Phoniatrics

The study of voice formation, diseases of the vocal apparatus, their prevention and treatment are included in the tasks of phoniatrics.

Phoniatric rooms are equipped with equipment for microlaryngoscopy, laryngostroboscopy, fibrolaringoscopy, spectral analysis of the voice, microsurgery of the larynx. In these offices, dispensary observation and treatment of persons of vocal and speech professions are carried out. Doctors otorhinolaryngologists-phoniatrists work in major opera houses, conservatories.

Reflexogenic zones of the larynx

In the larynx, there are 3 reflexogenic zones:

  1. The guttural surface of the epiglottis, the edges of the scoop-epiglottis folds.
  2. The anterior surface of the arytenoid cartilages, the space between their vocal processes.
  3. The lower floor of the larynx (the inner surface of the cricoid cartilage).

1 and 2 reflexogenic zones provide a respiratory and protective function. 3 zone together with the receptors of the joint-muscular apparatus of the larynx provides the act of phonation.

Physiological functions of the esophagus

The movement of food through the esophagus is the last phase in a complex mechanism that organizes the entry of the food lump into the stomach. The passage of food through the esophagus is an active physiological phase that proceeds with certain interruptions and begins with the opening of the entrance to the esophagus. Before the opening of the esophagus, there is a short period of delay in the swallowing act, when the entrance to the esophagus is closed, and the pressure in the lower part of the pharynx increases.

Structure and topography of the esophagus

The esophagus begins at the level of the sixth cervical vertebra by formation, called the entrance to the esophagus, and ends at the level of the left edge of the body of the X or XI thoracic vertebrae by a formation called cardia. The esophagus wall consists of adventitia, muscular, submucosal layers and mucous membrane.

Layers of the esophageal wall

Layers of the esophageal wall

Layers of the esophageal wall:

Chronic esophagitis

They can manifest as non-healing ulcers, a long-term inflammation, occur with cicatricial stenoses and tumors. Chronic esophagitis is divided into nonspecific and specific (tuberculosis, syphilis, actinomycosis).

Chronic nonspecific esophagitis

Etiopathogenesis. The disease, as a rule, arises as a result of prolonged irritation of the mucous membrane, loss of its protective properties and infection with the usual pathogenic or conditionally pathogenic microbiota, in rare cases - as a complication of acute esophagitis.

Inflammatory diseases of the esophagus

Types of inflammatory diseases of the esophagus are as numerous and diverse as inflammatory diseases of the pharynx, and they are often combined by the same etiological factors.

Acute nonspecific esophagitis

Etiopathogenesis. Acute nonspecific esophagitis is most often secondary, induced by inflammatory processes occurring in neighboring anatomical areas or at a distance.

Esophagial foreign bodies

Foreign bodies are objects alien to the body, concrements and living objects embedded in its tissues and organs or cavities through natural openings and damaged skin. They are divided into domestic, gunshot, casual, intentional (suicidal), exogenous, endogenous, as well as foreign bodies swallowed by small children and persons with mental disabilities. Often, foreign bodies of the esophagus appear with the first dish in fast food.

Chemical burns of the esophagus

Chemical burns occur when corrosive liquids coagulate and denature tissue proteins enter the esophagus. Most often, chemical burns of the esophagus are caused by ingestion of acids (acetic, hydrochloric, sulfuric, nitric) or alkalis (caustic potassium, sodium, caustic soda). The severity of a chemical burn depends on the amount of caustic liquid, its viscosity, concentration, and exposure. The deepest and extensive burns of the esophagus cause alkalis, which have the ability to melt tissues without the formation of a demarcation barrier.

Mechanical damage to the esophagus

Mechanical damage to the esophagus refers to the most severe injuries, often resulting in a fatal outcome. Anatomical injuries (injuries, ruptures, perforations of a foreign body) belong to the competence of thoracic surgeons, but uncomplicated injuries caused by foreign bodies and corrosive liquids, as well as certain strictures that do not require surgical treatment, are in the competence of the otorhinolaryngologist.