What Is the Oropharynx?

One of the 3 parts of the pharynx. It is also called the middle pharynx, which is located between the free edge of the fan and the plane of the upper edge of the epiglottis. The so-called pharynx refers to this area.

One of the 3 parts of the pharynx. It is also called the middle pharynx, which is located between the free edge of the fan and the plane of the upper edge of the epiglottis. The so-called pharynx refers to this area.

The palatine tonsils, pharyngeal tonsils, and lingual tonsils form a lymphatic ring in the nasal cavity and oral pharyngeal area, which is called pharyngeal lymphatic ring and has defensive function.

Chinese name

Oropharynx

Foreign name

Oral

Department

Stomatology

Oropharyngeal overview

The palatine tonsils, pharyngeal tonsils, and lingual tonsils form a lymphatic ring in the nasal cavity and oral pharyngeal area, which is called pharyngeal lymphatic ring and has defensive function.

Oropharyngeal related clinical applications

1. In the rescue process of critically ill patients, accurately and quickly dealing with respiratory problems is the key to maintaining life and stabilizing the disease, and to strive for further diagnosis and treatment opportunities for patients. The oropharyngeal ventilation tube is a non-tracheal duct ventilation tube, which is easy to operate and easy to grasp. It can quickly open the airway in seconds without special equipment.

2. Clinical application

2.1 The traditional method of lifting the back of the tongue is to use the oropharyngeal airway for unconsciousness, but in critically ill patients with spontaneous breathing, the root of the patient can be removed from the posterior wall of the pharynx to relieve airway obstruction and prevent the back of the tongue Choking caused by falling. Both methods can effectively improve ventilation, but the oropharyngeal airway is significantly better than the traditional group in maintaining airway patency and reducing mucosal damage.

2.2 Conducive to sputum suction When using the oropharyngeal ventilation tube to suck the sputum, the patient can be prevented from biting the sputum tube. At the same time, the sputum tube is inserted 5 to 6 cm deeper than the nasal cavity, which stimulates the cough reflex. , It is easy to sputum cough in the deep part of the airway to the upper respiratory tract to facilitate aspiration. In addition, suctioning with the oropharyngeal tube is performed under an open airway, which ensures that the suctioning measures are timely and effective, and can reduce the stimulation of the mouth and nasal mucosa. Some studies have found that the success rate of one-time intubation after suctioning with the oropharyngeal airway is high, the SPO2 does not drop significantly during suctioning, the sputum sounds in the lungs weaken or disappear, the suctioning operation time is relatively shortened, and it can reduce patient pain. Improve comfort and ease of patient acceptance.

2.3 The application of moderate and severe acute organophosphorus pesticide poisoning (AOPP) in gastric lavage Some researchers have found that the timing of airway opening in moderate and severe AOPP is closely related to its prognosis, and the complication rate and mortality in the preventive airway open group are obvious. Compared with the control group, the total length of hospital stay was significantly shortened. Applying the modified oropharyngeal airway to patients with moderate to severe AOPP can keep the patient's airway open, shorten the time of gastric lavage, and improve the success rate of AOPP patients.

3.Precautions

(1) Oropharyngeal airways should not be used in patients with throat edema, foreign bodies in the trachea, asthma, and hyperpharyngeal reflex. Patients with four teeth in the front of the mouth of the mouth with the risk of breaking or falling off are generally disabled. If it is required to be placed, the oropharyngeal ventilation tube can be placed in the lateral position to prevent the tooth from falling into the pharyngeal cavity and causing asphyxia. (2) If the patient vomits frequently and the volume is large, the risk of aspiration is increased, the trachea intubation and tracheotomy should be given in time. A small number of patients who use the oropharyngeal airway may have aspiration of gastric contents. To reduce aspiration, patients with full meals, manual gastric lavage, and traumatic brain injury are encouraged to place gastric tubes for prevention in addition to enhancing suction. (3) The oropharyngeal airway can increase blood pressure and increase heart rate, so it is not suitable for patients with heart and cerebrovascular diseases for long time use.

4. Related diseases and treatment

Oropharyngeal cancer includes cancers that originate in the mucous membranes of the root of the tongue, palatine tonsils, oropharyngeal wall, soft palate, and ptosis. It is one of the more common malignant tumors in the head and neck. 60% of oropharyngeal cancer; followed by pharyngeal wall, tongue base and soft palate. Oropharyngeal cancer occurs between 40 and 70 years of age. Oropharyngeal cancer is common in men, with a male to female ratio of 2.7: 1. The pathogenesis is not very clear. The pathological types of oropharyngeal tumors are more complicated. Various epithelial-derived cancers are the most common, followed by lymphoma.

Oropharyngeal clinical manifestations

1.Symptoms

Due to the deep location, oropharyngeal cancer has no obvious conscious symptoms in the early stage and is often easily ignored. Usually the more common symptoms are foreign body sensation or pain when swallowing or speaking. Depending on the location of the cancer, some characteristic symptoms may be displayed. For example, the cancer that originates in the pharyngeal wall may show reflex ear pain, tinnitus, and hearing , Deafness and other symptoms of Eustachian tube obstruction. Reflective ear-temporal pain may occur at the base of the tongue. Due to the high rate of cervical lymph node metastasis in oropharyngeal carcinoma, some patients often complain of a supra-neck or sub-mandibular mass at the time of consultation.

Signs

There is a clear mass at the onset site, which is substantial, mostly glandular epithelial cancer or lymphoma and other sarcomas. Those with exogenous ulcers, necrotic material on the surface, and a wide range of infiltration of the mass, often squamous cell carcinoma or undifferentiated cancer. Submandibular neck can often reach enlarged lymph nodes.

3.Auxiliary inspection

B-ultrasounds were performed to understand the conditions of the submandibular and cervical lymph nodes. CT or MRI examinations were performed to understand the extent of the lesion, the depth of infiltration, and lymph node metastasis. Laryngoscope + biopsy can determine the location and extent of the lesion, and exogenous mass can be confirmed by biopsy.

4.Diagnosis

Early diagnosis of oropharyngeal cancer is more difficult. Oropharyngeal examination and endoscopy should be performed in time when clinically felt foreign body swallowing or pain, and CT or MRI examination should be performed if necessary. The diagnosis of advanced cases is not difficult, and biopsy can confirm the diagnosis. For glandular or lymphomas, biopsy is difficult to obtain. Surgical exploration or intraoperative frozen biopsy can be used to confirm the diagnosis. The diagnosis and treatment can be completed at the same time.

Oropharyngeal carcinoma should be distinguished from ectopic thyroid, lingual lymphoid follicular hyperplasia, chronic tonsillitis, and epiglottic cysts.

5. Post-hospital treatment

Radiotherapy and surgery are the two main treatments for oropharyngeal cancer:

Oropharyngeal radiotherapy

Due to the anatomic location, biological behavior, and characteristics of oropharyngeal carcinoma, radical radiotherapy can achieve better results regardless of the primary tumor or metastatic lymph nodes in the neck. For patients with primary or neck metastases remaining after adequate radiation therapy, salvage resection is feasible.

Oropharyngeal surgery

Although most oropharyngeal cancers have better radiotherapy effects, such as undifferentiated or poorly differentiated cancers, tonsil cancers, and lymphomas. However, for soft palate, tongue root cancer, and glandular epithelial cancer, surgery should be the first comprehensive treatment.