Pharynx Region Research Articles

Swallowing functional outcomes and nutritional status in head and neck cancer radiotherapy: longitudinal study

ObjectiveTo explore the relationships between swallowing functional outcomes and nutritional status in patients with head and neck cancer undergoing radiotherapy (RT).MethodsThis longitudinal study included 122 patients. Data were collected at...

Sclerotherapy for Venous Malformations of the Pharynx or the Tongue Base Without Tracheostomy: Treatment Protocol With Intubation and Outcomes.

Venous malformations (VMs) occurring in the tongue base or pharynx are rare, but can cause airway obstruction. Considering the potential issues or morbidity related to surgical resection in the tongue or pharynx region, sclerotherapy is often preferred. We perform sclerotherapy for such lesions without conducting tracheotomy, but keep patients intubated for a certain period. Outcomes of sclerotherapy, and benefits and cautions related with our protocol were investigated.Our subjects were 10 cases in 9 patients who underwent sclerotherapy for VMs of the tongue base (6 patients) or pharynx (3 patients) from 2008 to 2017. One patient underwent treatment sessions twice. The sclerosants used were absolute ethanol (ET) (3 cases), 5% ethanolamine oleate (EO) (4 cases), or both ET and 5%EO (3 cases).In 5 of 9 patients, postoperative MRI was performed, which revealed lesion volume reduction by 12% to 47%. The intubation period varied according to the sclerosant used: ET, 5 to 11 days; 5% EO, 2 to 12 days; and combination of ET and 5% EO, 8 days. Postoperative complications included fever of unknown (n = 2), acute psychosis (n = 3), vocal cord paralysis (n = 2), and bradycardia induced from the use of a sedative agent (n = 1). One patient complained of mild transient swallowing difficulty that lasted for a month postoperatively.Although our method mandatorily requires careful postoperative management in an ICU, including sedation with anesthetic agents and artificial respiration by intubation for a certain period of time, no serious complications or post-therapeutic morbidities occurred.

Identification of a novel methyltransferase-type 12 protein from Haemonchus contortus and its effects on functions of goat PBMCs

BackgroundMethyltransferases (MTFs) are broad range of enzymes, which are ubiquitously expressed in diverse organisms ranging from bacteria to animals. MTFs proteins have been associated with various biological/cellular processes including transcriptional regulation, subcellular protein and RNA localization, signal transduction and DNA-damage repair. However, the role of MTFs in immune mechanism during host–parasite interaction has not been addressed yet.ResultsAn open reading frame (764 bp) of methyltransferase-type 12 gene of H. contortus denoted as HcMTF-12, was successfully cloned using reverse transcriptase-polymerase chain reaction (RT-PCR) followed by prokaryotic expression in Escherichia coli BL21 (DE3 strain). The recombinant HcMTF-12 protein (rHcMTF-12) was about 47 kDa along with a fusion vector protein of 18 kDa. Immunoblot results identified the native protein MTF-12 with antibodies produced in rats against rHcMT-12, whereas rHcMTF-12 protein was recognized with sera of goat experimentally infected with H. contortus. Immunohistochemical analysis revealed that the native MTF-12 protein was mainly located in the periphery (cuticle) of parasite sections as well as within the pharynx and intestinal region. An immunofluorescence assay validated that rHcMTF-12 attached to the surface of goat PBMCs. Furthermore, the cytokines transcription of IL-2, IFN-γ and IL-4 transcripts of PBMCs incubated with rHcMTF-12 were enhanced in a dose-dependent manner. The secretion of TGF-β1 and IL-10 was significantly decreased. However, IL-6 production was not significantly different as compared to the control groups. Moreover, the migration activity and nitric oxide (NO) production by PBMCs were induced considerably, whereas the proliferation of PBMCs cells was negatively affected when incubated with the rHcMTF-12 protein.ConclusionsOur findings suggest that HcMTF-12 significantly mediated the functions of PBMCs, and it might be a potential candidate for therapeutic interventions against haemonchosis.

Triticeal cartilage calcification

The triticeal cartilage (TC) is a tiny oval-shaped cartilage located at the lateral border of the thyrohyoid membrane between the hyoid bone greater horn and the thyroid cartilage superior horn. The exact function o TC is unknown; it has been proposed that TC was the site of the attachment for the triticeoglossus muscle. On panoramic radiographs, calcified TC may be observed in the soft tissues of the pharynx region, positioned inferior to the greater horn of the hyoid bone and adjacent to the superior border of the C4 vertebrae. The major concern of a calcified TC found incidentally in a routine radiographic examination is the differentiation between this alteration and other calcified tissue manifestations that require additional investigations, such as carotid calcified atheroma artery or other neck pathology such as foreign bodies. Thus, this report describes 3 cases in which TC calcifications were incidentally found in panoramic radiographs.

