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BACKGROUND: The Pharyngeal Endoderm (PE) is an extremely relevant developmental tissue, serving as the progenitor for the esophagus, parathyroids, thyroids, lungs, and thymus. While several studies have highlighted the importance of PE cells, a detailed transcriptional and epigenetic characterization of this important developmental stage is still missing, especially in humans, due to technical and ethical constraints pertaining to its early formation. RESULTS: Here we fill this knowledge gap by developing an in vitro protocol for the derivation of PE-like cells from human Embryonic Stem Cells (hESCs) and by providing an integrated multi-omics characterization. Our PE-like cells robustly express PE markers and are transcriptionally homogenous and similar to in vivo mouse PE cells. In addition, we define their epigenetic landscape and dynamic changes in response to Retinoic Acid by combining ATAC-Seq and ChIP-Seq of histone modifications. The integration of multiple high-throughput datasets leads to the identification of new putative regulatory regions and to the inference of a Retinoic Acid-centered transcription factor network orchestrating the development of PE-like cells. CONCLUSIONS: By combining hESCs differentiation with computational genomics, our work reveals the epigenetic dynamics that occur during human PE differentiation, providing a solid resource and foundation for research focused on the development of PE derivatives and the modeling of their developmental defects in genetic syndromes.

Salt (NaCl), is an essential nutrient for survival, while excessive salt can be detrimental. In the fruit fly, Drosophila melanogaster, internal taste organs in the pharynx are critical gatekeepers impacting the decision to accept or reject a food. Currently, our understanding of the mechanism through which pharyngeal gustatory receptor neurons (GRNs) sense high salt are rudimentary. Here, we found that a member of the ionotropic receptor family, Ir60b, is expressed exclusively in a pair of GRNs activated by high salt. Using a two-way choice assay (DrosoX) to measure ingestion volume, we demonstrate that IR60b and two co-receptors IR25a and IR76b are required to prevent high salt consumption. Mutants lacking external taste organs but retaining the internal taste organs in the pharynx exhibit much higher salt avoidance than flies with all taste organs but missing the three IRs. Our findings highlight the vital role for IRs in a pharyngeal GRN to control ingestion of high salt.

Dysphagia, a swallowing disorder, requires continuous monitoring of throat-related events to obtain comprehensive insights into the patient's pharyngeal and laryngeal functions. However, conventional assessments were performed by medical professionals in clinical settings, limiting persistent monitoring. We demonstrate feasibility of a ubiquitous monitoring system for autonomously detecting throat-related events utilizing a soft skin-attachable throat vibration sensor (STVS). The STVS accurately records throat vibrations without interference from surrounding noise, enabling measurement of subtle sounds such as swallowing. Out of the continuous data stream, we automatically classify events of interest using an ensemble-based deep learning model. The proposed model integrates multiple deep neural networks based on multi-modal acoustic features of throat-related events to enhance robustness and accuracy of classification. The performance of our model outperforms previous studies with a classification accuracy of 95.96%. These results show the potential of wearable solutions for improving dysphagia management and patient outcomes outside of clinical environments. [ABSTRACT FROM AUTHOR]

Purpose: Speech disorders associated with velopharyngeal dysfunction (VPD) are common. Some require surgical management, while others are responsive to speech therapy. This is related to whether the speech error is obligatory (passive) or compensatory (active). Accurate identification of speech errors is necessary to facilitate timely and appropriate intervention. Recent studies have supported the role of magnetic resonance imaging (MRI) in the assessment process for VPD. The purpose of this study was to utilize MRI to support differential diagnosis and treatment planning in a child presenting with inconsistent nasal air escape, mild hypernasality, and compensatory speech errors. Method: A nonsedated, fully awake, velopharyngeal (VP) MRI protocol was implemented to acquire anatomic data at rest and during phonation. Segmentations and visualization of the tongue, palate, adenoids, and nasopharyngeal airway were completed. Anatomic linear measurements were obtained for VP variables to assess VP function, establish a baseline, and monitor change over time. Results: VP anatomy was successfully visualized on MRI in multiple imaging planes. All anatomic measurements fell within normative expectations. Elevation and retraction of the soft palate occurred against the adenoid pad. A pharyngeal fricative was documented, resulting a small VP gap during speech. In contrast, adequate VP closure was obtained for vowels and other oral consonant sounds. Conclusions: Quantitative assessment and visualization of the anatomy demonstrated adequate VP closure capabilities and a pharyngeal fricative substitution that had not been adequately perceived during routine clinical assessments. This study suggests a promising additive role for VP MRI for enhanced differential diagnosis and therapeutic monitoring in children with VPD and concomitant speech disorders. Supplemental Material: https://doi.org/10.23641/asha.27905451 [ABSTRACT FROM AUTHOR]

Summary: Highbush blueberry is a blueberry species native to North America and is a food crop of significant economic importance for Canada. Plant-parasitic nematodes are known to infest this crop. Species of Hemicycliophora , commonly known as sheath nematodes, are obligatory plant-parasites, and some cause diseases on a wide range of crops. A population of Hemicycliophora of high number was found in highbush blueberry fields in Norfolk and Middlesex counties of southwestern Ontario. Following through morphological and molecular studies, this population was determined a new species as Hemicycliophora potteri n. sp. This species is characterised by its outer sheath adpressed fitting to the body, lateral fields with diagonal connections of transverse striae, amphid apertures covered by lateral plates, lip region slightly set-off with four annuli; excretory pore anterior to the base of the pharynx, stylet knob cavity moderate, vulva lips modified, tail tapering gradually and more abruptly towards the last one-third, and no males were found. Molecularly, the 18S, and 28S ribosomal DNA sequences are most similar to those of H. thienemanni , H. similis , H. gracilis , and a few unidentified species. A dichotomous key for the diagnostic of the species of Hemicycliophora in Canada was presented. To the best of our knowledge, Hemicycliophora potteri n. sp. is the first recorded species of the genus to be named and fully described from highbush blueberry. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the correlation between pharyngeal residue and penetration/aspiration in post-stroke individuals. Methods: Cross-sectional, descriptive, retrospective, clinical study with 157 post-stroke individuals, 71 females and 86 males, aged 26 to 92 years (mean age: 67.2 years), all diagnosed by neurological assessment and imaging exams (computed tomography or magnetic resonance imaging), who underwent fiberoptic endoscopic evaluation of swallowing (FEES) in a rehabilitation center. They were served 5 mL of moderately thick liquid (level 3 in the International Dysphagia Diet Standardization Initiative [IDDSI]) in a spoon three times. Two expert raters in dysphagia assessed them with the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) and Penetration Aspiration Scale (PAS). Their interrater sensitivity agreement was analyzed with the Kappa test, and Spearman's rank correlation (r) verified the correlation between pharyngeal residue and the PAS and calculated the effect size (r2). Results: YPRSRS in vallecula was positively correlated with PAS (r = 0.43; r2 = 0.18; p ≤ 0.000); YPRSRS in pyriform sinus, with PAS (r = 0.54; r2 = 0.29; p ≤ 0.000); and YPRSRS in both vallecula/pyriform sinus with PAS (r = 0.57; r2 = 0.32; p ≤ 0.000). Conclusion: The severity of pharyngeal residue in post-stroke individuals with dysphagia is correlated with the level of penetration-aspiration. [ABSTRACT FROM AUTHOR]

