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PubMed1997

Decrease in immunoreactive neutral endopeptidase in uvula epithelium of patients with obstructive sleep apnea.

The purpose of this study was to determine whether neutral endopeptidase (NEP; EC3.4.24.11) is decreased in the uvula epithelium of patients with obstructive sleep apnea (OSA). Tissues were obtained by uvulopharyngopalatoplasty in seven patients with moderate OSA and by autopsy in five individuals not known to have OSA. Using antisera to human NEP and immunoperoxidase staining, we found that NEP was localized in uvula epithelial cells of both patients with OSA and controls. However, there was a significant decrease in the number of epithelial cells staining for NEP in patients with OSA relative to controls (67 +/- 10 cells versus 261 +/- 33 cells, in 5 randomly selected high-power microscopic fields, respectively; mean +/- SEM; p < .05). The intensity of staining for NEP was similar in both groups. We conclude that immunoreactive NEP is significantly decreased in the uvula epithelium of patients with OSA.

Adult↗

PubMed1975

The bifid uvula in ear, nose and throat practice.

Out of 2,000 consecutive ear, nose and throat patients, 44 were found with bifid uvulas. Five of the cleft uvulas were associated with submucous cleft palate, and eight were associated with short palates; however, dyslalia was evident in only one case. Compensation for the wide palato-pharyngeal space can occur by hyperplasia of the nasopharyngeal tonsil and hypertrophy and increased mobility of the pharyngeal constrictors and Passavant's ridge. On the other hand, otologic manifestations were complained of in 13 cases. The asymptomatic cases were examined under magnification and audiometrically and a further three cases were, then, diagnosed as secretory otitis media. Hypoplasia of the tensor palati is the probable explanation of otologic manifestations in bifid uvula.

Abnormalities, Multiple↗

PubMed2001

MALT lymphoma originating in breast and uvula.

A case of marginal zone B cell lymphoma of MALT type arising in the uvula and breast is reported. The patient, a 30-year-old woman who delivered a child and lactated in 1997, was suffering from Sjögren syndrome (SS). She was diagnosed with MALT lymphoma after a biopsy of the right breast and uvula. To investigate the relationship of the delivery, lactation and MALT lymphoma, we examined the immunohistochemical analysis of hormone receptors. As a result, lymphoid cells of the breast were stained with anti-progesterone receptor antibodies in the cytoplasm. Consequently, the MALT lymphoma of the uvula appeared to be associated with SS. Moreover, hormones such as progesterone may have influenced the breast involvement of MALT lymphoma in our case.

Adult↗

PubMed2005

["Restricted ablation" of elongated uvula mucosa by the injection of the ethanol/steroid mixture: a new treatment for snoring and OSAS].

We developed a "Submucosal Ethanol/Steroid (E/S) Injection Method (SEIM)" using an injection prepared by dissolving steroid with powerful antiinflammatory effect, which has the excellent effect of contractile reduction in oral tissues. In this clinical trial, the ablation effect of SEIM on the abnormally elongated uvula and the soft palate was examined in each one clinical case of obstructive sleep apnea syndrome (OSAS) and simple snoring. In the OSAS, we found that the uvula was reduced from 15 to 10mm, the visual analog scale (VAS) of snoring was reduced from 10 to 4 points, and the respiration disturbance index of the apnea-hypopnea index (AHI) improved from 35.3 to 26.1 after treatment. In simple snoring, the uvula was reduced from 11 to 8.5mm and VAS was relieved from 7 to 2 points after treatment. Our approach will produce a great clinical significance for not only OSAS or simple snoring but also treatment of the allergic rhinitis, etc, because the contractile tissue reduction can be attained safely in these diseases without open surgical wounds and unnecessary deformation or destruction of the mucosal structure.

Adult↗

PubMed2006

Topography and axonal collaterals of trigeminocerebellar projection to the paramedian lobule and uvula in the rabbit cerebellum.

