Oropharyngeal anatomy, function, location, infection and cancer of the oropharynx (2023)

The oropharynx is the middle section of the pharynx (throat) behind the mouth. The oropharynx includes the base of the tongue (posterior 1/3), the soft palate at the back of the roof of the mouth, the tonsils, and the back of the pharynx. The oropharynx lies behind the oral cavity, below the soft palate, and above the epiglottis. The pharynx is a hollow tube about 5 inches long that starts behind the nose and ends where the trachea (windpipe) and esophagus (tube that runs from the throat to the stomach) begin. Air and food pass through the throat on its way to the trachea, or esophagus. The three parts of the pharynx are the nasopharynx, oropharynx, and hypopharynx.

The oropharynx includes the following:

• Gaumensegel.
• lateral and posterior walls of the pharynx.
• almonds.
• One third of the tongue back.

Figure 1. Anatomy of the oropharynx

Figure 2. Parts of the oropharynx

function of the oropharynx

The muscles of the oropharynx play an important role in swallowing and speaking.

Where is the oropharynx located?

The oropharynx is the middle section of the pharynx (throat) behind the mouth. The oropharynx includes the base of the tongue (posterior 1/3), the soft palate at the back of the roof of the mouth, the tonsils, and the back of the pharynx. The oropharynx lies behind the oral cavity, below the soft palate, and above the epiglottis.

The oropharynx includes the following:

• Gaumensegel.
• lateral and posterior walls of the pharynx.
• almonds.
• One third of the tongue back.

oropharyngeal infection

Pharyngitis

Pharyngitis, or sore throat, is a sore, sore, or itchy throat. It often makes swallowing painful.

causes pharyngitis

Pharyngitis is caused by inflammation in the back of the throat (pharynx) between the tonsils and the larynx (larynx).

Most sore throats are caused by the common cold, the flu, the Coxsackie virus, or mononucleosis.

Bacteria that can cause pharyngitis in some cases:

• Strep throat is caused by group A streptococci.
• More rarely, bacterial diseases such as gonorrhea and chlamydia can cause a sore throat.

Most cases of pharyngitis occur in the colder months. The disease often spreads between family members and close contacts.

Pharyngitis-Symptom

The main symptom is a sore throat.

Other symptoms may include:

• Fever
• headache
• joint pain and muscle pain
• skin irritation
• Swollen lymph nodes (glands) in the neck

Pharyngitis possible complications

Complications of pharyngitis can include:

• ear infection
• Sinusitis
• Abscess near the tonsils

diagnose pharyngitis

Your doctor will do a physical exam and look at your throat.

A rapid strep test or throat culture may be done to check for strep. Other laboratory tests may be done depending on the suspected cause.

pharyngitis treatment

Most sore throats are caused by viruses. Antibiotics do not help with a viral sore throat. Using these drugs when they are not needed makes antibiotics less effective when they are needed.

A sore throat is treated with antibiotics when:

• A strep test or culture is positive. Your doctor cannot diagnose a sore throat based solely on symptoms or a physical exam.
• A culture for chlamydia or gonorrhea is positive.

Sore throats caused by the flu (influenza) can be relieved with antiviral medications.

The following tips may help you feel better about your sore throat:

• Drink calming fluids. You can drink hot liquids such as honey lemon tea or cold liquids such as ice water. You can also suck on a fruity lollipop.
• Gargle with warm salt water (1/2 teaspoon or 3 grams of salt in 1 cup or 240 milliliters of water) several times a day.
• Suck on candies or throat drops. Young children should not receive these products, as they may choke on them.
• Using a Cool Mist vaporizer or humidifier can moisten the air and soothe a dry, sore throat.
• Try over-the-counter pain relievers such as acetaminophen.

tonsillitis

Tonsillitis is a common childhood disease, but it can affect adolescents and adults as well. It usually goes away on its own after a few days.

Tonsillitis can feel like a bad cold or flu. The tonsils at the back of the throat are red and swollen.

The main symptoms of tonsillitis in children and adults are:

• Sore throat
• swallowing difficulties
• hoarse or voiceless voice
• a high temperature of 38°C or higher
• Tos
• headache
• Feeling sick
• earache
• Feeling tired

Sometimes the symptoms can be more severe and include:

• swollen and painful glands in the neck; feels like a lump on the side of the neck
• white, pus-filled patches on the tonsils in the back of the throat
• halitosis (bad breath)

causes tonsillitis

Tonsillitis is most often caused by common viruses, but bacterial infections can also be the cause.