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Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The presence of a pseudodiverticulum of the anterior pharyngeal wall, or prominent "pharyngeal bar," is a well‐known phenomenon that occurs following total laryngectomy, which can be visualized by nasolaryngoscopy or videofluoroscopy. Among the different techniques of pharyngeal reconstruction, there is higher incidence following primary vertical multilayered closure. It has been postulated to cause dysphagia and lack of dietary progression despite a paucity of data. However, the direct impact of pseudodiverticulum is less clear and anecdotally its presence and severity does not necessarily correlate with dysphagia. Methods: A retrospective case series was performed of all consecutive patients who underwent total laryngectomy or laryngopharyngectomy between 2015 and 2022 at two tertiary head and neck institutions. All patients underwent routine videofluoroscopy postoperatively for swallow assessment. The presence of pseudodiverticulum on postoperative contrast swallow study was recorded to investigate the relationship with patient's ability to tolerate oral intake at 3 months discharge from the hospital. Results: Of 50 laryngectomized patients (mean age 63.8 ± 10.0, 86% male), the main closure techniques were primary vertical (n = 9, 18%), primary T‐closure (n = 14, 28%), and flap reconstruction (n = 27, 54%). Pseudodiverticulum was identified in 19 cases (38%). 43 patients underwent primary surgery and 30 had adjuvant radiotherapy. The presence of pseudodiverticulum was significantly associated with vertical primary closure versus non‐vertical (T‐closure or flap reconstruction) techniques (χ2 (df 1) = 7.4, p = 0.007, OR = 5.7, 95% CI 1.3–24.7). Pseudodiverticulum was not associated with an increased inability to tolerate solid intake or full diet compared to patients without pseudodiverticulum. 26.3% of patients with pseudodiverticulum were on full diet compared to 25.8% of patients without. The vertical closure technique showed no difference in ability to maintain solid intake compared with non‐vertical closure; however, no patients were on full diet. Only one patient in the pseudodiverticulum group required surgical management during the study period for retention. Conclusion: The presence of a pseudodiverticulum does not appear to be significantly associated with a need for postoperative dietary modification. The authors postulate that postlaryngectomy dysphagia is multifactorial with sensorimotor aperistalsis of the pharynx and cricopharyngeal stenosis. While a pseudodiverticulum is a common phenomenon, patients did not require modification of diet at higher rates than those without, and they seldom require intervention. [ABSTRACT FROM AUTHOR]

A new non-mineralised fauna was recently discovered in the Lower Ordovician Madaoyu Formation near Liexi Township, West Hunan Province, South China. Diverse animals are preserved in a thin layer of siltstone interbedded within the limestone. The most peculiar group among this new Fauna is a large quantity of palaeoscolecidan worms with multiple instars, which are only represented by trunks without any other soft tissues such as the introvert, pharynx, and intestine being preserved. The unique characteristic of these worms are that they have a dorsal-ventral differentiation of plates, which are arranged in longitudinal lines, this suggests that the worms probably were exquisite bottom crawlers. The palaeoscolecidans are uniform in morphology and attributed to a new genus and species, Liexiscolex hunanensis Liu & Huang, gen. et sp. nov. This discovery not only enriches our knowledge of the anatomy and palaeoecology but also helps us understand the evolution of palaeoscolecidan worms. Furthermore, it provides a better comprehension of the Lower Ordovician Liexi fauna in South China. [ABSTRACT FROM AUTHOR]

Objective: This retrospective study comprehensively assesses clinical characteristics, management, outcomes, and complications of deep neck space infections in adults at a UK ear, nose and throat tertiary centre. Methods: Adult deep neck space infection patients from April 2019 to March 2021 were retrospectively reviewed using health records and picture archiving and communication system data. Demographics, presentation, microbiology, treatment, complications, and outcomes were analysed. Results: Fifty-three patients (mean age: 53.8 years, M:F ratio 1.5:1) were studied. Deep neck space infections were polymicrobial in 29.4 per cent, with Streptococcus milleri group (64.7 per cent) occurring most frequently. Complications occurred in 20.8 per cent, including mediastinitis (13.2 per cent) and Lemierre's syndrome (7.5 per cent). Mortality was 5.7 per cent. Treatment included intensive care admission (32.1 per cent), tracheostomy (15.1 per cent), medical management alone (39.6 per cent), bedside peritonsillar abscess drainage (18.9 per cent), transcervical drainage (28.3 per cent), transoral drainage (13.2 per cent), and hot tonsillectomy (5.7 per cent). Patient age correlated with length of stay. Conclusion: The study highlights deep neck space infection complexity, emphasising tailored management, effective antibiotics, and frequency and severity of complications. Comprehensive understanding of deep neck space infections can improve care and outcomes. [ABSTRACT FROM AUTHOR]

Background: The functional relationship of striated esophagus (St.Eso) motor function with pharyngeal deglutitive biomechanical events has not been systematically studied. The aim of this study was to determine the spatio‐temporal characteristics of St.Eso function and its correlation with pharyngeal biomechanics and bolus transport. Methods: We studied 50 healthy volunteer subjects (age range: 21–82 years, 31 female) by digital videofluoroscopy. All subjects were studied in a seated, upright position. Thirteen of these 50 volunteers also underwent high‐resolution manometry (HRM) concurrent with fluoroscopy. We used laryngeal excursion as a surrogate for St.Eso excursion. Key Results: Median duration of St.Eso excursion was 2.35 [1.93,2.85, 5th and 95th percentile] seconds. Mean maximum extent of St.Eso excursion was 2.84 ± 0.72 cm. We identified four distinct periods in deglutitive St.Eso motor function: P1. Anterosuperior ascent without bolus or peristaltic activity, P2. Non‐peristaltic bolus receiving at the apogee of St.Eso excursion concurrent with UES opening and pharyngeal peristalsis P3. Peristaltic bolus transport as St.Eso descends and P4. Continued peristalsis in resting position. Conclusions and Inferences: 1. St.Eso motor function spans both pharyngeal and esophageal phases of swallowing for receiving and transporting the bolus, 2. Pressure signatures in HRM recordings currently attributed to St.Eso deglutitive motor activity does not represent the entirety of St.Eso peristalsis, only the part that occurs in its resting position. St.Eso peristalsis that occurs during its descent is recorded by pressure sensors initially in the pharynx. This finding needs to be considered when interpreting HRM recordings of the pharynx and proximal esophagus. [ABSTRACT FROM AUTHOR]