To study projections of the trigeminal sensory nuclei (TSN) to the rostral parts of the paramedian lobule (PML) and of the uvula of the rabbit cerebellar cortex, the retrograde double fluorescent labeling method was used. Injections of Fast Blue (FB) into PML and Diamidino Yellow (DY) into the uvula, resulted in prominent labeling neurons with FB bilaterally and with DY ipsilaterally, in the principal trigeminal nucleus, subnucleus oralis, and rostral and caudal subnucleus interpolaris. We observed topographical arrangement of neurons in such a fashion that FB labeled cells were localized in the medial and DY labeled cells in the lateral regions of TSN. Apart from this small number of double FB+DY labeled neurons (n = 138) were found in the narrow common region of single labeling. This implies that PML and the uvula receive independent trigeminal sensory information from neurons in separate regions of TSN. However, some trigeminal neurons may also exert simultaneous influences upon these hemispheral and vermal components by way of axonal branchings.

Amidines↗

PubMed1986

Bifid uvula and otitis media in Apache Indians.

The association of bifid uvula with otitis media and scarred tympanic membrane was studied in White Mountain Apache Indians at Canyon Day, Arizona. Of 349 persons seen during a survey for otitis media, 13.5 percent had clinical otitis media, and 64.2 percent had scarring of the tympanic membrane of the otoscopically worse ear; 20.3 percent had bifid uvula. Bifid uvula was not associated with clinical otitis media or scarred tympanic membrane.

Arizona↗

PubMed1994

Laser-assisted uvula-palatoplasty for snoring.

Laser-assisted uvula-palatoplasty (LAUP) is a new and effective surgical method for the elimination of habitual snoring. LAUP is safely performed under local anesthesia in the office, and it provides progressive enlargement of the oropharyngeal air space by reshaping and restructuring the uvula, soft palate, and pharyngeal pillars utilizing the CO2 laser with special attachments. LAUP can also reduce oropharyngeal obstruction that may occur during sleep in patients with obstructive sleep apnea syndrome. Our experience includes over 335 patients evaluated and treated within the past year. Successive laser ablation of the vibrating structures, such as the uvula, soft palate, and posterior pharyngeal pillars, provided an 84% cure rate. In addition, 7% of the patients reported significant improvement in the loudness of their snore. The major advantage of this surgical technique is that it is a safe, simple, reliable, and bloodless procedure that can be performed in the office. This method and the results of its use are discussed.

Adult↗

PubMed1980

The ponto-cerebellar projection in the rat: differential projections to sublobules of the uvula.

Microinjections of horseradish peroxidase (HRP) were made in different sublobules of the uvula (lobule IX, a, b, and c of Larsell, 1952) of the cerebellar cortex in the rat. These injections resulted in retrograde labeling of cells located in the pontine nuclei. Sublobule IXa receives a predominant input from a single column of cells situated in a dorsointermediate position in the caudal pontine nuclei. Sublobules IXb and IXc receive a pontine projection from two different columns of cells, one medial and one lateral. The location of the labeled cells in the lateral part of the caudal pons suggests a topographic projection to the subdivisions of the uvula. Sublobule IXa receives a projection from a distinct dorsointermediate region and sublobule IXb and IXc receive a projection from partially overlapping ventral regions. The cells of origin in the medial pons are organized such that more dorsally located cells project to sublobule IXb and ventrally located cells project to sublobule IXb with extensive overlap. These differential patterns of projections to the sublobules of the uvula along with other data in the literature suggest that sublobule IXa may be involved with different functional correlates than sublobules IXb and IXc.

Animals↗

PubMed2007

Spatial symmetries in vestibular projections to the uvula-nodulus.