The most common bacteria that causes tonsillitis is Streptococcus pyogenes (group A strep), the bacteria that causes strep throat. Other strains of strep and other bacteria can also cause tonsillitis.

Why are the tonsils inflamed?

The tonsils are the immune system's first line of defense against bacteria and viruses that enter the mouth. This function can make the tonsils particularly susceptible to infection and inflammation. However, the immune system's function of the tonsils declines after puberty, a factor that may explain the rare cases of tonsillitis in adults.

Risk Factors for Tonsillitis

Risk factors for tonsillitis include:

• Early age. Tonsillitis is more common in children, but rare in children under 2 years of age. Bacterial tonsillitis is more common in children ages 5 to 15, while viral tonsillitis is more common in younger children.
• Frequent contact with germs. School-age children are in close contact with their peers and are often exposed to viruses or bacteria that can cause tonsillitis.

prevent tonsillitis

The causative agents of viral and bacterial tonsillitis are contagious. Therefore, the best prevention is good hygiene. Teach your child:

• Wash your hands regularly and thoroughly, especially after using the bathroom and before eating.
• Avoid sharing food, glasses, water bottles, or utensils
• Replacing your toothbrush after being diagnosed with tonsillitis

To help your child prevent the spread of a bacterial or viral infection to others:

• Keep your child home when they are sick
• Ask your doctor when it's okay for your child to return to school
• Teach your child to cough or sneeze into a tissue or, if necessary, into the crook of your arm.
• Teach your child to wash their hands after sneezing or coughing

symptoms of tonsillitis

Tonsillitis most commonly affects children between preschool age and adolescence. Common signs and symptoms of tonsillitis include:

• red and swollen tonsils
• White or yellow coating or spots on the tonsils
• sore throat
• Difficult or painful swallowing
• Fever
• Enlarged and tender glands (lymph nodes) in the neck
• A rough, muffled, or hoarse voice
• Bad breath
• Stomach pain, especially in young children
• neck stiffness
• headache

In young children who cannot describe how they feel, signs of tonsillitis may include:

• Drooling due to difficult or painful swallowing
• negative to eat
• unusual emotion

Complications of tonsillitis

Inflammation or swelling of the tonsils from frequent or long-term (chronic) tonsillitis can cause complications such as:

• labored breathing
• Difficulty breathing during sleep (obstructive sleep apnea)
• Infection that spreads deep into surrounding tissues (cellulitis of the tonsils)
• Infection that causes a collection of pus behind a tonsil (peritonsillar abscess)

strep infection

If tonsillitis caused by group A strep or another strain of strep bacteria is left untreated, or if antibiotic treatment is incomplete, your child is at increased risk of rare diseases such as:

• Rheumatic fever, an inflammatory disease that affects the heart, joints, and other tissues
• Poststreptococcal glomerulonephritis, an inflammatory disease of the kidneys that causes insufficient waste removal and excess fluid from the blood

diagnose tonsillitis

Your child's doctor will begin with a physical exam, which includes:

• Use a lighted instrument to look at your child's neck and possibly his ears and nose, which can also be sources of infection.
• Look for a rash known as scarlet fever, which is associated with some cases of strep throat.
• Gently feel (palpate) your child's neck to look for swollen glands (lymph nodes).
• Listening to your breathing with a stethoscope.
• Check for enlarged spleen (to account for mononucleosis, which also inflames the tonsils)

throat swab

In this simple test, the doctor rubs a sterile swab down your child's throat to obtain a sample of secretions. The sample is tested for strep bacteria in the clinic or in a laboratory.

Many clinics are equipped with a laboratory that can obtain a test result in a matter of minutes. However, a more reliable second test is usually sent to a laboratory, which can return results within 24 to 48 hours.

If the rapid strep test at the clinic is positive, your child almost certainly has a bacterial infection. If the test is negative, your child likely has a viral infection. However, your doctor will wait for the most reliable laboratory test outside of the clinic to determine the cause of the infection.

Complete blood count (CBC)

Your doctor may order a complete blood count using a small sample of your child's blood. The result of this test, which can often be done in a clinic, gives a count of the different types of blood cells. Profiling what is elevated, what is normal, and what is below normal can indicate whether an infection is more likely to be caused by a bacterial or viral agent. Often a blood count is not needed to diagnose a sore throat. However, if the strep lab test is negative, a blood test may be needed to determine the cause of the tonsillitis.

tonsillitis treatment

home care

Whether tonsillitis is caused by a viral or bacterial infection, home care strategies can make your child more comfortable and promote a better recovery.

