Humans ; Hyperesthesia ; diagnosis ; etiology ; Pharynx ; physiopathology ; Syndrome

IgG4-related disease (IgG4-RD) is a newly recognized disease entity. IgG4-RD is characterized by a single or multiple masses in one or more organs; a lymphoplasmacytic infiltrate with a high percentage of plasma cells within the lesion staining for IgG4; a peculiar pattern of fibrosis known as "storiform" fibrosis; and elevated serum IgG4 concentrations. IgG4-RD can occur in various organs, including pancreas, kidneys, lungs, retroperitoneum, and prostate gland. The head and neck involvements of IgG4-RD have been chiefly described in Mikulicz disease (MD), Küttner's tumor, orbital? inflammatory pseudotumor, and idiopathic hypertrophic pachymeningitis (IHP) previously. Recent studies reported that IgG4-RD could also involve ear, nose and throat. Here we reviewed the literatures about ear, nose and throat involvement by IgG4-RD, in order to provide some theoretical bases for the diagnosis and treatment of IgG4-RD.
Autoimmune Diseases ; physiopathology ; Ear ; physiopathology ; Fibrosis ; Humans ; Immunoglobulin G ; Nose ; physiopathology ; Pharynx ; physiopathology ; Plasma Cells ; pathology

OBJECTIVE: to investigate the origin characters of snore in simple snorers and provide the basis for its treatment. METHOD: Thirty-two simple snorers diagnosed by polysomnography were induced to sleep by propofol and dexmedetomidine, then we observed the vibration sites, pattern and concomitant collapse of soft tissue in pharyngeal cavity by nasendoscopy. RESULT: Thirteen cases showed palatal fluttering only, and 1 case showed vibration of epiglottis only. Six cases showed palatal fluttering with vibration of epiglottis, and 2 cases showed palatal fluttering with vibration of epiglottis and tongue base. Five cases showed palatal fluttering with vibration of pharyngeal lateral wall, and 5 cases showed palatal fluttering with vibration of lateral wall, epiglottis and tongue base together. Palate and pharyngeal lateral wall vibrated strongly and always collapsed with vibrating, but epiglottis and tongue base usually vibrated slightly and seldom collapsed. CONCLUSION The palatal fluttering is the main source of snoring sounds for most simple snorers, then followed by vibration of palatal and pharyngeal lateral wall together. The site of collapse in pharyngeal cavity is consistent with the main site of vibration.
Endoscopy ; Epiglottis ; physiopathology ; Humans ; Palate ; physiopathology ; Pharynx ; physiopathology ; Polysomnography ; Propofol ; Sleep ; Sleep Apnea, Obstructive ; Snoring ; diagnosis ; Tongue ; physiopathology

OBJECTIVETo evaluate how the oral language development enhances articulators to function well in cleft palate movement and velopharyngeal closure in the young Chinese children with repaired cleft palate.

METHODSThe recordings of 78 cases of Chinese toddlers with repaired cleft palate were reviewed. This group of children aged from 27 months to 33 months (average: 30 months). Transcription using Pinyin system was made. Mean utterance count (MUC) and mean special consonant correct count (MSCC) were calculated. Correlation between MUC and MSCC was statistically analyzed.

RESULTSThe correlation coefficient of MUC and MSCC is 0.360 (P < 0.01).

CONCLUSIONSThere is positive correlation between the oral language development and restoration of velopharyngeal closure function. Children with repaired cleft palate should be encouraged to start oral language as early as possible and as much as possible in order to get the restoration of velopharyngeal closure function.

Child, Preschool ; Cleft Palate ; physiopathology ; surgery ; Humans ; Language Development ; Pharynx ; Velopharyngeal Insufficiency ; physiopathology ; surgery

Acupuncture Therapy ; Humans ; Pharyngeal Diseases ; physiopathology ; therapy ; Pharynx ; innervation ; physiopathology ; Sensation

BACKGROUNDThe role of nasal obstruction in the pathogenesis of obstructive sleep apnea/hypopnea syndrome (OSAHS) has been debated for decades. In this prospective study, we compared the pharyngeal aerodynamic characteristics of OSAHS patients and normal people, and investigated the contribution of total nasal airway resistance to the pathophysiology of OSAHS.

