltic wave of the pharynx, upper esophageal sphincter opening, and bolus residue in the pyriform sinus and vallecula after swallowing. Associations of the degree of aspiration with these parameters and the effect of CDSS maneuver on PAS were statistically examined. Fourteen patients had swallowing dysfunction with PAS score (1-3). Disturbance of laryngeal elevation was significantly correlated with the degree of aspiration ( p = 0.021). Multivariate logistic regression analysis demonstrated that reduced laryngeal elevation significantly enhanced aspiration ( p = 0.0026). Sixteen patients had already acquired compensated chin-down swallowing at the time of VF (Group I). Among the remaining nine patients (Group II), the PAS score was significantly ( p < 0.05) improved after training in chin-down swallowing. The mean PAS score of the Group I patients was not significantly different from that of the Group II patients after the training in CDSS. Laryngeal aspiration following esophagectomy with 3FL is significantly correlated with reduced laryngeal elevation and can be ameliorated after training in CDSS. Level of evidence IV. [ABSTRACT FROM AUTHOR]

Objectives This study aims to monitor the prevalence of suppurative otitis media in remote Indigenous communities after introduction of 13-valent pneumococcal conjugate vaccine (PCV13) in October 2011. We previously reported a decline in suppurative OM following replacement of PCV7 by 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) in October 2009. Methods We continued regular surveillance in remote Indigenous communities between February 2010 and August 2013. This analysis reports the general health, otitis media (OM), nasopharyngeal (NP) carriage and middle ear microbiology in children less than 36 months of age who received a primary course of at least two doses of PHiD-CV10 or PCV13, and not more than one dose of another pneumococcal vaccine. Results Mean ages of 511 PHiD-CV10- and 140 PCV13-vaccinated children were 19 and 13 months, respectively. Most children received 3-dose non-mixed PCV schedules. At the time of assessment, general health was poor and prevalence of risk factors was high in both groups: overall, around 14% of children had scabies, 20% had impetigo, 59% had runny nose and 39% had cough. Average household size was 8 persons, and 60% of the mothers smoked. Bilaterally normal middle ears were detected in 10% and 7%, respectively. OM with effusion (OME), almost all bilateral, was diagnosed in 52% and 50%, any suppurative OM (acute OM or any tympanic membrane perforation [TMP]) in 37% and 41%, and TMP in 14% and 12%, respectively. Children in the PCV13 group had significantly less NP carriage of combined Streptococcus pneumoniae (Spn) and non-typeable Haemophilus influenzae (NTHi) (62% versus 51%) but significantly more polymicrobial (Spn and NTHi) middle ear cultures (12% versus 43%), and significantly less Staphylococcus aureus -positive middle ears (40% versus 7%). Although NP carriage of pneumococcal serotype 19A was low in the PCV13 group, serotypes 19F and 23F persist. Conclusions The general health, particularly ear health, of little children in remote Australian Indigenous communities remains in crisis. In particular, transition to PCV13 did not show substantial further improvement in ear health. Possible vaccine-related differences in microbiology, including potential beneficial effects of PHiD-CV10 on NTHi infection, need to be further evaluated in randomised trials. [ABSTRACT FROM AUTHOR]

Introduction: It is important to evaluate the position of the hyoid bone in relation to the tongue at the beginning of orthodontic treatment so that during the treatment, its position may be directed hence overall impact on airway could be assessed. Aim: The aim of this study was to evaluate the upper and lower pharyngeal airway dimensions, posture of tongue and hyoid bone position in young adults with different growth patterns. Materials and Methods: Sample size of the study included 90 post-adolescent subjects, within the age range of 18-32 years. Based on the different growth pattern of the face, subjects were divided into Group I (n=30; average growth pattern), Group II (n=30; horizontal growth pattern) and Group III (n=30; vertical growth pattern). Lateral cephalogram were traced and analysed manually by the same investigator for evaluation of upper and lower pharyngeal airway, tongue posture and hyoid bone position. The intergroup comparison of upper and lower pharyngeal airway dimensions, posture of tongue and hyoid bone was performed with one-way ANOVA test. Results: The results showed that upper oropharyngeal widths were significantly different in different facial skeletal patterns (p=0.00). Subjects with vertical skeletal pattern have significantly narrower upper airways than those with horizontal skeletal pattern (p= 0.025). There was significantly higher difference in position of dorsum of the tongue in vertical growth pattern group (p=0.00). The hyoid bone was positioned farther from the mandibular symphysis in brachyfacial subjects, reflected by the larger H-RGN (Hyoid- retrognathion) values compared with the dolichofacial and normal subjects (p=0.044). Conclusion: The upper oropharyngeal width was found to be narrower in subjects with vertical growth pattern. The dorsum of the tongue is seen to be placed higher in subjects with vertical growth pattern. The hyoid bone was more inferiorly and posteriorly positioned in subjects with horizontal growth pattern. Variations are seen in upper and lower oropharyngeal widths, posture of the tongue and hyoid bone position in all the growth patterns. [ABSTRACT FROM AUTHOR]

