Diagnosing and managing dynamic pharyngeal collapse

The nasopharynx is an anatomically and functionally complicated structure, with a number of muscles innervated by a variety of cranial nerves. Sensory receptors present within the mucosa have an important role in maintaining the patency of the airway, induction of swallowing and ensuring airway protection. Nasopharyngeal collapse (NPC) can present dorsally, laterally or circumferentially, and is usually caused by muscular or nervous malfunction. At present an exact aetiology is unknown, but fitness and maturity of the nasopharyngeal musculature have been implicated. Neuromuscular disease, sedatives and muscle relaxants can also cause permanent and transient NPC. Inflammation of the nasopharynx, in particular the mucosa, may also be involved by affecting the pharyngeal plexus and the motor innervation to the nasopharyngeal muscles. Partial mechanical obstructions of the upper airway, such as cysts, tumours and scarring, have also been associated with the disorder ...