METHODSComputational fluid dynamics (CFD) was used to extract the average pressure and average airflow velocity in three transverse cross-sectional planes of the pharynx for statistical analysis, and the correlation between nasal resistance and the average pressure in the pharyngeal cavity was investigated.

RESULTSThe negative pressure within the pharyngeal cavity was significantly higher in OSAHS patients than in normal subjects, and total nasal airway resistance correlated well with the average pressure in three consecutive transverse cross-sections of the pharyngeal cavity.

CONCLUSIONSGreater negative pressure within the pharyngeal cavity contributed to the increased collapsibility of the pharynx in OSAHS patients, and the strong correlation between nasal resistance and pharyngeal pressure suggests that the nose plays a role in the pathogenesis of OSAHS.

Adult ; Humans ; Middle Aged ; Pharynx ; physiopathology ; Prospective Studies ; Sleep Apnea, Obstructive ; etiology ; physiopathology

To evaluate the clinical value of submucosal injection of pharyngeal ostium of Eustachian tube in diagnosing patulous Eustachian tube(PET).Twenty-six patients(32 sides),whose the symptoms were consistent with PET,were enrolled from March 2014 to May 2016.The symptoms and signs of all patients were evaluated after submucosal injection of saline into the Eustachian tube.Immediately after submucosal injection of saline into the Eustachian tube,the symptoms and signs disappeared in 24 cases(29 sides),and improved in 2 cases(3 sides).The resolution and/or improvement of symptoms and signs lasted for less than 24 hours in 12 patients,for more than 24 hours in 9 patients,and for more than 48 hours in 4 patients.No adverse reactions were observed.Submucosal injection may be a simple and practical method for auxiliary diagnosis of PET,and may be used in preoperative evaluation of Eustachian tuboplasty.
Ear Diseases ; diagnosis ; Eustachian Tube ; physiopathology ; surgery ; Humans ; Injections ; Otitis Media ; Pharynx ; Preoperative Care

OBJECTIVETo understand how sleep stage and position influence the mechanisms for pharyngeal collapse in different levels of upper airway (UA), overnight state-related changes and postural variation in obstructive sites in obstructive sleep apnea hypopnea syndrome (OSAHS) patients were studied.

METHODSFifty four OSAHS patients underwent overnight upper airway pressure monitoring during polysomnography. The lower limits of the UA obstruction were determined and their relationship with sleep stage, position, age, body mass index and apnea hypopnea index (AHI) were investigated.

RESULTSAll 54 patients had oropharynx (14 837 of the 23 172 analyzed events) and tongue base obstruction (5605/23,172), 2532 events were located at the oropharynx with extension to tongue base. Twenty nine patients has hypopharynx obstruction (105/23 172). Of the total amount of apnea hypopnea, the portions of obstruction located at tongue base level increased (t = 8.790, P = 0.000) in rapid eye movement (REM) sleep while those located at oropharynx decreased (t = -6.846, P = 0.000). Indexes of the apnea hypopnea caused by tongue base obstruction raised (t = 6.189, P = 0.000). Although the overall AHI in supine position was higher than in lateral position (t = 4.000, P = 0.000), increases in indexes of both the apnea hypopnea caused by tongue base (supine, 17.1 +/- 13.8 vs. lateral, 13.9 +/- 14.6) and oropharynx obstruction (44.3 +/- 20.3 vs. 37.2 +/- 25.9) were without significance (P > 0.05). Distribution of obstructive site varied little with different position (P > 0.05).

CONCLUSIONSUpper airway obstruction involves more than one specific site of the upper airway and the oropharynx is the most common collapse site. Obstructive sites are likely to extend to lower levels during REM sleep. Sleep position has little effect on the distribution of obstructive site.