Evaluation of pain in children submitted to hematopoietic stem cell transplantation

Objective: to evaluate pain in children undergoing transplantation of hematopoietic stem cells. Methods: longitudinal and analytical research with children hospitalized for transplant of hematopoietic stem cells with Faces Pain Scale Revised, every four hours from hospital admission to hospital discharge analyzed with relative/absolute frequency and chi-square test. Results: nine children aged four to nine years old were evaluated, totaling 1,095 ratings 23.4% were reported with some pain score; of these, 38.9% were in hypo pharynx region; 78.8%, moderate pain. The chi-square showed significance between pain scores weeks post-transplantation and pain existence among the analyzed children. Conclusion: although the pain has not affected large proportion of children, moderate and strong pain covered around 80.0% of complaints along the hematopoietic stem cell transplantation process. Thus, it is suggested that the evaluation of pain is one of the signs to be inserted in the protocols of nursing interventions in this context of caring.

Hypopharyngeal lipoma-A diagnostic work up.

Key Clinical MessageIt is important to examine the pharynx through nasoendoscopic examination in patients that present with dysphagia, to look for pharyngeal masses. Magnetic resonance imaging can accurately diagnose lipoma in the pharynx region.

Muscular pattern in three species of Macrostomum (platyhelminthes, macrostomorpha).

Previous studies demonstrated complex architecture of the muscular system of Macrostomum species, especially in the rostrum area and the pharynx. However, little is known about the differences in muscular pattern between species of the genus. This study examines and compares the muscular systems of specimens belonging to three freshwater Macrostomum species (M. quiritium, M. tuba and M. velastylum), labeled with phalloidin-rhodamine and studied by confocal microscopy. Our results agree with the previous descriptions, confirming that the muscular patterns for the body wall, rostrum area, pharynx and caudal region differ among species. The muscles of the body wall follow the typical architecture, but the number of fibers in the species analyzed varies between dorsal and ventral surfaces, ranging from 80 to 100 fibers, this record being higher than previous observations. The arrangement of the fibers in the rostrum is complex, especially in the brain area. Macrostomum tuba and M. quiritium have a set of two muscles crossing at brain level and forming an "X," which is not evident in M. velastylum. We identified five different sets of fibers associated to the pharynx and mouth at ventral, medium and deep levels. These different sets are present in all three species studied. The caudal plate in M. tuba has an additional layer of diagonal fibers in the body wall, which is not evident in the other two species. The muscles of the reproductive system are independent of the body wall musculature in the species analyzed, but connected to the intestinal wall by specific fibers that may serve as an anchor. J. Morphol. 278:264-282, 2017. © 2016 Wiley Periodicals,Inc.

Prevalence of Staphylococcus aureus Colonization and Risk Factors for Infection Among Military Personnel in a Shipboard Setting.

Staphylococcal skin and soft tissue infections (SSTIs), especially those due to methicillin-resistant Staphylococcus aureus (MRSA) are an important public health issue for the military. Limited data exist regarding the prevalence of S. aureus colonization in the shipboard setting. We conducted a cross-sectional, observational study to determine the point prevalence of S. aureus colonization among military personnel onboard a naval vessel. Asymptomatic active duty personnel completed a survey for risk factors associated with colonization and SSTIs. Culture specimens were obtained from the anterior nares, pharynx, groin, and perirectal regions. MRSA isolates underwent testing for antimicrobial resistance, virulence factors, and pulsed-field type. 400 individuals were enrolled, 198 (49.5%) of whom were colonized with S. aureus, with MRSA identified in 14 participants (3.5%). No significant risk factors were associated with MRSA colonization. USA800 was the most common colonizing MRSA strain in the cohort and was detected in 10 participants (71%). Two participants (14%) were colonized with USA300 MRSA. In this first report of S. aureus epidemiology in a shipboard setting, we observed high rates of S. aureus and MRSA colonization. Longitudinal studies are needed to document the incident rates of S. aureus colonization during shipboard deployment and its impact on SSTI risk.

Three-dimensional Evaluation of Nasal Surgery in Patients with Obstructive Sleep Apnea.