Understanding the burden of influenza-associated acute respiratory infection (ARI) and severe ARI (SARI) is crucial for public health decision-making. A population-based study with multiple data sources was conducted to estimate the burden of influenza-associated ARI in Wanzhou District, Chongqing, southern China. Population-based surveillance study. Active surveillance of ARI was conducted in different levels of health facilities in the Wanzhou District between October 2021 and March 2022. Nasal or throat swabs were collected and tested for influenza viruses in hospital-based surveillance. A health utilisation survey was used to estimate health-seeking behaviour, and all electronic medical records were collected. An epidemiological model was used to estimate the disease burden. There were an estimated 52,960 influenza-associated ARI (95 % confidence interval [CI]: 39,213–84,891), including 2,529 SARI cases (95 % CI: 1,385–21,712) during winter 2021/22 in the Wanzhou District. The incidence rate for all influenza-associated ARI and SARI was 3,385/100,000 and 162/100,000, respectively. A higher incidence rate of influenza-associated ARI was observed among individuals aged <50 years, while a higher influenza-associated SARI rate was observed in those aged ≥50 years. Using an epidemiological model with data from multiple sources, this study documented a substantial burden of influenza-associated ARI in the Wanzhou District, highlighting the need for influenza vaccination and providing a possible foundation for public health decision-making. [ABSTRACT FROM AUTHOR]

Accidental swallowing of fish bone is one of the most common emergencies in the otolaryngology department. The impacted fish bones are usually found in the palatine tonsil, base of the tongue, valleculae, pyriform sinus, and esophagus, which can be successfully removed after a thorough examination. However, in some cases, the fish bone may penetrate into the neck soft tissue and migrate to extraluminal organs, causing infection, abscess formation, or rupture of vessels. In such cases, prompt recognition and immediate removal of the impacted fish bone are necessary. Herein, we report a rare case of a 60-year-old woman who had accidently swallowed a fish bone 10 days prior to visiting the outpatient department. The fiberoptic scope and head and neck computed tomography scans were obtained from the outpatient department. The fish bone was found to migrate from the upper esophagus to the left thyroid gland. First, a rigid esophageal endoscopy was performed in the operating room, but no obvious fish bone was noted over the esophagus. Finally, the fish bone was removed via exploratory cervicotomy with left-sided total lobectomy of the thyroid. The patient recovered after the operation, and there were no further complications during the 3 years of follow-up. [ABSTRACT FROM AUTHOR]

The mouthparts of the pterygosomatid mite, Pterygosoma pseudotrapelus (Bochkov, Melnikov et Nazarov, 2009) (Acariformes, Pterygosomatidae), were studied with light microscopy, scanning (SEM) and transmission (TEM) electron microscopy. The mouthparts are located within the (pseudo)tagma gnathosoma. The gnathosoma is formed of the two frontal body segments with their appendages – chelicerae and pedipalps (palps). The two-segmented chelicerae occupy a dorsal position, whereas the infracapitulum – a derivative of the fused palp coxae – occupies a ventral position. The basal cheliceral segments are widen basally, and contain protractors and retractors of the movable digits and nerve fibres. The distal cheliceral segments, the movable digits, are small and stout, bear a lateral spur, and are provided with tips looking aside. The fixed digits are long and branched. The frontal projection of the infracapitulum, the hypostome, partly envelopes laterally the distal cheliceral portions. The dorsal wall, or the roof of the infracapitulum, consists of the long labrum anteriorly possessing its own muscles and the complexly organized epistome posteriorly. The epistome and its posterior projections – the epistomal apodemes serve for origin of the pharyngeal dilators. The wide cap-shaped pharynx goes along the bottom of the infracapitulum and attaches to it. The two sigmoid pieces articulate posteriorly to the epistome and serve for origin of different sets of muscles performing retraction and protraction of the chelicerae and retraction of the gnathosoma. The peritremes are exceedingly long and protrude freely above the chelicerae. The general architecture of the mouthparts of P. pseudotrapelus corresponds more to the anystid than eleutherengonid ground pattern. [ABSTRACT FROM AUTHOR]

The exchange of water vapor between high-concentration droplets and air significantly influences droplet deposition in the upper airway model during nebulizer use. This study employed a two-way coupled Eulerian–Lagrange method to quantify nebulized droplet evaporation and relative humidity (RH) variations within an idealized mouth–throat (MT) airway model, utilizing validated numerical models. The water vapor interaction between high-concentration droplets and inhaled air was computed using a multiplier based on the particle parcel method. Simulations of normal saline droplet flow inhalation in the MT airway were conducted under two environmental conditions: indoor (26.5 °C, RH = 50%) and warm and wet (30 °C, RH = 75%), with various inhalation flow rates mirroring previous experiments. Droplet deposition fractions (DFs) and deposition patterns were recorded. The results indicated that DF initially decreased and then increased with rising inhalation flow rates. The largest discrepancy between predicted and measured DFs was 10.86%. These findings support the theory that the balance between droplet evaporation and elevated air RH dictates the deposition of nebulized droplets in the airway. Additionally, simulations revealed that environmental conditions significantly affect droplet DF, with variations up to 20.78%. The deposition hotspot shifted from the anterior to the posterior pharynx. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the influence of common pediatric orthodontic appliances on velopharyngeal (VP) MRI and to compare MR image sequences to determine if sequence parameters impact the visibility of key VP structures commonly assessed in clinical VP MRI. Design: Participants undergoing orthodontic treatment completed a VP MRI study. Level of distortion caused by orthodontic devices on 8 anatomical sites of interest and using variable MRI sequences was evaluated. Setting: Single institution Participants: Nineteen participants undergoing orthodontic treatment. Main Outcome: Level of distortion caused by metal artifacts and MR sequence used. Results: The results of this study demonstrate that appliances such as hyrax palatal expanders and braces with stainless steel brackets are acceptable for a VP MRI, while class II corrector springs are not recommended. The HASTE MRI sequence with 2D imaging techniques should be utilized if the child has orthodontic devices, while FSE and 3D imaging techniques are not recommended. The presence of wire spring coils and molar bands are likely to not to interfere with the MRI evaluation. Conclusions: Findings from this study suggest that the presence of orthodontic appliances does not hinder visualization of all velopharyngeal structures during an MRI. Therefore, careful consideration must be made prior to disqualifying or recommending patients for VP MRI. [ABSTRACT FROM AUTHOR]

The majority of patients with Parkinson's disease (PD) develop swallowing, speech, and voice (SSV) disorders. Importantly, swallowing difficulty or dysphagia and related aspiration are life-threatening conditions for PD patients. Although PD treatments have significant therapeutic effects on limb motor function, their effects on SSV disorders are less impressive. A large gap in our knowledge is that the mechanisms of SSV disorders in PD are poorly understood. PD was long considered to be a central nervous system disorder caused by the death of dopaminergic neurons in the basal ganglia. Aggregates of phosphorylated α-synuclein (PAS) underlie PD pathology. SSV disorders were thought to be caused by the same dopaminergic problem as those causing impaired limb movement; however, there is little evidence to support this. The pharynx, larynx, and tongue play a critical role in performing upper airway (UA) motor tasks and their dysfunction results in disordered SSV. This review aims to provide an overview on the neuromuscular organization patterns, functions of the UA structures, clinical features of SSV disorders, and gaps in knowledge regarding the pathophysiology underlying SSV disorders in PD, and evidence supporting the hypothesis that SSV disorders in PD could be associated, at least in part, with PAS damage to the peripheral nervous system controlling the UA structures. Determining the presence and distribution of PAS lesions in the pharynx, larynx, and tongue will facilitate the identification of peripheral therapeutic targets and set a foundation for the development of new therapies to treat SSV disorders in PD. [ABSTRACT FROM AUTHOR]