Adult ; Female ; Humans ; Male ; Middle Aged ; Pharynx ; pathology ; physiopathology ; Polysomnography ; Posture ; Sleep Apnea, Obstructive ; pathology ; physiopathology ; Sleep Stages ; Young Adult

OBJECTIVETo investigate the influence of the local sensory abnormality in throat while the change of motility in the upper esophageal sphincter (UES) and lower esophageal sphincter (LES), as well as the change of esophageal body in pharyngeal paraesthesia.

METHODSFrom January 2014 to January 2015 there were sixty-four patients who had pharyngeal susceptible syndrome (PSS) but without confirmed organic disease were enrolled as the PSS group, forty healthy volunteers as the control group. High resolution manometry (HRM) was utilized to distinguish esophageal motility patterns of PSS, including the muscular tension of LES and UES, the integrity, adaptability, amplitude, speed and duration of esophageal peristalsis at 10 swallows.

RESULTSThe resting LES and UES pressures and the distal contractile integral (DCI) of esophagus in PSS group were lower than that in control group (P < 0.05). The esophageal peristalsis was decelerated and shortened in duration, and amplitude of contraction notably lower in PSS group compared with its counterpart (P < 0.05). The integrity of esophageal peristalsis was impaired in PSS with remarkable changes in motility patterns, involving ratio of major and minor interrupts, and synchronous contraction rate (P < 0.05). As for the time course from relaxation to the lowest pressure point of UES and time for restoration, no definite difference was noticed between the two groups (P > 0.05). The average peak pressure was similar in two groups (P > 0.05).

CONCLUSIONSMuscle tension around the UES has no obvious change when pharyngeal paraesthesia occurred, but the reduction of esophageal motor function, clearance ability, anti-reflux gastroesophageal junction, causing the abnormal reflux which hurt the pharyngeal surface mucosa maybe one of the most important reasons leading to pharyngeal paresthesia.

Esophageal Motility Disorders ; diagnosis ; Esophageal Sphincter, Lower ; physiopathology ; Esophageal Sphincter, Upper ; physiopathology ; Humans ; Manometry ; Muscle Tonus ; Paresthesia ; physiopathology ; Peristalsis ; Pharynx ; physiopathology ; Pressure

OBJECTIVE: To discuss the pressure changing characteristics of upper esophageal sphincter (UES), lower esophageal sphincter (LES) and the esophagus kinetic characteristics of pharyngeal paraesthesia patients. METHOD: To take high resolution manometry in 44 cases of pharyngeal paraesthesia patients and 23 normal subjects separately. According to the RSI score,the 44 patients were divided into group A (the group without reflux, RSI < 13, n = 25) and group B (the group with reflux, RSI ≥ 13, n = 19). RESULT: The UES average resting pressure and average residual pressure of patients group were higher than the control group (P < 0.05); The UES average resting pressure and average residual pressure of group B were higher than group A (P < 0.05); The LES average resting pressure and average residual pressure of group B were lower than group A and the control group (P < 0.05); The comparison of LES average resting pressure and average residual pressure between group A and the control group was not statistically significant (P > 0.05). The esophagus DCI of group B was lower than that of group A and control group (P < 0.05). The esophagus DCI comparison between group A and control group was not statistically significant (P > 0.05). CONCLUSION The pharyngeal paresthesia symptoms of'patients was associated with the increasing of UES pressure. The pharyngeal paresthesia symptoms of group with reflux was related to low pressure of LES and high pressure of UES. The last part of esophagus of group with reflux had obstacles in powers, which weaken the peristalsis and declined the ability to clear the bolus and gastric reflux material.
Case-Control Studies ; Esophageal Sphincter, Lower ; physiopathology ; Esophageal Sphincter, Upper ; physiopathology ; Gastroesophageal Reflux ; physiopathology ; Humans ; Manometry ; Paresthesia ; diagnosis ; pathology ; Peristalsis ; Pharynx ; physiopathology ; Pressure