When a virus is the expected cause of tonsillitis, these strategies are the only treatment. Your doctor will not prescribe antibiotics. Your child will probably get better in seven to 10 days.

Home care strategies that can be used during the recovery period include the following:

• promote calm. Encourage your child to get enough sleep.
• Offer plenty of fluid. Give your child plenty of water to keep his throat moist and prevent dehydration.
• Provide comfort food and drink. Warm liquids (broth, decaffeinated tea, or warm water mixed with honey) and cold treats like popsicles can help soothe a sore throat.
• Prepare a saltwater gargle. If your child can gargle, a saltwater gargle made with 1 teaspoon (5 milliliters) of table salt in 8 ounces (237 milliliters) of warm water can help soothe a sore throat. Have your child gargle the solution and then spit it out.
• Humidify the air. Use a cool humidifier to remove dry air that can further irritate a sore throat, or sit in a steamy bath with your child for a few minutes.
• Offer pills. Children up to 4 years old can suck on lozenges to relieve a sore throat.
• Avoid irritants. Keep your home free of cigarette smoke and cleaning products that can irritate your throat.
• treat pain and fever. Talk to your doctor about using ibuprofen (Advil, Children's Motrin, others) or acetaminophen (Tylenol, others) to minimize sore throat and control fever. Low painless fever does not require treatment.

Except for certain medical conditions, children and adolescents should not take aspirin because it has been linked to Reye's syndrome, a rare but life-threatening condition, when used to treat the symptoms of a cold or flu-like illness.

antibiotics

If your tonsillitis is caused by a bacterial infection, your doctor will prescribe a course of antibiotics. Penicillin, taken by mouth for 10 days, is the most common antibiotic treatment prescribed for tonsillitis caused by group A strep. If your child is allergic to penicillin, your doctor will prescribe an alternative antibiotic.

Your child must take all prescribed antibiotics, even if the symptoms go away completely. If all medications are not taken as prescribed, the infection may worsen or spread to other parts of the body. In particular, not completing the full course of antibiotics can increase your child's risk of developing rheumatic fever and serious kidney infections.

Talk to your doctor or pharmacist about what to do if you forget to give your child a dose.

Operation

Surgery to remove the tonsils (tonsillectomy) may be used to treat frequent recurring tonsillitis, chronic tonsillitis, or bacterial tonsillitis that does not respond to antibiotic treatment. Common tonsillitis is broadly defined as:

• More than seven episodes in a year
• More than four to five episodes per year in each of the previous two years
• More than three episodes per year in each of the previous three years

A tonsillectomy may also be performed if tonsillitis is causing complications that are difficult to manage, such as:

• Obstructive Sleep Apnea (OSA)
• labored breathing
• Difficulty swallowing, especially with meat and other chunky foods
• An abscess that does not improve with antibiotic treatment

Tonsillectomy is usually done on an outpatient basis, unless your child is very young, has a complex medical condition, or has complications during surgery. This means that your child can go home the day of the operation. Full recovery usually takes seven to 14 days.

Oropharyngeal-Krebs

Oropharyngeal cancer is a form of head and neck cancer. Sometimes more than one cancer can occur in the oropharynx and other parts of the oral cavity, nose, pharynx, larynx (larynx), trachea, or esophagus at the same time.

Most oropharyngeal carcinomas are squamous cell carcinomas (SCC) (~95 percent). Squamous cells are the thin, flat cells that line the inside of the oropharynx.

Causes of oropharyngeal cancer

Smoking or human papillomavirus infection may increase the risk of oropharyngeal cancer.

Oropharyngeal cancer risk factors

Anything that increases the risk of developing a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; The absence of risk factors does not mean that you will not get cancer. Talk to your doctor if you think you may be at risk.

The most common risk factors for oropharyngeal cancer include:

• A history of cigarette smoking of more than 10 pack years and other tobacco use.
• Personal history of head and neck cancer.
• Excessive alcohol consumption.
• Human papillomavirus (HPV) infection, particularly HPV type 16. Cases of oropharyngeal cancer associated with HPV infection are increasing.
• Chew betelquid, a stimulant commonly used in parts of Asia.

Signs and symptoms of oropharyngeal cancer

Signs and symptoms of oropharyngeal cancer include a lump in the neck and a sore throat.

These and other signs and symptoms may be caused by oropharyngeal cancer or other medical conditions. Contact your doctor if you have:

• Sore throat that doesn't go away.
• Difficulties swallowing.
• Difficulty opening the mouth fully.
• Difficulty moving the tongue.
• Weight loss for no known reason.
• earache.
• A lump in the back of the mouth, throat, or neck.
• A white patch on the tongue or lining of the mouth that does not go away.
• cough up blood

Oropharyngeal cancer sometimes does not cause early signs or symptoms.

