Uvula

Uvula

"Uvula" redirects here. For other uses, see Uvula of cerebellum and Uvula of urinary bladder.
Uvula
Uvula's location in the human mouth
Latin uvula palatina
Gray's subject #241 1112
MeSH Uvula
Dorlands/Elsevier Uvula

The palatine uvula, usually referred to as simply the uvula /ˈjuːvjələ/, is a conic projection from the posterior edge of the middle of the soft palate, composed of connective tissue containing a number of racemose glands, and some muscular fibers (musculus uvulae).[1][2]

Etymology

In Latin, ūvula means 'little grape', the diminutive form of ūva 'grape' (of unknown origin). A swollen uvula was called "ūva."[3]

Muscle

The musculus uvulae, which lies entirely within the uvula, shortens and broadens the uvula. This changes the contour of the posterior part of the soft palate. This change in contour allows the soft palate to adapt closely to the posterior pharyngeal wall to help close the nasopharynx during swallowing.[4]

It is innervated by the pharyngeal branch of vagus nerve (cranial nerve X).

Function in speech

The uvula plays a role in the articulation of some sounds of the human voice.[5] The uvula functions in tandem with the back of the tongue, the palate, and air coming up from the lungs to create a number of guttural and other sounds. Uvular consonants are not found in English, though they are found in many Semitic, Caucasian, and Turkic languages, as well as several languages of Western Europe such as German, French, Portuguese, a few Celtic languages as well as some dialects of the Swedish language. Certain African languages such as the Khoisan languages use the uvula to produce click consonants as well, though other than that, uvular consonants are fairly uncommon in Sub-Saharan Africa.

Pathology

Emetic effect

Massaging the uvula causes the gag reflex to initiate and expel stomach contents. This is often an issue for people who plan to get uvula piercings.

Velopharyngeal insufficiency

In a small number of people, the uvula does not close properly against the back of the throat, causing a condition known as velopharyngeal insufficiency or VPI. This causes "nasal" (or more properly "hyper-nasal") speech, where a lot of extra air comes down the nose, and the speaker is unable to say certain consonants, for example producing the sound 'b' like 'm'. The uvula can get swollen and fat.

Snoring and sleep apnea

The uvula can also contribute to snoring or heavy breathing during sleep; having an elongated uvula can cause vibrations which lead to snoring. In some cases this can lead to sleep apnea, which may be treated by removal of the uvula or part of it if necessary, an operation known as uvulopalatopharyngoplasty (commonly referred to as UPPP, or U3P). However, this operation can also cause sleep apnea if scar tissue forms and the airspace in the velopharynx is decreased. The success of UPPP as a treatment for sleep apnea is unknown, but some research has shown 40–60% effectiveness in reducing symptoms.[6] Typically apnea subsides for the short term, but returns over the medium to long term, and sometimes is worse than it was before the UPPP.

Nasal regurgitation

During swallowing, the soft palate and the uvula move superiorly to close off the nasopharynx, preventing food from entering the nasal cavity. When this process fails, the result is called nasal regurgitation. It is common in people with VPI, the myositides, and neuromuscular disease.

Uvulitis


At times, the mucous membrane around the uvula may swell, causing the uvula to expand 3–5 times its normal size. When the uvula touches the throat or tongue, it can cause sensations like gagging or choking, even though there is no foreign matter present. This can cause problems with breathing, talking, and eating.

There are many theories about what causes the uvula to swell, including dehydration (e.g. from arid weather); excessive smoking or other inhaled irritants; snoring; allergic reaction; or a viral or bacterial infection. An aphthous ulcer which has formed on the uvula can also cause swelling and discomfort.[7]

If the swelling is caused by dehydration, drinking fluids may improve the condition. If the cause is a bacterial infection, gargling salt water may help. However, it can also be a sign of other problems. Some people with a history of recurring uvulitis have to carry an EpiPen containing Adrenaline (Epinephrine) to inject themselves whenever the uvulitis begins. A swollen uvula is not normally life threatening and subsides in a short time, typically within a day.

Bifid uvula

A bifid or bifurcated uvula is a split or cleft uvula. Newborns with cleft palate often also have a split uvula. The bifid uvula results from incomplete fusion of the palatine shelves but it is considered only a slight form of clefting. Bifid uvulas have less muscle in them than a normal uvula, which may cause recurring problems with middle ear infections. While swallowing, the soft palate is pushed backwards, preventing food and drink from entering the nasal cavity. If the soft palate cannot touch the back of the throat while swallowing, food and drink can enter the nasal cavity.[8] Splitting of the uvula occurs infrequently but is the most common form of mouth and nose area cleavage among newborns. Bifid uvula occurs in about 2% of the general population,[9] although some populations may have a high incidence, such as Native Americans who have a 10% rate.[10]

Bifid uvula is a common symptom of the rare genetic syndrome Loeys-Dietz syndrome,[11] which is associated with an increased risk of aortic aneurysm.[12]

Cultural implications

In some parts of Africa, including Ethiopia and Eritrea, the uvula or a section of it is ritually removed by a traditional healer.[13] In this case, the uvula may be noticeably shortened. It is not thought to contribute to velopharyngeal inadequacy, except in cases where the tonsils have also been removed.[14]

See also

References

External links

  • 001257 - Uvulitis