Cerebrospinal fluid (CSF) in the subarachnoid space around the brain has long been known to drain through the lymphatics to cervical lymph nodes1-17, but the connections and regulation have been challenging to identify. Here, using fluorescent CSF tracers in Prox1-GFP lymphatic reporter mice18, we found that the nasopharyngeal lymphatic plexus is a major hub for CSF outflow to deep cervical lymph nodes. This plexus had unusual valves and short lymphangions but no smooth-muscle coverage, whereas downstream deep cervical lymphatics had typical semilunar valves, long lymphangions and smooth muscle coverage that transported CSF to the deep cervical lymph nodes. α-Adrenergic and nitric oxide signalling in the smooth muscle cells regulated CSF drainage through the transport properties of deep cervical lymphatics. During ageing, the nasopharyngeal lymphatic plexus atrophied, but deep cervical lymphatics were not similarly altered, and CSF outflow could still be increased by adrenergic or nitric oxide signalling. Single-cell analysis of gene expression in lymphatic endothelial cells of the nasopharyngeal plexus of aged mice revealed increased type I interferon signalling and other inflammatory cytokines. The importance of evidence for the nasopharyngeal lymphatic plexus functioning as a CSF outflow hub is highlighted by its regression during ageing. Yet, the ageing-resistant pharmacological activation of deep cervical lymphatic transport towards lymph nodes can still increase CSF outflow, offering an approach for augmenting CSF clearance in age-related neurological conditions in which greater efflux would be beneficial.

ObjectiveThe purpose of this study was to evaluate long-term outcomes of sphincter pharyngoplasties, including speech outcomes, revision surgeries, and postoperative incidence of obstructive sleep apnea (OSA).DesignRetrospective matched-cohort study SETTING: Two craniofacial centers in Los Angeles, CA PATIENTS: Patients (n = 166) with cleft lip and palate (CLP) or isolated cleft palate (iCP) who underwent sphincter pharyngoplasty from 1992 to 2022 were identified. An age- and diagnosis-matched control group of 67 patients with CLP/iCP without velopharyngeal insufficiency (VPI) was also identified.InterventionsThe pharyngoplasty group underwent sphincter pharyngoplasty, whereas the non-VPI group had no history of VPI surgery or sphincter pharyngoplasty.Main outcome measuresPostoperative speech outcomes, revision surgeries, and incidence of OSA were evaluated. Multivariable regression was used to evaluate independent predictors of OSA.ResultsAmong the patients in the pharyngoplasty cohort, 63.9% demonstrated improved and sustained speech outcomes after a single pharyngoplasty, with a median postoperative follow-up of 8.8 years (interquartile range [IQR], 3.6-12.0 years). One-third of the patients who underwent pharyngoplasty required a revision surgery, with a median time to primary revision of 3.9 years (IQR, 1.9-7.0 years). OSA rates increased significantly among the pharyngoplasty cohort, from 3% before surgery to 14.5% after surgery (p

Abstract Background While prior research on the SPC (second primary cancer) risk among pharyngeal carcinoma (PC) patients has been conducted in other regions, the European perspective is underrepresented. Our register-based cohort study aims to assess the subsite-specific risk of SPC among individuals initially diagnosed with a pharyngeal index tumour. Methods Standardized incidence ratios (SIR) of SPC were calculated relative to the general population for all patients diagnosed with a primary oropharyngeal, nasopharyngeal, and hypopharyngeal carcinoma (OPC, NPC, and HPC) in Finland during 1953–2021. Results A total of 4701 PC patients – 3320 men (71%) and 1381 women (29%) – were identified. The average and median follow-up times were 5.7 and 2.8 years, respectively. A SPC was diagnosed in 561 patients (11.9%): in 12.3% of men (n = 410) and 10.9% of women (n = 151). For male PC patients, the overall SIR for an SPC at any primary site was 1.83 (95% CI: 1.65–2.01). For female patients, the corresponding SIR was 1.89 (95% CI: 1.60–2.22). OPC and HPC showed increased risks for SPCs of the mouth/pharynx (SIR 4.41 and 6.91, respectively) and respiratory organs (SIR 3.51 and 4.80). OPC patients also had an increased risk in digestive organs (SIR 1.83). Male NPC patients exhibited increased risks for oral/pharyngeal, brain, and haematolymphoid SPCs (SIRs 5.14, 6.60, and 3.05, respectively). Conclusion PC patients face an 80% higher SPC risk, which persists decades after treatment. Healthcare professionals must be aware of this, providing counselling and encouraging a healthy lifestyle, including smoking cessation, while monitoring symptoms.

Pharyngitis is an inflammatory condition of the pharynx and/or tonsils commonly seen in both children and adults. Viruses and bacteria represent the most common encountered etiologic agents—yeast/fungi and parasites are infrequently implicated. Some of these are predominantly observed in unique populations (eg, immunocompromised or unvaccinated individuals). This article (part 1 of 3) summarizes the impact of acute pharyngitis on the health care system and reviews the etiologic agents of acute pharyngitis, including both emerging and reemerging pathogens that health care providers should consider when evaluating their patients. Finally, it sets the stage for parts 2 and 3, which discuss the current and evolving state of diagnostic testing for acute pharyngitis. [ABSTRACT FROM AUTHOR]

Background Although polioviruses (PVs) replicate in lymphoid tissue of both the pharynx and ileum, research on polio vaccine–induced mucosal immunity has predominantly focused on intestinal neutralizing and binding antibody levels measured in stool. Methods To investigate the extent to which routine immunization with intramuscularly injected inactivated polio vaccine (IPV) may induce nasal and pharyngeal mucosal immunity, we measured PV type-specific neutralization and immunoglobulin (Ig) G, IgA, and IgM levels in nasal secretions, adenoid cell supernatants, and sera collected from 12 children, aged 2–5 years, undergoing planned adenoidectomies. All participants were routinely immunized with IPV and had no known contact with live PVs. Results PV-specific mucosal neutralization was detected in nasal and adenoid samples, mostly from children who had previously received 4 IPV doses. Across the 3 PV serotypes, both nasal (Spearman ρ ≥ 0.87, P ≤.0003 for all) and adenoid (Spearman ρ ≥ 0.57, P ≤.05 for all) neutralization titers correlated with serum neutralization titers. In this small study sample, there was insufficient evidence to determine which Ig isotype(s) was correlated with neutralization. Conclusions Our findings provide policy-relevant evidence that routine immunization with IPV may induce nasal and pharyngeal mucosal immunity. The observed correlations of nasal and pharyngeal mucosal neutralization with serum neutralization contrast with previous observations of distinct intestinal and serum responses to PV vaccines. Further research is warranted to determine which antibody isotype(s) correlate with polio vaccine–induced nasal and pharyngeal mucosal neutralizing activity and to understand the differences from intestinal mucosal immunity. [ABSTRACT FROM AUTHOR]

