scholarly journals Surgical Anatomy of the Tonsils

2021 ◽  
Author(s):  
Gülay Açar
Keyword(s):  
Airway Obstruction ◽  
Surgical Intervention ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Surgical Anatomy ◽  
Optimal Choice ◽  
Upper Airway Obstruction ◽  
Lymphoid Tissues ◽  
Waldeyer’S Ring ◽  
Iatrogenic Complications

The tonsils represent a circular band of mucosa associated with lymphoid tissues, Waldeyer’s ring, which is located at the entrance of the upper aerodigestive tract, with a significant role in the immune defense system. Waldeyer’s ring is composed of the pharyngeal, tubal, palatine, and lingual tonsils acting as secondary lymphoid tissues. Particularly, the palatine tonsils are the largest of the tonsils with deep branching crypts and contain B and T lymphocytes and M cell which plays a role in the uptake and transport of antigens. Because of the tonsil enlargement during childhood, upper airway obstruction and obstructive sleep apnea syndrome are mostly seen. Knowledge of the surgical anatomy of the tonsils and variations of the neurovascular and muscular structures around it allows optimal choice of surgical technique to avoid iatrogenic complications during tonsillectomy. Recent medical studies reported that a detailed understanding of the anatomic risk factors in upper airway obstruction allows to predict treatment response to surgical intervention. Due to the penetration of benign or malign lesions of the tonsil into the lateral wall of the pharynx, transoral robotic approach to this region is necessary to identify the surgical anatomic landmarks which are required to perform safe and effective surgical intervention.

scholarly journals Children with Upper Airway Dysfunction: At Risk of Obstructive Sleep Apnea

2019 ◽  
Vol 09 (01) ◽  
pp. e59-e67
Author(s):  
Carlos Sisniega ◽  
Umakanth Katwa
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Adverse Outcomes ◽  
Upper Airway Obstruction ◽  
Lymphoid Tissues ◽  
Obstructive Sleep ◽  
Potential Risk Factors

AbstractObstructive sleep apnea is characterized by prolonged partial upper airway obstruction or intermittent complete obstruction that disrupts normal ventilation during sleep and alters normal sleep patterns. Patients with obstructive sleep apnea tend to develop neurocognitive, cardiovascular, behavioral, attention issues, and poor academic performance. Therefore, it is essential to diagnose and treat obstructive sleep apnea early and avoid significant and long-lasting adverse outcomes. Most commonly, upper airway obstruction is caused by enlarged lymphoid tissues within the upper airway, and therefore adenotonsillectomy is considered as the first-line treatment of obstructive sleep apnea in children. Fifty to 70% of patients who have obstructive sleep apnea and treated by surgery are not entirely cured on follow-up polysomnography. In light of this, it is recommended that patients with suspected obstructive sleep apnea undergo a thorough evaluation, and all potential risk factors are identified and treated. The purpose of this review is to familiarize pediatricians with developmental, anatomical, and physiological risk factors involved in the development of obstructive sleep apnea. Additionally, we will present an array of evaluation techniques that can offer adequate assessment of the patient's upper airway anatomy and physiology.

Sleep apnea syndrome: Diagnosis of upper airway obstruction by fluoroscopy

1978 ◽  
Vol 93 (5) ◽  
pp. 891-892 ◽  
Author(s):  
Thomas H. Smith ◽  
R. Eugene Baska ◽  
C.B. Francisco ◽  
Glen M. McCray ◽  
Steve Kunz
Keyword(s):  
Sleep Apnea ◽  
Airway Obstruction ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Syndrome Diagnosis ◽  
Apnea Syndrome

Management of upper airway obstruction in Pierre Robin sequence

1997 ◽  
Vol 111 (12) ◽  
pp. 1155-1156 ◽  
Author(s):  
A. P. Bath ◽  
P. D. Bull
Keyword(s):  
Airway Obstruction ◽  
Surgical Intervention ◽  
Neonatal Period ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Pierre Robin Sequence ◽  
Severe Respiratory Distress ◽  
Feeding Difficulties ◽  
Robin Sequence ◽  
Pierre Robin