Background:Obstructive sleep apnea (OSA) is a common sleep disorder and is characterized by airway collapse at multiple levels of upper airway. The effectiveness of nasal surgery has been discussed in several studies and shows a promising growing interest. In this study, we intended to evaluate the effects of nasal surgery on the upper airway dimensions in patients with OSA using three-dimensional (3D) reconstruction of cone-beam computed tomography (CT).Methods:Twelve patients with moderate to severe OSA who underwent nasal surgery were included in this study. All patients were diagnosed with OSA using polysomnography (PSG) in multi sleep health centers associated with Massachusetts General Hospital, Massachusetts Eye and Ear Infirmary and the Partners Health Care from May 31, 2011 to December 14, 2013. The effect of nasal surgery was evaluated by the examination of PSG, subjective complains, and 3D reconstructed CT scan. Cross-sectional area was measured in eleven coronal levels, and nasal cavity volume was evaluated from anterior nasal spine to posterior nasal spine. The thickness of soft tissue in oral pharynx region was also measured.Results:Five out of the 12 patients were successfully treated by nasal surgery, with more than 50% drop of apnea–hypopnea index. All the 12 patients showed significant increase of cross-sectional area and volume postoperatively. The thickness of soft tissue in oral pharynx region revealed significant decrease postoperatively, which decreased from 19.14 ± 2.40 cm2 and 6.11 ± 1.76 cm2 to 17.13 ± 1.91 cm2 and 5.22 ± 1.20 cm2.Conclusions:Nasal surgery improved OSA severity as measured by PSG, subjective complaints, and 3D reconstructed CT scan. 3D assessment of upper airway can play an important role in the evaluation of treatment outcome.

Extensiv scleroma at 11 years old girl

Rhinoscleroma is a rare chronic granulomatous disease caused by Klebsiella rhinoscleromatis, which is a Gram-negative bacilli. Scleroma primarily affects the upper respiratory airway, preferably the nasal cavity, but the pharynx and larynx may also be involved. The term scleroma is preferred over the term rhinoscleroma because this disease affects not only the nose. Scleroma is endemic in countries of East Europe, Africa, South-East Asia and in sporadic areas worldwide. Scleroma usually begins at the nose and may progress to involve the larynx, pharynx or other regions of the neck. Scleroma generally progresses in three stages: the catarrhal or exudative phase, the proliferative or granulomatous phase, the sclerotic stage. Diagnosis of Rhinoscleroma depends on identification of the pathognomonic Mickulicz cells which is most prominent during granulomatous phase but spares or absent during catarrhal or sclerotic phases of the disease. We report a case of 11-year-old girl with the sclerotic stage of scleroma. This diagnose was proved by Mikulich cells histological detecting. We review the history, epidemiology, pathology, diagnosis, and treatment of scleroma. We report the case of a 11-year-old girl, hospitalize in our institute, diagnosed with rhinoscleroma in the context of recurrent breathlessness, wheezes and cough. The diagnosis difficulty caused by changes of nasal laryngeal mucous membrane after septoplasty 3 months ago and bronchial asthma diagnosed 2 years ago. The patient was given a six-month regimen of ciprofloxacin, and a dramatic improvement was observed.

Rotylenchus cretensis n. sp. and R. cypriensis Antoniou 1980 (Nematoda: Hoplolaimidae) recovered from the rhizosphere of olive at Crete (Greece) with a molecular phylogeny of the genus

A new and a known species of Rotylenchus from Crete, each collected from the rhizosphere of olive, are described and illustrated based on morphological, morphometric and molecular studies. Rotylenchus cretensis n. sp. is characterised by having a truncate lip region with irregular longitudinal striation, lateral field areolated only in pharynx region, stylet length less than 41 μm, vulva located at 53–59 %, conoid-rounded to dorsally convex-conoid female tail with 7–11 annuli and specific D2-D3 of 28S, ITS, and partial 18S rRNA. Rotylenchus cretensis n. sp. appears to be similar to R. urmiaensis, having overlapping character ranges. Rotylenchus cretensis is also similar to R. striaticeps from which has got shorter stylet length (35.5–41.5 vs 39–50 μm), female tail shape (conoid-rounded to dorsally convex-conoid vs rounded), shorter spicules length (34–40 vs 41–50 μm), and phasmid position (varying from at level to three annuli posterior to the anus vs at level to seven annuli anterior to anus). Multivariate analysis of variance performed on R. cretensis n. sp., as well as two populations of R. striaticeps and R. urmiaensis from Iran on combined morphometric characters data set revealed a significant effect by species populations, indicating that closely morphological and morphometrically species differed significantly from each other. Additionally, analysis of variance showed that morphometric characters such as lip region width, distance from phasmid to tail tip (PHS) or a ratio can be used as key morphometric characters for species differentiation in this group. The results of phylogenetic analyses based on D2-D3 region, ITS of rRNA, and the partial 18S sequences confirmed the close molecular relationships between R. cretensis n. sp., R. urmiaensis and R. striaticeps, but clearly support the proposal of R. cretensis n. sp. as a new species. Also, the recognition of this cryptic species within Rotylenchus shows that the biodiversity of these nematodes is still not fully understood and requires further studies. Additionally, R. cypriensis is described and molecularly analysed for first time in Greece.