Objective To describe Neisseria gonorrhoeae treatment failure to the recommended antimicrobial regimens (azithromycin, cefixime and ceftriaxone). Methods Our study was a longitudinal analysis of treatment failures from an observational open cohort of gonococcal infection cases collected in Québec, Canada (n  = 2547) between September 2015 and December 2019. Epidemiological and clinical data were collected using a self-administered questionnaire, direct case interviews and chart reviews. Antimicrobial susceptibility testing was performed using the agar dilution method. To be retained as a treatment failure, cases must have had (i) a laboratory-confirmed gonococcal infection; (ii) a documented treatment; (iii) a positive test of cure (TOC) performed within a defined period and (iv) no sexual contact (vaginal, oral or anal), even protected with a condom, between the beginning of treatment and the positive TOC. A broader definition, including suspected cases, was also examined. Results Among 1593 cases where a TOC was performed, 83 had a positive TOC: 11 were retained as treatment failure, and 6 were considered suspected cases (overall = 17/1593; 1.1%). Possible explanations for retained or suspected treatment failure included resistance to the antibiotics used for treatment (n  = 1), pharyngeal infection (n  = 9, of which 5 had been treated with ceftriaxone and 4 with other regimens); and azithromycin monotherapy (n  = 1). Some cases had more than one potential explanation. Conclusions Treatment failure occurred in 1.1% of cases of Neisseria gonorrhoeae infection for which a TOC was performed, including some cases of pharyngeal infection treated with ceftriaxone. [ABSTRACT FROM AUTHOR]

Objective: This observational study investigates migratory foreign bodies in the upper aerodigestive tract, emphasising clinical presentation, assessment and factors contributing to extraluminal migration. Methods: Conducted across multiple medical centres in India, the study included 15 patients aged 11 to 70 years. Detailed observations, demographic information, clinical history, radiological findings and intra-operative outcomes were compiled. Results: Fifteen patients presented with varied symptoms. Fish and chicken bones, along with metal wires, were common foreign bodies. Computed tomography scans played a crucial role in diagnosis, confirming extraluminal migration. Neck exploration successfully retrieved foreign bodies in most cases, with varied sites of impaction. Conclusion: Migratory foreign bodies, although rare, pose significant challenges for otolaryngologists. Early recognition, thorough diagnosis and meticulous neck exploration, is crucial for effective management, preventing severe complications. This study adds valuable insights to the understanding of migratory foreign bodies, contributing to the existing literature in otolaryngology practice. [ABSTRACT FROM AUTHOR]

Head and neck cancers affect speech, swallowing, and breathing, presenting physical and psychosocial challenges for patients. Understanding risk factors, symptoms, importance of early detection, and treatment options is essential for effective management and improved outcomes. [ABSTRACT FROM AUTHOR]

The article focuses on pediatric sore throats in the emergency department, highlighting the need to differentiate viral and bacterial causes, identify life-threatening conditions like epiglottitis, and implement effective diagnostic and treatment strategies.

Purpose: Respiratory-swallow coordination (RSC) frequently changes in people with Parkinson's disease (PwPD). Little is known about how these changes relate to impairments in swallowing safety (penetration and aspiration) and efficiency (pharyngeal residue). Therefore, the aims of this study were to assess the relationships between RSC, pharyngeal residue, penetration, and aspiration in PwPD. Method: Twenty-four PwPD were recruited to undergo simultaneous assessment of RSC, swallowing safety, and swallowing efficiency. RSC was assessed using respiratory inductive plethysmography and nasal airflow and included measurements of respiratory pause duration, respiratory phase patterning, and lung volume during swallowing. Swallowing safety and efficiency were assessed using flexible endoscopic evaluation of swallowing, analyzed using the Visual Analysis of Swallowing Efficiency and Safety, and included measurements of pharyngeal residue, penetration, and aspiration. All data were blindly analyzed, with 20% of the data repeated for interrater reliability assessment. Multilevel statistical models were used to examine the relationships between RSC and swallowing. Results: A total of 812 swallows were analyzed from 24 participants. Only 33.4% of swallows exhibited the typical exhale-swallow-exhale pattern. Additionally, 95% of participants exhibited abnormal swallow function. More severe hypophar-yngeal residue ratings were associated with inhaling before the swallow compared to exhaling before the swallow. Additionally, more severe events of penetration and aspiration were associated with (a) inhaling before the swallow compared to exhaling before the swallow, (b) inhaling after the swallow compared to exhaling after the swallow, and (c) longer swallow-related respiratory pause durations. Inhaling after the swallow exhibited the strongest relationship with impairments in swallowing safety when compared to all other RSC variables. Conclusions: RSC exhibited significant relationships with pharyngeal residue, penetration, and aspiration in these PwPD. Clinicians should attend to RSC when assessing swallowing in PwPD. Future research is needed to examine if training an exhale-swallow-exhale pattern can be used to improve disordered swallowing in PwPD. [ABSTRACT FROM AUTHOR]

Purpose: Age- and disease-related changes in oropharyngeal anatomy and physiology may be identified through quantitative videofluoroscopic measures of pharyngeal area and dynamics. Pixel-based measures of nonconstricted pharyngeal area (PhAR) are typically taken during oral bolus hold tasks or on post-swallow rest frames. A recent study in 87 healthy adults reported mean post-swallow PhAR of 62%(C2-4)², (range: 25%-135%), and significantly larger PhAR in males. The fact that measures were taken after initial bolus swallows without controlling for the presence of subsequent clearing swallows was identified as a potential source of variation. A subset of study participants had completed a protocol including additional static nonswallowing tasks, enabling us to explore variability across those tasks, taking sex differences into account. Method: Videofluoroscopy still shots were analyzed for 20 healthy adults (10 males, 10 females, Mage = 26 years) in head-neutral position, chin-down and chin-up positions, a sustained /a/ vowel vocalization, and oral bolus hold tasks (1-cc, 5-cc). Trained raters used ImageJ software to measure PhAR in %(C2-4)² units. Measures were compared to previously reported mean postswallow PhAR for the same participants: (a) explorations of sex differences; (b) pairwise linear mixed-model analyses of variance (ANOVAs) of PhAR for each nonswallowing task versus postswallow measures, controlling for sex; and (c) a combined mixed-model ANOVA to confirm comparability of the subset of tasks showing no significant differences from postswallow measures in Step 2. Results: Overall, PhAR measures were significantly larger in male participants; however, most pairwise task comparisons did not differ by sex. No significant differences from postswallow measures were seen for 5-cc bolus hold, chin-down and chin-up postures, and the second (but not the first) of two repeated head neutral still shots. PhAR during a 5-cc bolus hold was most similar to postswallow measures: mean ± standard deviation of 51 ± 13%(C2-4)² in females and 64 ± 16%(C2-4)² in males. Conclusions: PhAR is larger in men than in women. Oral bolus hold tasks with a 5-cc liquid bolus yield similar measures to those obtained from postswallow rest frames. [ABSTRACT FROM AUTHOR]

