OBJECTIVE: To summarize the diagnostic and therapeutic experience of primary cricopharyngeal achalasia and introduce new operandi modus. METHOD: Report the two cases we treated in 2008 and integrate published literature, and approach its diagnostic and therapeutic experience and make use of new operandi modus. RESULT: The diagnosis of primary cricopharyngeal achalasia is difficult, and we must apply exclusive diagnosis according to the examinations of fibrolaryngoscopy, esophagoscopy and barium meal et al. CONCLUSION Surgical treatment is the best option. Partial resection of cricopharyngeal muscle and upper esophageal ring-shaped muscle is superior to simple cricopharyngeal myotomy.
Aged ; Esophageal Achalasia ; diagnosis ; surgery ; Female ; Humans ; Middle Aged ; Pharyngeal Diseases ; diagnosis ; surgery ; Pharyngeal Muscles ; physiopathology

No abstract available.
Adult ; Botulinum Toxins/*therapeutic use ; Brain Infarction/diagnosis/therapy ; Deglutition Disorders/diagnosis/physiopathology/*therapy ; Dilatation ; Esophagoscopy ; Humans ; Male ; Microscopy, Video ; Pharyngeal Muscles/*physiopathology ; Pharynx/*physiopathology

OBJECTIVETo investigate the relationship between the changes of upper airway and genioglossus muscle activity after the treatment with Snoreguard.

METHODS31 patients with OSAS or snoring were treated with Snoreguard Cephalometric analysis was carried out to compare the changes of the upper airway before and after the treatment. The relationship between the change in morphology and that of genioglossus muscle activity among 22 patients was investigated.

RESULTS(1) The size of upper airway decreased significantly with Snoreguard. SPP-SPPW increased from (9.14 +/- 3.79) mm to (12.36 +/- 3.74) mm and TB-TPPW increased from (10.63 +/- 3.71) mm to (11.90 +/- 4.33) mm. UC-LC decreased from (21.96 +/- 11.06) mm to (10.48 +/- 8.55) mm and H-MP decreased from (20.60 +/- 6.65) mm to (11.01 +/- 6.84) mm. (2) The size of upper airway in part of the patients decreased with Snoreguard, but good treatment efficiency remained.

CONCLUSIONThe mechanism of Snoreguard is caused by the mechanical enlargement of upper airway.

Adult ; Aged ; Electromyography ; Female ; Humans ; Male ; Middle Aged ; Palate ; pathology ; Pharyngeal Muscles ; physiopathology ; Sleep Apnea, Obstructive ; pathology ; physiopathology ; therapy ; Snoring ; pathology ; physiopathology ; therapy ; Tongue ; pathology ; Trachea ; pathology

OBJECTIVETo study the pathologic changes of the palatopharyngeal muscles with transmission electronmicroscopy (TEM) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), the role of the above muscle in OSAHS pathogenesis was discussed.

METHODSThirty-eight palatopharyngeal muscle from OSAHS patients receiving uvulopalatopharyngoplasty (UPPP) were collected in in-patient department of Chinese Medical University and five palatal tumor patients receiving resection without snoring were chosen as the control. The palatopharyngeal muscle fiber and the feature of changes in mitochondrial morphology were observed by TEM.

RESULTSThe pathological changes were not observed in the normal control group. The muscle fibers were regularly arranged, and the mitochondrial between muscles were normal. The palatopharyngeal myofibrillar in mild OSAHS group was regularly arranged. The Z lines were straight, and most mitochondria structure were normal. In the moderate group, the myofibrillar was disorganized, and the Z lines were shortened or distorted. The myofibrillar in severe group was disorganized, similar to point-like or flake, and the Z lines and the structures of sarcomeres were disappeared. And organelle were disintegrated and mitochondria were disappeared similar to flocculent. There existed obvious fatty infiltration in the palatopharyngeal muscle. In the control, mild, moderate and severe group, pharyngeal muscle fiber disarrangement of the occurrence rate was 0, 2/10, 8/13, 14/15, the occurrence rate of mitochondrial degeneration was 0, 2/10, 8/13, 14/15, increased with the severity of the ultrastructural changes in the trend of increasing incidence.

CONCLUSIONSThe degree of OSAHS is correlated with the pathological changes of palatopharyngeal muscles. Incidence of myopathy is an important part of OSAHS secondary to chronic intermittent hypoxia in OSAHS and other pathological lesions, but also an important reason for increasing pharyngeal collapse.

Adult ; Humans ; Male ; Microscopy, Electron, Transmission ; Middle Aged ; Mitochondria, Muscle ; pathology ; ultrastructure ; Muscle Fibers, Skeletal ; pathology ; ultrastructure ; Pharyngeal Muscles ; pathology ; ultrastructure ; Sleep Apnea, Obstructive ; physiopathology

OBJECTIVE: To discuss the effect of reducing the cricopharyngeal dysfunction on the Groningen prosthesis voice restoration following total laryngectomy and the effect of different methods. METHOD: Fifty-six patients were implanted with Groningen voice prostheses to rebuild voice after total laryngectomy. The clinical data were analyzed retrospectively. RESULT: Of 56 patients, 412 patients successes in voice restoration. The success rate of amputating pharynx plexus nerves group was 60.0%, amputating cricopharyngeal muscle group was 62.5%, and the amputating pharynx plexus nerves and cricopharyngeal muscle group was 96.0%. CONCLUSION The combination of pharynx plexus nerves resection and cricopharyngeal myotomy can make higher success rate of voice restoration.
Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Larynx, Artificial ; Male ; Middle Aged ; Pharyngeal Muscles ; physiopathology ; Retrospective Studies

OBJECTIVETo evaluate the mechanical load of retropalatal airway in obstructive sleep apnea patients, and to investigate the contributions of pharyngeal anatomy to upper airway collapsibility.

METHODSStatic mechanical load of transpalatal pharynx was determined by opening pressure (Popen) of the segment during general anesthesia in 30 patients and 14 controls. Size of pharynx was measured while intraluminal pressure was controlled at 3-20 cm H2O (1 cm H2O = 0.09806 kPa) and the minimal intraluminal pressure that needed to compensate for the mechanical load of a retropalatal segment was determined.

RESULTSPharyngeal cavity collapse at the level of the hard palate was observed in only one of the 30 subjects (3.3%), and in none of the 14 controls. At tongue base level, 23 subjects had a Popen > 0 cm H2O (76.7%) while in 7 of the controls (50.0%) had a Popen > 0 cm H2O. And at the level of the uvual and soft palate, pharyngeal collapses was observed in all subjects except in 9 of the controls (64.3%). The median of Popen was 8.3 [5.9;11.5] cm H2O in the patients group and was 2.7 [-3.9;6.0] cm H2O in the control group. Differences of Popen were significant between patients and controls (U = 58.500, P = 0.000). The correlation between Popen and AHI was also significant at 0.05 level (r = 0.377, P = 0.044).

CONCLUSIONSPatients with sleep apnea have more collapsible passive upper airway than controls. Retropalatal and retroglossal airway are the most collapsible segments and positive pressures are needed to compensate for the mechanical loads.

Adult ; Case-Control Studies ; Female ; Humans ; Middle Aged ; Muscle Relaxation ; Palate, Soft ; anatomy & histology ; physiology ; physiopathology ; Pharyngeal Muscles ; physiology ; Pressure ; Sleep Apnea, Obstructive ; etiology ; pathology ; physiopathology ; Tongue ; anatomy & histology ; physiology ; Young Adult