The pharyngeal muscles of the nasal, oral, and laryngeal pharynxes are required for swallowing. Pharyngeal muscles are preferentially affected in some muscular dystrophies yet spared in others. Muscle stem cells, called satellite cells, may be critical factors in the development of pharyngeal muscle disorders; however, very little is known about pharyngeal satellite cells (PSC) and their role in pharyngeal muscles. We show that PSC are distinct from the commonly studied hindlimb satellite cells both transcriptionally and biologically. Under basal conditions PSC proliferate, progress through myogenesis, and fuse with pharyngeal myofibers. Furthermore, PSC exhibit biologic differences dependent on anatomic location in the pharynx. Importantly, PSC are required to maintain myofiber size and myonuclear number in pharyngeal myofibers. Together, these results demonstrate that PSC are critical for pharyngeal muscle maintenance and suggest that satellite cell impairment could contribute to pharyngeal muscle pathology associated with various muscular dystrophies and aging. S tem C ells 2015;33:3581-3595 [ABSTRACT FROM AUTHOR]

The article presents a case study of a 30‑year‑old male with recurrent chondrosarcoma who was diagnosed with oral fiber-optic bronchoscopy for difficulty in nasopharyngeal airway. Also includes analysis of mass' presence in sinus through magnetic resonance imaging, and surgeries performed such as lateral rhinotomy, extensive dissection and excision of mass.

In early tetrapods, it is assumed that the tympana were acoustically coupled through the pharynx and therefore inherently directional, acting as pressure difference receivers. The later closure of the middle ear cavity in turtles, archosaurs, and mammals is a derived condition, and would have changed the ear by decoupling the tympana. Isolation of the middle ears would then have led to selection for structural and neural strategies to compute sound source localization in both archosaurs and mammalian ancestors. In the archosaurs (birds and crocodilians) the presence of air spaces in the skull provided connections between the ears that have been exploited to improve directional hearing, while neural circuits mediating sound localization are well developed. In this review, we will focus primarily on directional hearing in crocodilians, where vocalization and sound localization are thought to be ecologically important, and indicate important issues still awaiting resolution. This article is part of a Special Issue entitled < Annual Reviews 2015 > . [ABSTRACT FROM AUTHOR]

Direct observation, filmed behaviour and morphological analysis were used to investigate mechanisms of larval feeding and movement in 20 species of Cyclorrhapha (Diptera). Feeding mechanisms refer to techniques of gathering food close to the pharynx entrance prior to sucking it in. A total of 12 mechanisms were recorded. Contrasting mechanisms were associated with saprophagy, phytophagy, mycophagy and zoophagy. Larvae had role-specific, compartmentalised bodies. The rear compartment grips substrates enabling the front ones to scan for food by sweeping from side to side or up and down. The front compartments extend or lunge to gather food or grip substrates during locomotion. Lower cyclorrhaphans had more disparate mechanisms than higher cyclorrhaphans. In the latter, the size, shape and movements of the thorax, pseudocephalon and head skeleton are diverse. Influences on this diversity are food quality and access conditions at development sites. Movement capabilities and functions were established for many components. [ABSTRACT FROM PUBLISHER]

Objectives To evaluate safety of positioning and distending the functional lumen imaging probe in the pharyngo-oesophageal segment in adults with known pharyngo-oesophageal segment dysfunction and to obtain preliminary measurements of pharyngo-oesophageal segment distensibility and opening during swallowing in a clinical group. Methods Prospective case series of ten adults post total laryngectomy (61-75 years) recruited from an outpatient ENT clinic. Functional lumen imaging probe was inserted trans-nasally, and the balloon was positioned in the pharyngo-oesophageal segment. Two 20- mL ramp distensions were completed, and subjects performed two dry and two 5- mL and 10- mL liquid swallows at a 12- mL balloon volume. Pharyngo-oesophageal segment distensibility was calculated from cross-sectional area (mm2) and intraballoon pressure (mmHg) measures. During swallowing, extent (mm) and duration (secs) of pharyngo-oesophageal segment opening and intraballoon pressure drop (mmHg) were evaluated. Results Functional lumen imaging probe could be passed through the pharyngo-oesophageal segment in seven subjects, all of whom completed the protocol. During distensions, pharyngo-oesophageal segment cross-sectional area increased significantly (19.47-148.3 mm2, P < 0.001), and intraballoon pressure increased significantly (15- to 20- mL balloon volume, P = 0.005). Pharyngo-oesophageal segment diameter (5.1 mm) increased during dry (7.4 mm), 5- mL (7.3 mm) and 10- mL (7.7 mm) liquid swallows ( P = 0.018). Pharyngo-oesophageal segment opening duration varied across dry (1 s), 5- mL (0.8 s) and 10- mL (1.6 s) liquid swallows. Resting intraballoon pressure (25.5 mmHg) did not alter significantly during swallowing ( P = 0.656). Conclusion Functional lumen imaging probe provides novel quantitative information regarding pharyngo-oesophageal segment distensibility and opening during swallowing in adults post total laryngectomy. No adverse events were observed in this first clinical study. Data were easy to acquire, and measures may direct candidacy for and establish effectiveness of interventions to alter pharyngo-oesophageal segment tone. [ABSTRACT FROM AUTHOR]

