Odynophagia pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2]

Odynophagia pathophysiology is related to causes.Following are common mechanisms involved in inducing pain in esophagus and pharynx

Anatomic facts of pharynx and esophagus:

• Pharynx is divided in to into three sections: the nasopharynx, the oropharynx and the laryngopharynx. Odynophagia is due to painful stimuli of orophyranx and laryngopharynx.
• The oropharynx lies behind the oral cavity, extending from the uvula to the level of the hyoid bone. It opens anteriorly, through the isthmus faucium, into the mouth, while in its lateral wall, between the palatoglossal arch and the palatopharyngeal arch, is the palatine tonsil. 
• The oropharynx is lined by non-keratinised squamous stratified epithelium.
• The laryngopharynx, (Latin: pars laryngea pharyngis), also known as hypopharynx, is the caudal part of pharynx; it is the part of the throat that connects to the esophagus.
• The mucosa of the larynx is supplied on each side chiefly by the internal laryngeal branch of the superior laryngeal nerve, which supplies the larynx as far down as the vocal folds. The inferior part of the larynx receives sensory fibers from the recurrent laryngeal nerve.
• The motor and most of the sensory supply to the pharynx is by way of the pharyngeal plexus, which, situated chiefly on the middle constrictor, is formed by the pharyngeal branches of the vagus and glossopharyngeal nerves and also by sympathetic nerve fibers.
• The motor fibers in the plexus are carried by the vagus (although they likely represent cranial accessory nerve components) and supply all the muscles of the pharynx and soft palate except the stylopharyngeus (supplied by cranial nerve IX) and tensor veli palatini (supplied by cranial nerve V).
• The sensory fibers in the plexus are from the glossopharyngeal nerve, and they supply the greater portion of all three parts of the pharynx. 
• The pharynx is supplied by branches of the external carotid (ascending pharyngeal) and subclavian (inferior thyroid) arteries.
• The motor and most of the sensory supply to the pharynx is by way of the pharyngeal plexus.
• Pharyngeal plexus is formed by the pharyngeal branches of the vagus and glossopharyngeal nerves and also by sympathetic nerve fibers.
• The motor fibers in the plexus are carried by the vagus (although they likely represent cranial accessory nerve components) and supply all the muscles of the pharynx and soft palate except the stylopharyngeus (supplied by cranial nerve IX) and tensor veli palatini (supplied by cranial nerve V).
• The sensory fibers in the plexus are from the glossopharyngeal nerve, and they supply the greater portion of all three parts of the pharynx. The pharynx is supplied by branches of the external carotid (ascending pharyngeal) and subclavian (inferior thyroid) arteries.
• The esophagus, like the rest of the viscera, receives dual sensory innervation, traditionally referred to as parasympathetic and sympathetic, but more properly based on the actual nerves, vagal, and spinal.

Pathological conditions causing pain in swallowing:

Infections:

Infection of esophagus or pharynx causes fluid leaking in interstitial media of mucous epithelium and it produce pressure on sensory nerve terminals situated in mucousa.

Tumors:

It produce pain due to compression effect of mass on sensory nerve terminals situated in mucousa.

Foreign body:

It produce pain due to compression effect of foreign body on sensory nerve terminals situated in mucousa.