AbstractPierre Robin sequence (PRS) presents in the neonatal period with upper airway obstruction and feeding difficulties. Infants with pronounced micrognathia may fail to thrive because of chronic airway obstruction, or experience severe respiratory distress. This is potentially fatal and surgical intervention in these cases is necessary. We present our series of cases with severe PRS requiring surgical relief of their airway obstruction, and the reasons for preferring tracheostomy over glossopexy.

scholarly journals Localized Advanced Hürthle Cell Carcinoma with Symptomatic Intrathoracic Goiter

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Kabir Ahmed ◽  
Darren Swartz ◽  
Deepu Daniel ◽  
Craig Crespi ◽  
Andrew Rosenthal ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Cell Carcinoma ◽  
Surgical Intervention ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Indication For Surgery ◽  
Intrathoracic Goiter ◽  
Hürthle Cell ◽  
Hürthle Cell Carcinoma ◽  
Hurthle Cell Carcinoma

Intrathoracic goiters are divided into two categories: primary and secondary. Intrathoracic goiters (IG) can cause upper airway obstruction. The presence of obstructive symptoms secondary to increased thyroid growth and tracheal compression is major indication for surgery; however, goiters do not always require immediate surgical attention. In addition, although some diagnostic tests indicate upper airway obstruction, many patients remain asymptomatic. Surgeries to remove IG are performed routinely however, they are not without risk. In some cases, intrathoracic goiters present as thyroid cancers. Very rare cancers such as Hürthle cell carcinoma (HCC) can create a challenge for the surgeon when surgical intervention is vital.

scholarly journals Functional Upper Airway Obstruction

1998 ◽  
Vol 26 (2) ◽  
pp. 216-218 ◽  
Author(s):  
A. Norton ◽  
G. Roberton
Keyword(s):  
Airway Obstruction ◽  
Surgical Intervention ◽  
Correct Diagnosis ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Functional Disorders ◽  
Vocal Cords ◽  
Functional Dysphonia ◽  
Acute Airway Obstruction ◽  
Appropriate Therapy

Functional disorders of the vocal cords can present with acute, dramatic upper airway obstruction, with features mimicking asthma or functional dysphonia. We report the case of an eighteen-year-old female with acute airway obstruction initially misdiagnosed as asthma. Laryngoscopy, bronchoscopy and psychiatric assessment confirmed a diagnosis of functional disorder of the vocal cords. Although a diagnosis of exclusion, it must be borne in mind in order to reduce unnecessary medical therapy and surgical intervention. It is only with the correct diagnosis that patients can receive appropriate therapy.

Utility of sleep nasendoscopy versus microlaryngotracheobronchoscopy in the diagnosis of paediatric upper airway obstruction

2021 ◽  
pp. 1-3
Author(s):  
G Khong ◽  
S Sood ◽  
H Jones ◽  
S Sharma ◽  
S De
Keyword(s):  
Airway Obstruction ◽  
Surgical Intervention ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Upper Airway Obstruction ◽  
Paediatric Hospital ◽  
Obstructive Sleep ◽  
Hospital Patients ◽  
Physiological Sleep ◽  
Sleep Nasendoscopy

Abstract Objective To describe the utility of sleep nasendoscopy in determining the level of upper airway obstruction compared to microlaryngotracheobronchoscopy. Methods A retrospective observational study was conducted at a tertiary level paediatric hospital. Patients clinically diagnosed with upper airway obstruction warranting surgical intervention (i.e. with obstructive sleep apnoea or laryngomalacia) were included. These patients underwent sleep nasendoscopy in the anaesthetic room; microlaryngotracheobronchoscopy was subsequently performed and findings were compared. Results Twenty-seven patients were included in the study. Sleep nasendoscopy was able to induce stridor or stertor, and to detect obstruction at the level of palate and pharynx, including tongue base collapse, that was not observed with microlaryngotracheobronchoscopy. Only 47 per cent of patients who had prolapse or indrawing of arytenoids on sleep nasendoscopy had similar findings on microlaryngotracheobronchoscopy. However, microlaryngotracheobronchoscopy was better in diagnosing shortened aryepiglottic folds. Conclusion This study demonstrates the utility of sleep nasendoscopy in determining the level and severity of obstruction by mimicking physiological sleep dynamics of the upper airway.

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