Objective: To introduce a highly innovative imaging method to study the complex velopharyngeal (VP) system and introduce the potential future clinical applications of a VP atlas in cleft care. Design: Four healthy adults participated in a 20-min dynamic magnetic resonance imaging scan that included a high-resolution T2-weighted turbo-spin-echo 3D structural scan and five custom dynamic speech imaging scans. Subjects repeated a variety of phrases when in the scanner as real-time audio was captured. Setting: Multisite institution and clinical setting Participants: Four adult subjects with normal anatomy were recruited for this study. Main Outcome: Establishment of 4-D atlas constructed from dynamic VP MRI data. Results: Three-dimensional dynamic magnetic resonance imaging was successfully used to obtain high quality dynamic speech scans in an adult population. Scans were able to be re-sliced in various imaging planes. Subject-specific MR data were then reconstructed and time-aligned to create a velopharyngeal atlas representing the averaged physiological movements across the four subjects. Conclusions: The current preliminary study examined the feasibility of developing a VP atlas for potential clinical applications in cleft care. Our results indicate excellent potential for the development and use of a VP atlas for assessing VP physiology during speech. [ABSTRACT FROM AUTHOR]

Dynamic nasopharyngeal collapse (NPC) is an obstructive upper airway disease that affects mainly the inspiratory phase of respiration in horses undergoing strenuous exercise. It occurs when the neuromuscular activity of the nasopharynx is overwhelmed by the intense negative pressures generated during exercise. This leads to collapse of at least one of the four components of the nasopharynx which is comprised of the two lateral walls, the dorsal roof and the ventral soft palate. As a result, the airway diameter and thus airflow become compromised. Even small changes in the airway diameter produces profound increases in negative inspiratory pressure, perpetuating the cycle of collapse. Compared to other dynamic upper respiratory tract disorders, the amount of literature on NPC as a disease entity is limited. The exact pathophysiology of NPC is unknown; however, it impacts up to one quarter of high‐performance equine athletes presenting for poor performance. There is currently no definitive treatment for this severely performance‐limiting condition. Thus, the prognosis for future athletic prognosis is guarded, with most horses being retired from racing or athletic use in general. Further research is warranted in this field to reduce the impact of disease and in turn, reduce the turnover rate and economic loss by enhancing the career longevity of elite equine athletes diagnosed with NPC. [ABSTRACT FROM AUTHOR]

Early detection of severe acute respiratory syndrome coronavirus 2 infection by diagnostic tests can prompt actions to reduce transmission and improve treatment efficacy, especially for vulnerable groups such as immunocompromised individuals. Recent evidence suggests that sampling the throat in addition to the nose improves clinical sensitivity during early infection for both antigen and molecular coronavirus disease 2019 tests. We urge test manufacturers to validate tests for use with throat swab, in combination with nasal swabs. [ABSTRACT FROM AUTHOR]

Objective: Oxaliplatin is a platinum-group chemotherapeutic agent commonly used in the treatment of colorectal cancer. In addition to hematological and gastrointestinal side effects, laryngopharyngeal dysesthesia associated with cold is reported as a rare side effect. In this article, seven cases with pharyngolaryngeal dysesthesia were presented and the diagnosis and treatment planning were reviewed in the light of literature findings. Material and Methods: Patient records of cancer patients with laryngopharyngeal dysesthesia were retrospectively analyzed between 2020 and 2023. Demographic characteristics, presenting complaints, vital signs, physical examination, and laboratory tests of the patients diagnosed with laryngopharyngeal dysesthesia were recorded. Results: Seven patients who had gastrointestinal malignancy and oxaliplatin chemotherapy were diagnosed with laryngopharyngeal dysesthesia. The symptoms most commonly developed due to cold weather. The symptoms of three patients had developed while receiving treatment, while four patients were admitted to emergency service after oxaliplatin infusion. The physical examinations revealed no pathological findings of the allergic reaction at presentation or during follow-up skin. Patients were monitored and nasal oxygen therapy was administered. A 5 mg intravenous infusion was given for anxiety symptoms in three patients. Patients were discharged after 4 hours of follow-up with resolution of all symptoms Conclusion: Laryngopharyngeal dysesthesia should be kept in mind in patients treated with oxaliplatin and presenting with shortness of breath and a feeling of suffocation after cold exposure. [ABSTRACT FROM AUTHOR]

Objective: For over a century, circumferential pharyngoesophageal junction reconstruction posed significant surgical challenges. This review aims to provide a narrative history of pharyngoesophageal junction reconstruction from early surgical innovations to the advent of modern free-flap procedures. Methods: The review encompasses three segments: (1) local and/or locoregional flaps, (2) visceral transposition flaps, and (3) free-tissue transfer, focusing on the interplay between pharyngoesophageal junction reconstruction and prevalent surgical trends. Results: Before 1960, Mikulicz-Radecki's flaps and the Wookey technique prevailed for circumferential pharyngoesophageal junction reconstruction. Gastric pull-up and colonic interposition were favoured visceral techniques in the 1960s–1990s. Concurrently, deltopectoral and pectoralis major flaps were the preferred cutaneous methods. Free flaps (radial forearm, anterolateral thigh) revolutionised reconstructions in the late 1980s, yet gastric pull-up and free jejunal transfer remain in selective use. Conclusions: Numerous pharyngoesophageal junction reconstructive methods have been trialled in the last century. Despite significant advancements in free-flap reconstruction, some older methods are still in use for challenging clinical situations. [ABSTRACT FROM AUTHOR]

By summarizing and analyzing the diagnostic and treatment process of a case with atypical Stevens–Johnson syndrome (SJS) characterized by mucosal ulcerations of the pharynx and larynx, and reviewing related literature, we would like to remind that in the presence of unexplained mucosal lesions, atypical SJS should not be ignored. [ABSTRACT FROM AUTHOR]

Although swallowing has been reviewed extensively, the coordination of the phases of swallowing have not. The phases are controlled by the brainstem, but peripheral factors help coordinate the phases. The occurrence, magnitude, and duration of esophageal phase depends upon peripheral feedback activated by the bolus. The esophageal phase does not occur without peripheral feedback from the esophagus. This feedback is mediated by esophageal slowly-adapting mucosal tension receptors through the recurrent and superior laryngeal nerves. A similar reflex mediated by the same peripheral pathway is the activation of swallowing by stimulation of the cervical esophagus. This reflex occurs primarily in human infants and animals, and this reflex may be important for protecting against aspiration after esophago-pharyngeal reflux. Not only are there inter-phase excitatory processes, but also inhibitory processes. A significant inhibitory process is deglutitive inhibition. When one swallows faster than peristalsis ends, peristalsis is inhibited by the new pharyngeal phase. This process prevents the ongoing esophageal peristaltic wave from blocking the bolus being pushed into the esophagus by the new wave. The esophageal phase returns during the last swallow of the sequence. This process is probably mediated by mucosal tension receptors through the superior laryngeal nerves. A similar reflex exists, the pharyngo-esophageal inhibitory reflex, but studies indicate that it is controlled by a different neural pathway. The pharyngo-esophageal inhibitory reflex is mediated by mucosal tension receptors through the glossopharyngeal nerve. In summary, there are significant peripheral processes that contribute to swallowing, whereby one phase of swallowing significantly affects the other. [ABSTRACT FROM AUTHOR]