The discharge of secondary vestibular neurons relays the activity of the vestibular endorgans, occasioned by movements in three-dimensional physical space. At a slightly higher level of analysis, the discharge of each secondary vestibular neuron participates in a multifiber projection or pathway from primary afferents via the secondary neurons to another neuronal population. The logical organization of this projection determines whether characteristics of physical space are retained or lost. The logical structure of physical space is standardly expressed in terms of the mathematics of group theory. The logical organization of a projection can be compared to that of physical space by evaluating its symmetry group. The direct projection from the semicircular canal nerves via the vestibular nuclei to neck motor neurons has a full three-dimensional symmetry group, allowing it to maintain a three-dimensional coordinate frame. However, a projection may embed only a subgroup of the symmetry group of physical space, which incompletely mirrors the properties of physical space. The major visual and vestibular projections in the rabbit via the inferior olive to the uvula-nodulus carry three degrees of freedom-rotations about one vertical and two horizontal axes-but do not have full three dimensional symmetry. Instead, the vestibulo-olivo-nodular projection has symmetries corresponding to a product of two-dimensional vestibular and one-dimensional optokinetic spaces. This combination of projection symmetries provides the foundation for distinguishing horizontal from vertical rotations within a three dimensional space. In this study, we evaluate the symmetry group given by the physiological organization of the vestibulo-olivo-nodular projection. Although it acts on the same sets of elements and mirrors the rotations that occur in physical space, the physiological transformation group is distinct from the spatial group. We identify symmetries as products of physiological and spatial transformations. The symmetry group shapes the information the projection conveys to the uvula-nodulus; this shaping may depend on a physiological choice of generators, in the same way that function depends on the physiological choice of coordinates. We discuss the implications of the symmetry group for uvula-nodulus function, evolution, and functions of the vestibular system in general.

Animals↗

PubMed1990

An electrophysiological and anatomical study of afferents reaching the cerebellar uvula in the rabbit.

Stimulation of a medial region of the cerebellar uvula cortex produces sympathetically mediated cardiovascular effects in the decerebrate rabbit. In the present study the afferents to this cerebellar area have been determined using electrophysiological and neuroanatomical methods. Field potentials of prevalent mossy origin evoked by single-shock stimulation of different peripheral nerves have been recorded from sublobules IXa and IXb. No response to vagus and aortic nerves stimulation has been found. A modulation of Purkinje cell discharge following natural vestibular stimulation has been found. A modulation of Purkinje cell discharge following natural vestibular stimulation has been recorded from sublobules IXb and IXc. The retrograde transport of horseradish peroxidase from the uvula cortex has revealed a widespread afferent input to this cerebellar region arising from brain stem reticular and sensory nuclei. On the basis of the results obtained, together with the results of experiments performed in conscious rabbits, contained in the following paper (Bradley, Ghelarducci, La Noce & Spyer, 1990), it is suggested that the uvula participates in co-ordination of the visceral and somatic components of the alerting reaction in the rabbit.

Afferent Pathways↗

PubMed1990

Autonomic and somatic responses evoked by stimulation of the cerebellar uvula in the conscious rabbit.

The present study has investigated the effects of electrical stimulation of the cerebellar posterior cortex in the conscious rabbit. Stimulation of lobule IX (the uvula) elicited an increase in mean arterial blood pressure and heart rate, accompanied by EEG desynchronization, pupillary dilatation and a specific motor reaction, consisting of pricking of the ears, neck stiffening and running movements. Stimulation of lobule VIII was ineffective in evoking equivalent responses. The administration of barbiturates reversed the cardiovascular response to uvula stimulation, producing a fall in mean arterial pressure. The characteristics of the pattern of responses obtained, together with the anatomical and electrophysical observations provided in the preceding paper (Bradley, Ghelarducci, La Noce, Paton, Spyer & Withington-Wray, 1990), suggest a possible involvement of uvula cortex in the expression of the alerting reaction in the rabbit.

Analysis of Variance↗

PubMed1997

Topography and reciprocal activity of cerebellar Purkinje cells in the uvula-nodulus modulated by vestibular stimulation.

