PHARYNGEAL

APPARATUS
DR.AHAMAD JALWA
Pharyngeal Apparatus
 Pharyngeal arches
 Pharyngeal clefts
 Pharyngeal pouches
Pharyngeal arches
 Inthe human embryo, the arches are first seen
during the fourth week of development
 They appear as a series of outpouchings
of mesoderm on both sides of the
developing pharynx.
 The vasculature of the pharyngeal arches is
known as the aortic arches
Schematic of developing human fetus with
first, second and third arches labelled
Scheme of pharyngeal arches
I–IV: pharyngeal arches
1–4: pharyngeal pouches (inside)
and/or pharyngeal grooves (outside)
a: Tuberculum laterale
b: Tuberculum impar
c: Foramen cecum
d: Ductus thyreoglossus
e: Sinus cervicalis
Pharyngeal arches derivatives
Pharyngeal pouch disorders

• I Arch syndrome

First arch syndromes are congenital defects caused

by a failure of neural crest cells to migrate into
the first pharyngeal arch.

They can produce facial anomalies.

Eg. of first arch syndromes include :

Treacher Collins syndrome and Pierre Robin
syndrome.
Treacher Collins Syndrome
• An inherited autosomal dominant condition in which some
bones and tissues in the face aren't developed.

• It most oftenly affects the cheek bones, jaw, chin and ears.
Treacher Collins Syndrome symptoms
Pierre Robin Syndrome
• It is a rare congenital autosomal recessive disorder
characterized by an underdeveloped jaw, backward
displacement of the tongue and upper airway obstruction.

• Cleft palate is also commonly present in children with Pierre

Robin sequence.
Pierre Robin Syndrome symptoms
Pharyngeal clefts
• Invagination of surface ectoderm between the pharngeal
arches
• Four pharyngeal clefts
• 2nd pharyngeal arch grows rapidly downwards and overlap 2nd, 3rd, 4th
pharyngeal pouch- Cervical Sinus
Pharyngeal Clefts derivatives
Pharyngeal clefts disorders
· Branchial cyst
Branchial cleft cysts, also known as branchial cleft anomalies, are congenital anomalies
arising from the first through fourth pharyngeal pouches.
These anomalies can exist as true fistulae, cysts, or sinus tracts, depending on the degree of
incomplete obliteration during embryogenesis. 
· Branchial fistula
When branchial cyst ruptures – branchial fistula
Open along ant border of sternocleidomastoid
Branchial cyst & Branchial fistula
· Lateral cervical fistula
Pharyngeal Pouches
· Pharyngeal pouches are endodermal out-pockets occurring
between the pharyngeal arches in embryological development.

· Various transcription factors regulate the mechanical bending of

the endodermal tube, resulting in pharyngeal pouch formation.

· The pouches give rise to tissues responsible for the formation of

the middle ear cavity and eustachian tube, palatine tonsils, thymus,
parathyroid glands, and parafollicular cells of the thyroid.
FIRST PHARYNGEAL POUCH

· First pharyngeal pouch – tubotympanic recess

· Distal part of tubotympanic recess – middle ear cavity and mastoid antrum
· Proximal part – eustachian/auditory tube
SECOND PHARYNGEAL POUCH

• Endoderm proliferates to Form solid buds, central core of these buds breaks down to form Tonsillar crypts
• Part of this pouch remains as intratonsillar crypt (crypta magna)
THIRD PHARYNGEAL POUCH
· Dorsal bulbar part – parathyroid III or inferior parathyroid gland
· Ventral tubular part - thymus
 FOURTH PHARYNGEAL POUCH

· Dorsal bulbar part – superior parathyroid gland IV

· Fifth pouch incorporated with fourth pouch – caudal pharyngeal complex – para follicular cells or c cells
Pharyngeal Pouches derivative
Pharyngeal Pouch disorders
DiGeorge syndrome

A disorder caused by a defect in chromosome 22.

It is a chromosomal disorder that results in poor development of

several bodily systems. Its features vary widely, even among
members
Branchio-oto-renal (BOR) syndrome
Branchiootorenal (BOR) syndrome is a condition that disrupts the
development of tissues in the neck and causes malformations of
the ears and kidneys
Thank you.