Background: Many infectious diseases are diagnosed in emergency departments (ED) and patients are prescribed antimicrobial therapy. Results from cultures typically take a few days to become finalized. Following up on these results is necessary when medication changes are indicated due to results that show bacteria are resistant to the prescribed antibiotics. Involving pharmacists in assessing the culture and sensitivity results, and making interventions when needed, is an innovative way to ensure that patients receive appropriate antimicrobial therapy based on the culture and sensitivity data. This study analyzed the impact of pharmacist involvement in the ED's post-discharge positive culture review process on ED re-visits and hospitalizations. Methods : This single-center, pre- and post-implementation study examined the impact of pharmacist involvement in the post-ED visit culture review process on ED re-visits and hospitalizations. Positive microbiological results included documented growth from urine, skin and soft tissue, throat, blood, or stool cultures. Patients included in the study were of 18 years of age or older and had a positive culture result post ED-discharge. Patients were excluded from the study if they were admitted to the hospital or transferred to another facility. The primary outcomes included ED re-visits within 7 days and hospital readmissions within 30 days for the same condition. The secondary outcomes were percentage of pharmacist interventions accepted and types of pharmacist interventions implemented. Results : A total of 141 patients were included in the study, with 65 in the pre-implementation group and 76 in the post-implementation group. The primary outcome of ED re-visits within 7 days for the same condition occurred in 11 (17%) patients in the pre-implementation group and 5 (7%) patients in the post-implementation group (P =.0454). The primary outcome of hospitalizations within 30 days for the same condition occurred in 5 (8%) patients in the pre-implementation group and 1 (1%) patient in the post-implementation group (P =.0137). Seventeen (94%) out of the 18 pharmacist interventions were accepted and implemented. The intervention types implemented were to recommend to: change antibiotic (35%), not initiate antibiotic (24%), initiate antibiotic (24%), and continue antibiotic (18%). Conclusion : Pharmacist involvement in the ED post-discharge positive culture review process showed a decrease in ED re-visits and hospitalizations for the same condition. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study is to (a) provide quantitative data on the growth of levator veli palatini (LVP), velopharyngeal (VP), and craniofacial dimensions in children under 12 months while controlling for corrected age and sex and (b) compare variability within age and sex groups. Method: Magnetic resonance imaging scans of 75 infants between 0 and 12 months were measured and divided into four age groups. These data were obtained as part of a larger retrospective study. Following exclusion criteria, scans were analyzed, and dependent variables were obtained. Results: There was a statistically significant (p < .0001) difference between corrected age groups on LVP muscle, VP, and craniofacial variables while controlling for sex. Significant growth effects were observed for LVP length (p < .0001), extravelar length (p < .0001), intravelar length (p = .048), midline thickness (p = .0001), origin-origin distance (p < .0001), velar length (p < .0001), velar thickness (p = .003), nasion-sella turcica distance (p < .0001), sella turcica-basion distance (p < .0001), and hard palate length (p < .0001). Significant sex effects were observed for pharyngeal depth (p = .026) and effective VP ratio (p = .014). When age was treated as a continuous variable, similar results were observed for all variables except pharyngeal depth. Within-group comparisons revealed the most variability occurs between 3 and 5.99 months for LVP and craniofacial variables and between 9 and 11.99 months of age for VP variables. Male participants demonstrated greater variability than female participants. Conclusions: Differences were observed in LVP, VP, and craniofacial variables in children under 12 months while controlling for sex. Males demonstrated larger values and greater variability for most variables. [ABSTRACT FROM AUTHOR]

Objective: We have used micro-computed tomography (CT) to elucidate the relationship between the muscle fibers in specimens with cleft palate. These findings could be useful for muscle reconstruction in cleft palate repair and to better understand cleft palate speech. Design: Cadaveric anatomical study. Participants: This study included three specimens with cleft palate Intervention: The specimens were stained with phosphomolybdic acid and scanned by Micro-CT. Main Outcome Measure(s): The anatomy of the muscles. Results: Using 2D projection images and 3D reconstruction models, subtle anatomical structures could be observed in the muscles. The attachment of the levator veli palatini (LVP) was not at the posterior edge of the hard palate or palatine aponeurosis (PA), but at the anterior 21.71-44.2% of the cleft edge. The palatopharyngeal (PP) was composed of two bundles: inferior and superior heads, which clasped the LVP. The uvularis was unevenly distributed, and located on both sides of the cleft edge, originating at the edge. The palatoglossus, superior constrictor of pharynx and anatomical structure around the pterygoid hamulus, were normal. The PA, PP and LVP were attached to the cleft edge from front to back, in that order. The position of the uvularis was not fixed. Conclusions: With the help of Micro-CT technology, detailed anatomical features and the relationship between muscles could be visualized. In the specimen with cleft palate, muscles in the soft palate were associated with the pharyngeal muscles, which formed the 3D "velopharyngeal muscles complex." These findings provide anatomical evidence for muscle reconstruction in cleft palate repair. [ABSTRACT FROM AUTHOR]

This study evaluated the validity of pharyngeal 2D area measurements acquired from the lateral view for predicting the actual 3D volume in healthy adults during swallowing. Seventy-five healthy adults (39 females, 36 males; mean age 51.3 years) were examined using 320-row area detector computed tomography (320-ADCT). All participants swallowed a 10 mL honey-thick barium bolus upon command while seated in a 45° semi-reclining position. Multi-planar reconstruction images and dynamic 3D-CT images were obtained using Aquilion ONE software. Pharyngeal 2D area and 3D volume measurements were taken before swallowing and at the frame depicting maximum pharyngeal constriction. Pharyngeal volume before swallowing (PVhold) was accurately predicted by 2D area (R2 = 0.816). Adding height and sex to the model increased R2 to 0.836. Regarding pharyngeal volume during maximum constriction (PVmax), 2D area also exhibited acceptable predictive power (R2 = 0.777). However, analysis of statistical residuals and outliers revealed a greater tendency for prediction errors when there is less complete constriction of the pharynx as well as asymmetry in bolus flow or movement. Findings highlight the importance of routinely incorporating anterior–posterior views during VFSS exams. Future work is needed to determine clinical utility of pharyngeal volume measurements derived from 320-ADCT. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the normal volumetric space and variations in the measurements of different landmarks in adults with different skeletal relations of the maxilla and the mandible based on CBCT data. The study also analyses these landmarks to locate any correlations. Background: Numerous studies in orthodontics have found a relationship between orthodontic treatment and changes in the anatomy and function of the airway. Severe changes in airway morphology can cause breathing difficulties, lower quality of life, and even result in life-threatening conditions such as obstructive sleep apnoea. Consequently, orthodontic diagnosis and treatment planning require a thorough understanding of the airway space and its function. Methods: The present retrospective study was conducted using CBCT records of 120 adult patients, containing 40 samples of each skeletal class (20 males and 20 females). The boundaries were defined for the 3 major regions: the nasopharynx, the oropharynx, and the hypopharynx. Various measurements were recorded across these regions, as well as selective cephalometric landmarks. The obtained data was used to calculate average and standard deviation, while regression analysis was used to evaluate correlations and t-test was used to test statistical significance of gender differences. Results: The results demonstrate that skeletal Class III individuals exhibit a reduced airway volume in the nasopharynx compared to other groups, whereas skeletal Class II individuals displayed a diminished airway volume in the hypopharynx. A strong correlation was observed for Sella turcica parameters. There were no significant differences in skeletal parameters across genders. Nasopharynx cavity volume demonstrated significant differences between skeletal Class I–Class III as well as between skeletal Class II–Class III. Hypopharynx cavity volume also demonstrated significant differences between skeletal Class I–Class II and between skeletal Class II–Class III. Conclusion: The major findings are the presence of a reduced nasopharyngeal volume in skeletal Class III malocclusions while skeletal Class II individuals displayed a diminished hypopharyngeal volume, making these critical areas to consider during the diagnostic and orthodontic treatment planning stages. This study also revealed a consistent correlation between Sella turcica parameters across various facial skeletal profiles, with skeletal Class II patients exhibiting a distinct pattern and skeletal Class I and Class III demonstrating an average relationship. [ABSTRACT FROM AUTHOR]

