The back portion of the oral cavity leads into the throat, and this is termed the pharynx. The hard, bony palate of the roof of the mouth above gives way to the soft palate behind. In the centre of this hangs the uvula (“little bunch of grapes”), which is the troublemaker with snorers. It waggles back and forth fiercely with nocturnal mouth breathing, and the currents set up a reverberating sound we call snoring. Moral: A snorer should keep the mouth closed, and sleep on the side.
On either side are the rounded, pink, meaty glands, the tonsils. These are the cause of much infection, particularly during childhood, but adults frequently are involved also. Below this is the root of the tongue, often with large, obvious flat pimples over it. These are the large taste buds, often imagined to be some sort of disease. In mild infections, they may enlarge a little and so become more prominent, but they are a normal part of the oral anatomy.
Behind is the posterior (back) wall of the throat, the pharynx. This is usually pink. In infections it often becomes covered with thick mucus, and small lumps of pink to red lymphoid material become prominent. This is part of the body’s normal defense mechanism, and is not a disease in itself. The pharynx gives way below to a rear tube, which is the food canal or esophagus, and an anterior or front tube, the trachea, which conveys air. This connects above (and behind the uvula) with the rear part of the nose and the nasal airways.
Above and behind the tonsils is a small aperture. This leads into a canal on either side connecting with the inner car, and is called the Eustachian tube. This is important in maintaining pressure balances between the inner and outer parts of the ear, and stabilizing balance also. If it becomes blocked (which is common with infections in this part), the voice sounds abnormally loud, and some balance disability may be experienced. It can often be cleared simply by holding the nose firmly with the fingers, closing the mouth, and blowing into the ears; this is known as the Valsalva manoeuvre. Most can do this readily, and those who travel by air often find it helps reduce any sudden car discomfort when coming in to land.
The most important disorder occurring in this region and the most common is tonsillitis. This is usually an acute condition, and is more frequent in children. Sometimes, one side may advance to “peritonsillar abscess” (or quinsy), producing considerable discomfort. More common, but usually far less disabling, is an acute pharyngitis, which is usually part of most upper respiratory tract infections.