Diagnosticar Oropharynxkarzinom

Tests that examine the mouth and throat are used to detect (find), diagnose, and stage oropharyngeal cancer.

The following tests and procedures may be used:

• Physical exam and medical history:An exam of the body to check for general signs of health, including checking for signs of disease, such as swollen lymph nodes in the neck or other unusual symptoms. The doctor or dentist will perform a complete examination of the mouth and throat, looking under the tongue and throat with a small, long-handled mirror to look for abnormal areas. An eye exam may be done to check for vision problems caused by nerves in the head and neck. A history of the patient's health habits and previous illnesses and treatments is also collected.
• PET-CT scan:A procedure that combines positron emission tomography (PET) and computed tomography (CT) images. PET and CT scans are performed simultaneously using the same machine. Combined scans provide more detailed images of areas inside the body than either scan alone. A PET-CT scan can be used to diagnose diseases such as cancer, plan treatment, or find out how well treatment is working.
• Computed Tomography (CAT-Scan):A procedure in which a series of detailed pictures of areas of the body, such as the head and neck, are taken from different angles. The pictures are taken by a computer linked to an x-ray machine. A dye is injected into a vein or swallowed to make organs or tissues more visible. This procedure is also called a computed tomography, computed tomography, or computerized axial tomography.
• PET-Scan (Positronen-Emissions-Tomographie-Scan):A method of finding malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and takes a picture of the part of the body where the glucose is being used. Malignant tumor cells appear brighter on the image because they are more active and take up more glucose than normal cells.
• MRI (Magnetic Resonance Imaging):A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear spin tomography (NMRI).
• Biopsy:The removal of cells or tissues so that a pathologist can examine them under a microscope for signs of cancer. A fine needle biopsy is usually done to remove a sample of tissue with a fine needle.

The following procedures may be used to obtain cell or tissue samples:

• endoscopy:A procedure to examine organs and tissues inside the body to look for abnormal areas. An endoscope is inserted through an incision (cut) in the skin or an opening in the body, such as through the B. mouth or nose. An endoscope is a thin, tubular instrument with a light and a lens for viewing. It may also have a tool to remove abnormal tissue or lymph node samples, which are examined under a microscope for signs of disease. The nose, throat, dorsum of the tongue, esophagus, stomach, larynx, trachea, and large airways are examined. The type of endoscopy is named after the part of the body to be examined. For example, a pharyngoscopy is an exam to check the throat.
• Laringoscopia:A procedure in which the doctor examines the larynx (larynx) for abnormal areas using a mirror or laryngoscope. A laryngoscope is a thin, tube-shaped instrument with a light and a lens for viewing the inside of the throat and larynx. It may also have a tool to take tissue samples to be looked at under a microscope for signs of cancer.

If cancer is found, the following test may be done to look at cancer cells:

• HPV test (human papillomavirus test): A laboratory test that analyzes the tissue sample for certain types of HPV infection. This test is done because HPV can cause oropharyngeal cancer.

Oropharyngeal carcinoma prognosis

The prognosis (chance of recovery) depends on the following:

• If the patient has an HPV infection of the oropharynx.
• If the patient has smoked cigarettes for ten or more pack years in the past.
• The stage of the cancer.
• The number and size of lymph nodes with cancer.

Oropharyngeal tumors associated with HPV infection have a better prognosis and are less likely to recur than tumors not related to HPV infection.

Oropharyngeal cancer treatment

Treatment Options for Oropharyngeal Carcinoma

• There are different types of treatment for patients with oropharyngeal cancer.
• Treatment of patients with oropharyngeal cancer should be planned by a team of doctors experienced in the treatment of head and neck cancer.
• Four types of standard treatments are used:
  1. Operation
  2. radiotherapy
  3. chemotherapy
  4. Targeted Therapy
• New forms of treatment are being tested in clinical trials.
• Treatment for oropharyngeal cancer can cause side effects.
• Patients may wish to consider participating in a clinical trial.
• Patients can participate in clinical trials before, during or after starting their cancer treatment.
• Follow-up exams may be required.

Treatment options depend on the following:

• The stage of the cancer.
• Maintain the patient's ability to speak and swallow as normally as possible.
• The general health of the patient.

Patients with oropharyngeal cancer have a higher risk of developing another type of head or neck cancer. This risk is increased in patients who continue to smoke or drink alcohol after treatment.