Introduction: Introduction: Junctional Epidermolysis Bullosa (JEB) is a rare subtype of the Epidermolysis Bullosa which itself is a rare genetic disorder. While mucosal involvement of pharynx and oesophagus has been reported, laryngeal involvement is rare. Case Report: A 7-month-old male child who was known to have Junctional Epidermolysis Bullosa presented to the emergency department with respiratory distress associated with a stridor which was eventfully found to have multiple level laryngeal stenosis. Conclusions: Longitudinal cohort studies are required to determine the long-term outcome and the anticipated behavior of epidermolysis bullosa in patients with laryngeal manifestation to avoid unnecessary surgical interventions. [ABSTRACT FROM AUTHOR]

Stilbonematinae are nematodes commonly found in shallow marine sands. They are overgrown by a genus- and species-specific coat of chemoautotrophic sulphur-oxidizing ectosymbiotic bacteria which profit from the vertical migration of their hosts through the chemocline by alternately gaining access to oxidizing and reducing chemical species, while in return, the host feeds on its symbionts. The subfamily exhibits a large morphological variability; e.g. the anterior pharynx is cylindrical in genera possessing a voluminous coat, but species with a bacterial monolayer possess a distinctly swollen corpus and therefore a tripartite pharynx. Since 18S-based phylogenetic analyses do not show close relationships between corpus-bearing species, we investigated the pharynx morphology using phalloidin staining in combination with confocal laser scanning microscopy, transmission electron microscopy and light microscopy in order to assess an independent evolution. The class-wide stable position of the subventral pharynx ampullae was used as a morphological marker. Ampullae are positioned at the anterior-most end of the isthmus in Cyathorobbea, further posterior in Catanema and Robbea and inside the corpus in Laxus oneistus. We therefore conclude an independent evolution of corpus enlargements within Stilbonematinae. This further suggests that pharynx morphology is driven by the volume of the symbiotic bacterial coat rather than phylogeny. Based on an existing mathematical model, an enlarged corpus should enable its bearer to ingest food in smaller quantities, in gourmet style, whereas a cylindrical pharynx would restrict its bearer to ancestral gourmand feeding. A review of pharynx types of Nematoda showed that the Stilbonematinae pharynx is substantially different compared to other tripartite pharynges. The lack of pharyngeal tubes and valves, the undivided corpus and evenly distributed nuclei in the isthmus warrant the definition of the "stilbonematoid" three-part pharynx. [ABSTRACT FROM AUTHOR]

Background: Natural head position (NHP), pharyngeal airway and maxillofacial growth pattern are correlated. The author's previous studies proved that following surgical correction of Skeletal Class II malocclusion, the over‐extended NHP returned upright, and the pharyngeal airway space (PAS) dimension expanded. Objective: The present study compares the post‐operative change in NHP and PAS after orthognathic surgery in Skeletal Class II and III malocclusion patients. Methods: Patients receiving orthognathic procedures to correct Skeletal Class II or III malocclusions were reviewed in this retrospective study. Pre‐operative and 6‐week post‐operative cone‐beam computed tomography datasets were collected. Variables representing the craniofacial pattern, the NHP and the PAS were measured three‐dimensionally. Post‐operative variables were compared with their pre‐operative counterparts using either repeat‐measure 2‐way analysis of variance or Wilcoxon matched‐pairs signed rank test. Results: Thirty cases of Skeletal Class II malocclusion and 13 cases of Skeletal Class III malocclusion were collected. Preoperatively, the inter‐group differences were significant in craniofacial pattern (68.14 ± 3.552 degree vs. 79.63 ± 2.497 degree, p <.0001) and the NHP (68.77 ± 11.02 degree vs. 82.83 ± 7.738 degree, p =.0002) while not significant in PAS; after surgery, the intergroup differences in craniofacial pattern and the NHP between groups decreased, and the PAS increased in both groups. Conclusion: Orthognathic surgery may improve compromised NHP and increase PAS in Skeletal Class II and III malocclusion patients. [ABSTRACT FROM AUTHOR]

The present study explores rare but taxonomically and geographically widespread cases of anterior body axial bifurcation in adult sea cucumbers (Echinodermata: Holothuroidea). One individual of Holothuria (Halodeima) grisea, a common intertidal species along the Atlantic coast of Brazil, was studied externally and internally. Individuals of Apostichopus californicus from the northeastern Pacific coast of Washington (USA), H. (Mertensiothuria) leucospilota in the Indian Ocean off La Réunion, H. (Panningothuria) forskali from the Atlantic coast of Spain, and Parastichopus tremulus from the northeastern Atlantic off Norway were also reported to display similar anterior body axial bifurcation. In each of these species, the anterior body presented two mouths with their respective crown of tentacles. In vivo observations of H. (Halodeima) grisea showed that the two tentacle crowns and mouths were independently functional. Micro‐computed tomography (μCT) revealed that the anterior region of the body (up to the pharynx) was duplicated. Internally, two aquapharyngeal bulbs were found, each with their own calcareous ring (one with two plates missing), madreporite, and Polian vesicles. The body presented a normal set of five longitudinal muscle bands, some of which bifurcated orally to support more than one calcareous ring plate. This is the first report of such abnormalities in Holothuroidea and hypotheses that may explain such phenomenon are discussed. [ABSTRACT FROM AUTHOR]

The article focuses on a case study of a 15-year-old girl exhibiting chronic throat-squeezing behavior as a form of nonsuicidal self-injury (NSSI) following trauma. Topics include the prevalence and implications of NSSI among adolescents, the psychological impact of negative childhood experiences on such behaviors, and the effectiveness of sertraline treatment in reducing both depressive symptoms and the frequency of throat-squeezing behavior.