ear, nose, and throat disorders
Evaluation of the Patient with Nasal and Pharyngeal Symptoms
Nasal and Pharyngeal Anatomy
The uvula hangs in the midline at the far end of the soft palate. It varies greatly in length. A long uvula and loose or excess velopharyngeal tissue may cause snoring and occasionally contribute to obstructive sleep apnea. Tonsils and adenoids are patches of lymphoid tissue surrounding the posterior pharynx in an area termed Waldeyer’s ring. Their role is to combat infection. The larynx is discussed in Overview of Laryngeal Disorders . The nasal cavity is covered with a highly vascular mucosa that warms and humidifies incoming air. Each lateral wall of the cavity has three turbinates, which are bony shelves that increase the surface area, thus providing more effective heat and moisture exchange. Nasal mucus traps incoming particulate matter. The space between the middle and inferior turbinate is the middle meatus, into which the maxillary and most of the ethmoid sinuses drain. Polyps may develop between the turbinates, often in association with asthma, allergy,aspirinuse, and cystic fibrosis. The paranasal sinuses are mucus-lined bony cavities that connect to the nasopharynx. There are four types: Maxillary Frontal Ethmoid Sphenoid They are located in the facial and cranial bones (see figure Paranasal sinuses ). The physiologic role of the sinuses is unclear. 