Choanal atresia (CA) is a rare, congenital malformation resulting as a failure in communication between the posterior nasal cavity and the nasopharynx. The clinical course is often asymptomatic in unilateral CA leading to higher rates of misdiagnosis, in comparison to bilateral CA, which manifests itself as a surgical emergency at birth. Most cases present as isolated malformations, but it may also be associated with other congenital anomalies in 20-50% of cases. Currently, the most important diagnostic tool for CA is computerized tomography (CT) and confirmatory diagnosis is usually achieved with the help of nasoendoscopic examination. Although, different surgical approaches have been used in the past, transnasal endoscopic repair is currently preferred over others. Herein, we describe our experience of three cases and share our simple stentless endoscopic technique, to facilitate physicians working in low facility units for a timely diagnosis and prompt treatment. [ABSTRACT FROM AUTHOR]

Otitis media is the second most common infection in children and the leading cause for seeking medical advice. Indigenous populations such as the Inuits, indigenous Australians and American Indians have a very high prevalence of otitis media and are considered to be high-risk populations. Streptococcus pneumoniae, one of the three main bacterial causes of otitis media, colonises the nasopharynx prior to disease development. In high-risk populations, early acquisition of high bacterial loads increases the prevalence of otitis media. In these settings, current treatment strategies are insufficient. Vaccination is effective against invasive pneumococcal infection but has a limited impact on otitis media. Decreasing the bacterial loads of otitis media pathogens and/or colonising the nasopharynx with beneficial bacteria may reduce the prevalence of otitis media. Probiotics are live microorganisms that offer health benefits by modulating the microbial community and enhancing host immunity. The available data suggest that probiotics may be beneficial in otitis media. This review discusses the potential use of probiotics to reduce pathogen colonisation and decrease the prevalence of otitis media, providing justification for further investigation. [ABSTRACT FROM AUTHOR]

Camels are very important livestock particularly in arid and semiarid lands. The oestrid fly, Cephalopina titillator (Clark), causes nasopharyngeal myiasis in camels, and it is widely distributed in many camel breeding areas triggering health hazards and severe economic losses in camels. The prevalence of infestation of camels (slaughtered at Tokh's slaughterhouse, Qalyubia Governorate, Egypt, during the period from September 2011 to March 2012) was 41.67 % (100 out of 240). Most infested camels developed clinical signs of nasal discharge, restlessness, loss of appetite, difficulty in breathing, frequent sneezing, and snoring. Postmortem examination of infested camels explained that breathing of the animal is greatly impaired because of blockage of the nasopharynx by larvae and/or mucofibrinous secretions. The larval count per camel ranged from 1 to 250 (mean 28.45 ± 6.48). In vitro larval immersion tests were carried out to determine the efficacy of doramectin (0.003 %) as well as some essential oils (50 % each) such as lavender, camphor, and onion oils against the second and third larval stages (L2 and L3) of C. titillator. Another trial had been done for imitating what could happen if the area around camels were treated with an insecticide or an insect repellent. All treated L2 died 18 h posttreatment (PT) with both doramectin and lavender, and 100 % mortality was reached for L3 after 24 and 30 h PT with lavender and doramectin, respectively. Doramectin and lavender induced the highest response against C. titillator as their lethal time (LT) values after treatment of L2 were 3.40 and 3.60 h, respectively, and those of L3 were 4.99 and 5.53 h, respectively. Against both L2 and L3 of C. titillator and based on LT values of onion oil and those of other applied materials, doramectin and lavender oil were four times more effective than onion oil, and camphor oil was two times more effective than onion oil. Based on LT values of essential oils and those of doramectin, as a reference substance, the relative speed of efficacy indicated that camphor and onion oils were, respectively, two and four times less effective than doramectin and lavender. With regard to fumigant technique, neither the insecticide, New Pyrosol®, nor the insect repellent, Keto®, was effective in controlling C. titillator larvae. Our results indicated that doramectin and lavender could be selected as drugs of choice for controlling C. titillator, but it is not permitted to use doramectin on dairy animals during lactation. Lavender (50 %) has a great potential to be developed as a novel larvicide and could be used as nasal drench against nasal botfly which will reflect on camel production and the national economy. [ABSTRACT FROM AUTHOR]