In the rabbit uvula-nodulus, vestibular and optokinetic information is mapped onto parasagittal zones by climbing fibers. These zones are related functionally to different pairs of vertical semicircular canals, otolithic inputs and horizontal optokinetic inputs. Vestibular stimulation restricted to one of these zones modulates climbing fiber responses (CFRs). Within each of these zones, simple spikes (SSs) are modulated reciprocally with CFRs. In rabbits anesthetized with chloralose-urethan, we have used vestibular and optokinetic stimulation to evoke CFRs within a parasagittal zone while recording from Purkinje cells in adjacent zones. We have examined whether the CFRs evoked by vestibular stimulation in one zone influence the SSs of an adjacent zone. CFRs and SSs were recorded during roll vestibular stimulation. The orientation of the head of the rabbit with respect to the axis of rotation was varied systematically so that a climbing fiber null plane could be determined. This null plane was the orientation of the head about the vertical axis at which no modulation of the CFR was observed during rotation about the longitudinal axis of the vestibular rate table. In the left uvula-nodulus, a medial sagittal strip extending through all the folia contained Purkinje cells with CFRs that had optimal planes of stimulation coplanar with the left posterior-right anterior semicircular canals (LPC-RAC). Lateral to this strip was a strip of Purkinje cells with CFRs that were characterized by optimal planes corresponding to stimulation of the left anterior-right posterior semicircular canals (LAC-RPC). SSs in Purkinje cells were modulated out of phase with CFRs from the same Purkinje cell. The depth of modulation of both CFRs and SSs was reduced during rotation in the climbing fiber "null plane". The depth of modulation of SSs was greatest when recorded from Purkinje cells located at the center of semicircular canal-related strip. We observed that 1) all folia of the uvula-nodulus receive vestibular climbing fiber inputs; 2) these climbing fiber inputs convey information from the vertical semicircular canals and otoliths but not the horizontal semicircular canals; 3) CFRs evoked in a particular sagittal zone do not influence SSs in adjacent zones; 4) modulation of a CFRs in a particular Purkinje cell can occur without modulation of SSs in the same Purkinje cell, although modulation of SSs was not observed in the absence of CFR modulation; and 5) modulation of SSs sometimes preceded that of CFRs in the same cell, implying that interneuronal pathways may contribute to SS modulation. Climbing fiber-driven Golgi cells, the inhibitory axon terminals of which end on granule cell dendrites in the classic glomerular synapse, may provide this interneuronal mechanism.

Animals↗

PubMed1993

Quincke's disease: nonhereditary angioneurotic edema of the uvula.

We report two cases of Quincke's disease, an isolated form of angioneurotic edema involving the uvula that is induced by several factors, including foods, drugs, and inhalants. Although Quincke's disease has prominent oral manifestations, it has only rarely been described in the dental literature. The rapid onset and progression of the disorder, combined with the risk of respiratory compromise, may result in a serious medial emergency. Clinical manifestations include a nonerythematous swollen uvula, fullness in the throat, and signs of airway obstruction. A hereditary form of angioneurotic edema is associated with a biochemical defect; this must be differentiated from nonhereditary, localized forms such as Quincke's disease to determine appropriate treatment and predict prognosis. Clinical features and laboratory tests can distinguish hereditary angioneurotic edema from the nonhereditary form.

Adult↗

PubMed1988

Interstitial and external radiotherapy in carcinoma of the soft palate and uvula.

Forty-three patients, all male, with limited epidermoid carcinoma of the soft palate and uvula were treated by interstitial implant usually associated with external radiotherapy. Most patients received 50 Gy external irradiation to the oropharynx and neck followed by 20-35 Gy by interstitial iridium-192 wires using either guide gutters or a plastic tube technique. Twelve primary tumors and two recurrences after external irradiation alone had implant only for 65-75 Gy. Total actuarial local control is 92% with no local failures in 34 T1 primary tumors. Only one serious complication was seen. Overall actuarial survival was 60% at 3 years and 37% at 5 years but cause-specific survivals were 81% and 64%. The leading cause of death was other aerodigestive cancer, with an actuarial rate of occurrence of 10% per year after treatment of a soft palate cancer. Interstitital brachytherapy alone or combined with external irradiation is safe, effective management for early carcinoma of the soft palate and uvula but second malignancy is a serious problem.

