Odynophagia pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2]


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Overview

Odynophagia pathophysiology is related to causes.

Pathophysiology

Odynophagia pathophysiology is related to causes. The following are common mechanisms involved in inducing pain in esophagus and pharynx

Anatomic facts of pharynx and esophagus:
  • Pharynx is partitioned as the nasopharynx, the oropharynx and the laryngopharynx. Odynophagia is outcome of pain sensed in orophyranx and laryngopharynx.[1]
  • The oropharynx starts from the uvula ends at hyoid bone. Anteriorly, through isthmus faucium,opens into the mouth, latterly it has the palatine tonsil. 
  • It is lined with non-keratinised squamous stratified epithelium.[2]
  • The laryngopharynx aka hypopharynx, is on rare end.
  • Internal laryngeal branch of the superior laryngeal nerve, innervate larynx up to vocal folds. The recurrent laryngeal nerve innervate larynx inferoirly..[3]
  • Vagus nerve supply all the muscles of the pharynx and soft palate except the two muscles.
  • Stylopharyngeus receives innervation from cranial nerve IX.
  • Tensor veli palatini receives innervation from cranial nerve V.
  • The glossopharyngeal nerve receives sensory input from greater portion of all three parts of the pharynx. [4]
  • The Pharyngeal plexus is motor and sensory center of larynx.
  • Pharyngeal plexus consist of nerves from vagus and glossopharyngeal nerves and also by sympathetic nerve fibers.
  • The esophagus has dual sensory innervation, from parasympathetic and sympathetic, which depends on location of level independently .[5]
Pathological conditions causing pain in swallowing:

Infections:

Infection of esophagus or pharynx causes fluid leaking in interstitial media of mucous epithelium and it produce pressure on sensory nerve terminals situated in mucosa.[6]

Tumors:

It produces pain due to compression effect of mass on sensory nerve terminals situated in mucosa.[7]

Foreign body:

It produce pain due to compression effect of foreign body on sensory nerve terminals situated in mucosa.[8]

References

  1. Isono S, Remmers JE, Tanaka A, Sho Y, Sato J, Nishino T (1997). "Anatomy of pharynx in patients with obstructive sleep apnea and in normal subjects". J Appl Physiol (1985). 82 (4): 1319–26. doi:10.1152/jappl.1997.82.4.1319. PMID 9104871.
  2. Schubert FR, Singh AJ, Afoyalan O, Kioussi C, Dietrich S (2018). "To roll the eyes and snap a bite - function, development and evolution of craniofacial muscles". Semin Cell Dev Biol. doi:10.1016/j.semcdb.2017.12.013. PMID 29331210.
  3. Li X, Wang Y, Wang F, Li B, Sun S, Yang H (2017). "An unusual case of oropharyngeal chordoma: A case report and literature review". Medicine (Baltimore). 96 (48): e8963. doi:10.1097/MD.0000000000008963. PMC 5728799. PMID 29310398.
  4. Negrete L, Brusa F (2017). "Increasing diversity of land planarians (Platyhelminthes: Geoplanidae) in the Interior Atlantic Forest with the description of two new species and new records from Argentina". Zootaxa. 4362 (1): 99–127. doi:10.11646/zootaxa.4362.1.5. PMID 29245445.
  5. Irani SK, Oliver DR, Movahed R, Kim YI, Thiesen G, Kim KB (2018). "Pharyngeal airway evaluation after isolated mandibular setback surgery using cone-beam computed tomography". Am J Orthod Dentofacial Orthop. 153 (1): 46–53. doi:10.1016/j.ajodo.2017.05.031. PMID 29287649.
  6. Salgado C, Garcia AM, Rúbio C, Cunha F (2017). "[Infectious Mononucleosis and Cholestatic Hepatitis: A Rare Association]". Acta Med Port. 30 (12): 886–888. doi:10.20344/amp.8715. PMID 29364802.
  7. Sheridan GA, Nusrath MA, Toner M, Stassen LF (2017). "Treatment Options for Amelobastic Carcinoma of the Mandible: A Case Series and Review of the Literature". Ir Med J. 110 (9): 639. PMID 29372954.
  8. Sclafani JA, Ross DI, Weeks BH, Yang M, Kim CW (2017). "Validity and reliability of a novel patient reported outcome tool to evaluate post-operative dysphagia, odynophagia, and voice (DOV) disability after anterior cervical procedures". Int J Spine Surg. 11: 35. doi:10.14444/4035. PMC 5779272. PMID 29372139.

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