I.

INTRODUCTION

The upper respiratory tract comprises the conjunctiva,nose, paranasal sinuses, middle ear,
nasopharynx, oropharynx and laryngopharynx. It is largely covered withciliated columnar
epithelium. Exceptions are the oropharynx,vocal cords, upper posterior epiglottis and
mastoidantrum of the middle ear, which are lined with stratifi edsquamous epithelium. The
conjunctiva is also composedof stratifi ed squamous epithelium, continuous with andsimilar to
the epithelium of the cornea.The adenoids and tonsils are important structures ofthe upper
respiratory tract. They are lymphoid organswhose surfaces are marked by many deep clefts, both
macroscopicand microscopic.The whole upper respiratory tract is colonized by a variety
of normal flora.

Temporary colonization of the pharynx, nose or eye by potential pathogens is also

common, and may provide an important reservoir of infection, for instance with Neisseria
meningitidis or Corynebacterium diphtheriae. Similarly, highly transmissible viruses, such as
rhinoviruses, paramyxoviruses, enteroviruses, adenoviruses and myxoviruses, can infect the
nasopharynx, mildly or asymptomatically. Latent viruses may be intermittently shed from the
pharynx. Herpes simplex virus, other human herpesviruses, such as HHV-6, Epstein–Barr and
cytomegalovirus virus are the most important of these. The environment of the upper respiratory
tract is varied, and different areas are susceptible to infection with different pathogens. While
most infections are of surfaces, the middle ear and the paranasal sinuses are hollow structures
with narrow outlets (the ostia of the sinuses and the Eustachian tubes of the middle ears) whose
obstruction leads to loculated infection and abscess formation. The soft tissues of the fauces,
surrounding the tonsils, are susceptible to abscess formation if severely inflamed.

II. GENARAL DATA