Oropharyngeal reflexes

The need to summarize from time to time our knowledge of reflexology, collecting all or approximately all the material that exists about the reflexes of one organ (hand, leg), one sphere (sexual sphere), or some cavity (pelvic cavity, oropharyngeal cavity), long overdue. The science of reflexes has grown to such an extent that it has become immense even for a specialist in his field.

Biological Aspects of the Tongue and Oropharyngeal Cavity of the Eurasian Collared Dove (Streptopelia decaocto, Columbiformes, Columbidae): Anatomical, Histochemical, and Ultrastructure Study

We characterized the morphological and anatomical adaptations of the lingual microstructures of the Eurasian collared dove and discussed their implications for its dietary niche. We analyzed tongues of nine S. decaocto using histological, histochemical, stereomicroscopic, and scanning electron microscopic techniques. Our findings showed that the tongue is relatively short with a tapered apex that carries a terminal lingual nail. However, the lingual body has median scales and is bordered laterally by filiform papillae. Further, the tongue body bears a distinctive papillary crest. The tongue root is nonpapillate and infiltered with orifices of the posterior salivary glands. The bulky laryngeal mound has a circular glottic fissure, carrying a single row of papillae at the rear edge. Concurrently, our histological and histochemical findings demonstrate that the tongue has taste buds, anterior and posterior salivary glands, along with an elongated entoglossum that extends from lingual apex to root. Besides, ovoid and globular mucous glands displayed intense alcianophilic reactions. More substantially, the palate is made up of three palatine ridges with a caudal choanal cleft that was bounded by two rows of palatine papillae. Our data indicate multiple and novel structural variations for the lingual and palatal sculptures coopted for their feeding style.

A rare case of difficult airway management in a Klippel-Feil syndrome pediatric patient with osseous torticollis undergone orthopedic surgery

Background Orthopedic surgery for cervical torticollis poses potential threat to airway management both in tracheal intubation and extubation. Klippel-Feil syndrome (KFS) is a complex syndrome of osseous and visceral anomalies. The anatomical characteristics of KFS might have significant implications for airway management. Case presentation This is a rare case of an 8-year-old boy presenting with osseous torticollis, congenital occipito-atlantal deformity, congenital basilar invagination and KFS undergone elective torticollis correction surgery. Though with difficulty, tracheal intubation was successfully performed. Extubation failed twice on postoperative day 2 and 10, and required tracheostomy. Based on radiological findings, we speculated that prolonged airway edema accounted for the main reason of the failed extubation, the hypertrophic tonsil and occipito-cervical fusion resulted in reduced oropharyngeal space and limited cervical range of motion. Moreover, the Chiari malformation and KFS complicated the airway condition and lead to prolonged airway obstruction. The tracheostomy casing was removed 1 month later. Conclusions Cautions should be taken in extubation of pediatric patients undergone major osseous torticollis surgery. Reintubation should be prepared in case of failed extubation. Severe post-operative airway edema, complicated with hypertrophic tonsil, the structural abnormalities in the oropharyngeal cavity, and occipito-cervical deformities constituted the decreased oropharyngeal space and resulted in failed extubation. For severe airway compromise and prolonged intubation, tracheostomy should be considered.

Comparison of prophylactic effect of topical Alchemilla vulgaris in glycerine versus that of dexamethasone on postoperative sore throat after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled study

Background: Sore throat and hoarseness frequently occur following general anesthesia with tracheal intubation and are effectively reduced when dexamethasone is used prophylactically. Alchemilla vulgaris in glycerine (Neo Mucosal Activator®) suppresses inflammatory response, possibly relieving sore throat.Methods: We enrolled 94 patients (age ≥ 18 years) scheduled for thoracic surgery using double-lumen tube intubation. Before intubation, 0.2 mg/kg of dexamethasone was administered intravenously and 2 ml of normal saline was sprayed into the oropharyngeal cavity (Group D; n = 45), or 0.04 ml/kg normal saline was administered intravenously and 1 g of Neo Mucosal Activator® mixed with 1 ml of normal saline was sprayed into the oropharyngeal cavity (Group N; n = 43), in a double blind and prospectively randomized manner. Postoperative sore throat and hoarseness were recorded using a numeral rating scale and a 4-point scale to detect a change in voice quality following tracheal extubation (at 1, 6, and 24 h). The primary outcome was the incidence of sore throat at 24 h following surgery. The secondary outcomes were incidence and severity of sore throat and hoarseness.Results: There were no significant differences in the incidence of sore throat at 24 h following surgery (57.8% vs. 46.5%; P = 0.290) or in the incidence and intensity of sore throat and hoarseness at 1, 6, and 24 h following surgery between the groups. Conclusions: A. vulgaris in glycerine did not significantly differ from dexamethasone for preventing sore throat and hoarseness owing to intubation.

Oral and Palatal Dentition of Axolotl Arises From a Common Tooth-Competent Zone Along the Ecto-Endodermal Boundary

Vertebrate dentitions arise at various places within the oropharyngeal cavity including the jaws, the palate, or the pharynx. These dentitions develop in a highly organized way, where new tooth germs are progressively added adjacent to the initiator center, the first tooth. At the same time, the places where dentitions develop house the contact zones between the outer ectoderm and the inner endoderm, and this colocalization has instigated various suggestions on the roles of germ layers for tooth initiation and development. Here, we study development of the axolotl dentition, which is a complex of five pairs of tooth fields arranged into the typically tetrapod outer and inner dental arcades. By tracking the expression patterns of odontogenic genes, we reason that teeth of both dental arcades originate from common tooth-competent zones, one present on the mouth roof and one on the mouth floor. Progressive compartmentalization of these zones and a simultaneous addition of new tooth germs distinct for each prospective tooth field subsequently control the final shape and composition of the axolotl dentition. Interestingly, by following the fate of the GFP-labeled oral ectoderm, we further show that, in three out of five tooth field pairs, the first tooth develops right at the ecto-endodermal boundary. Our results thus indicate that a single tooth-competent zone gives rise to both dental arcades of a complex tetrapod dentition. Further, we propose that the ecto-endodermal boundary running through this zone should be accounted for as a potential source of instruction factors instigating the onset of the odontogenic program.

A mammalian commensal of the oropharyngeal cavity produces antibiotic and antiviral valinomycin in vivo

Around weaning, piglets are susceptible to infection by bacterial pathobionts, leading to increased morbidity and mortality. We identified isolates of Rothia nasisuis in the upper respiratory tract of weaned healthy piglets that produce valinomycin in vitro and in vivo via its vlm-encoded non-ribosomal peptide synthase (NRPS) enzyme complex. Valinomycin is an antiviral and antibiotic ionophore that shuttles potassium ions across membranes and is capable of inflammasome activation and apoptosis in LPS-primed macrophages at concentrations of 1 uM. Polarized monolayers of epithelial cells were much less sensitive to valinomycin but concentrations ≥ 10 µM decreased trans-epithelial resistance. R. nasisuis inhibited growth of closely related species of Rothia. Deliberate inoculation of valinomycin-producing R. nasisuis into newborn piglets suggested this species can shape the microbiota post weaning. Our findings support the idea that valinomycin is a competitive niche factor potentially also compromising epithelial integrity to gain access to (micro)nutrients.