Actuarial Analysis↗

PubMed1987

Quincke's disease of the uvula.

Upper airway compromise may be the result of numerous factors, among which a swollen uvula should be considered in the differential diagnosis. We present a case of a 21-year-old man who presented with complaints of throat discomfort, altered voice, and tachypnea secondary to acute uvular edema. The patient was treated with sympathomimetic drugs both by injection and by inhalation with complete resolution of the swelling and his symptoms within 30 minutes. The uvula is a potential cause of upper airway obstruction and should be examined in persons presenting with airway-related complaints.

Adult↗

PubMed2000

Muscle fiber area distribution of musculus uvulae in obstructive sleep apnea and non-apneic snorers.

OBJECTIVE: To determine whether differences exist in the morphology of upper airway muscles between apneic and non-apneic snorers DESIGN: Muscle characteristic analysis in patients undergoing upper airway surgery in a tertiary sleep center. SUBJECTS: 10 non-apneic snorers and 10 sleep apnea hypopnea syndrome (SAHS). MEASUREMENTS: Frequency distribution of musculus uvulae (MU) muscle fiber area determined from 475+/-207 (mean s.d.) and 697 +/- 165 type IIA fibers and 92 +/- 32 and 68 45 type I fibers in snorers and SAHS, respectively. RESULTS: Histochemical analyses of MU revealed as expected that type IIA fibers occupied a significantly larger area within that muscle in SAHS compared to Snorers (89.4 +/- 5.8% and 76.1 +/- 15.1% respectively, P= 0.01). No difference was found in the frequency distribution of type I and type IIA fiber areas between the two groups comparing the between-groups and within-group variance of individual area distributions found in snorers and SAHS. CONCLUSION: There is no difference in muscle fiber area frequency distribution between non-apneic snorers and SAHS patients. This suggests that musculus uvulae of these groups of patients does not have a specific prevalence of atrophic or hypertrophic muscle fibers.

Adult↗

PubMed2000

Functions of the uvula and Z-pharyngoplasty.

UPPP includes uvulotomy. The uvula works as the pilot for eating and swallowing. We performed an operation which left the uvula intact and opened the pharynx by Z-opening the palate, Z-pharyngoplasty (ZPP). Twenty-four patients were studied before and after ZPP. The results of the operations were satisfactory. No patients complained of symptoms after uvulectomy. As for the changes indicated by sleep monitoring, minimum SaO2 increased significantly (P = 0.0026), pulse rate decreased significantly (P = 0.0144), apnea index decreased significantly (P = 0.0392), snoring decreased (P = 0.064), and the amount of hours of sleep when SaO2 was over 95% increased (P = 0.0690) after ZPP.

Adult↗

PubMed1993

[Nicotine concentrations in the palatine tonsil, uvula mucosa and septum cartilage of smokers--a pilot study].

The concentrations of nicotine were determined via radioimmunoassay in the palatine tonsils (n = 22) and in the mucosa of the uvula (n = 5) of eleven male smokers, and in the nasal septal cartilage of four other smokers. The same tissues of five nonsmokers served as controls. The mean values of the nicotine concentrations were 77 ng/g for the tonsils (level of serum: 151 ng/g), 114.5 ng/g for the mucosa of the uvula (level of serum: 215 ng/g) and 36 ng/g for the septal cartilage (level of serum: 97 ng/g). There was no nicotine in the tissues and serum of the control group. The correlations between the nicotine concentrations of the three tissues and the levels of the serum were significant. Another significant correlation was found between the nicotine level of the serum and the daily consumption of cigarettes of the eleven patients on whom tonsillectomy had been performed. These concentrations of nicotine in the three types of tissue and in serum appear to be high after an interval of twelve hours non-smoking. With gas-chromatography/mass-spectrometry also unchanged nicotine was found in the tonsils which is considered to be the damaging substance of tobacco.

Adult↗