Upper airway dysfunction and inflammation

摘要

These proceedings will present evidence to support a hypothesis that many dynamic upper respiratory obstructive diseases are due to inflammation. These diseases include dorsal displacement of the soft palate, dorsal pharyngeal collapse, and other dynamic nasopharyngeal collapsing syndromes. The motor and most of the sensory supply to the nasopharynx is derived from the pharyngeal plexus of nerves on the surface of the dorsal nasopharynx. This plexus is composed of the pharyngeal branch of the vagusnerve, the pharyngeal branch of the glossopharyngeal nerve, and by sympathetic branches from the superior cervical ganglion. The motor fibers in the pharyngeal plexus are carried by the vagus nerve to the muscles of the nasopharynx and soft palate, except the stylopharyngeus muscles (supplied by IX) and the tensor veli palatini muscle (supplied by the mandibular branch of V). The pharyngeal branch of the glossopharyngeal nerve and portions of the maxillary nerve provide afferent innervation to the nasopharyngeal mucosa. The superior laryngeal nerve provides sensory innervation to the laryngeal mucosa. Muscles of the nasopharynx are important in respiration and swallowing. During the second stage of swallowing, the walls of the pharynx contract. The soft palate is elevated by coordinated action of the tensor veli palatine, levator veli palatine, and palatinus muscles. The palatopharyngeus and stylopharyngeus muscles help elevate the larynx and pharynx during swallowing. Contraction of the inferior constrictor muscle pushes the food bolus into the esophagus. The muscles that constrict the pharynx during swallowing receive motor innervation from the pharyngeal and superior laryngeal branches of the vagus nerve through the pharyngeal plexus of nerves. The pharyngeal branch of the vagus nerve through the pharyngeal plexus provides motor innervation to the levator veil palatini, palatinus, and palatopharyngeus muscles.