Galectin-11: A novel host mediator targeting specific stages of the gastrointestinal nematode parasite, Haemonchus contortus

Galectin-11 is released from epithelial cells of the gastrointestinal tract, specifically following infection with gastrointestinal parasites including the highly pathogenic nematode, Haemonchus contortus. The function(s) of galectin-11 are currently unknown but seem to be associated with the development of immunity by the host. The aim of the present study was to examine the interaction of galectin-11 with the different parasitic life cycle stages of H. contortus and determine any effects on parasite development. The results of this study showed that galectin-11 binds to the surface of the L4 and adult stages of the parasite but not to the exsheathed L3 stage. In addition, at a lower concentration, binding to the L4 was specifically localised to the pharynx region. Subsequent in vitro assays demonstrated significant inhibition of larval growth and development in the presence of recombinant galectin-11. These results indicate, to our knowledge for the first time, a functional role for galectin-11 in gastrointestinal nematode infection of ruminants and a mechanism of action of galectin-11, targeting the development and growth of the L4 and possibly the adult parasite stage.

Safety and efficacy of concurrent neck dissection and transoral robotic surgery.

The literature is scarce regarding transoral robotic surgery (TORS) with simultaneous neck dissection. This study evaluates the safety and efficacy of concurrent neck dissection in oropharyngeal squamous cell carcinoma (SCC) treated with TORS. Analysis of 113 patients with oropharyngeal SCC treated with TORS and concurrent neck dissection. Six intraoperative communications between the pharynx and neck region were recognized. After pharyngeal mucosal flap advancement, 1 defect was closed primarily and another one was reinforced with acellular dermal matrix. In 1 case, submandibular gland was transposed posteriorly over the sutured defect as a support. One omohyoid and 2 digastric muscular pedicle rotation flaps were used in the remaining 3 patients for the reconstruction of pharyngeal communications. None of the patients developed postoperative pharyngocutaneous fistula. The advantage of TORS oropharyngectomy, when compared with open approaches, is the avoidance of pharyngocutaneous fistula even in the presence of concurrent neck dissection © 2015 Wiley Periodicals, Inc. Head Neck 38: E519-E523, 2016.

Protection and Delivery of Anthelmintic Protein Cry5B to Nematodes Using Mesoporous Silicon Particles.

The ability of nano- and microparticles of partially oxidized mesoporous silicon (pSi) to sequester, protect, and deliver the anthelmintic pore-forming protein Cry5B to nematodes is assessed in vitro and in vivo. Thermally oxidized pSi particles are stable under gastric conditions and show relatively low toxicity to nematodes. Fluorescence images of rhodamine-labeled pSi particles within the nematodes Caenorhabditis elegans and Ancylostoma ceylanicum show that ingestion is dependent on particle size: particles of a 0.4 ± 0.2 μm size are noticeably ingested by both species within 2 h of introduction in vitro, whereas 5 ± 2 μm particles are excluded from C. elegans but enter the pharynx region of A. ceylanicum after 24 h. The anthelmintic protein Cry5B, a pore-forming crystal (Cry) protein derived from Bacillus thuringiensis, is incorporated into the pSi particles by aqueous infiltration. Feeding of Cry5B-loaded pSi particles to C. elegans leads to significant intoxication of the nematode. Protein-loaded particles of size 0.4 μm display the highest level of in vitro toxicity toward C. elegans on a drug-mass basis. The porous nanostructure protects Cry5B from hydrolytic and enzymatic (pepsin) degradation in simulated gastric fluid (pH 1.2) for time periods up to 2 h. In vivo experiments with hookworm-infected hamsters show no significant reduction in worm burden with the Cry5B-loaded particles, which is attributed to slow release of the protein from the particles and/or short residence time of the particles in the duodenum of the animal.

High-Resolution Multi-Photon Imaging of Morphological Structures of Caenorhabditis elegans.

In this protocol, we combine two-photon excitation fluorescence with nonlinear optical measurements to reconstruct the three-dimensional architecture of the pharyngeal region and the muscular system of the anterior and mid-body region of Caenorhabditis elegans (C. elegans). Femto-second laser pulses excite second-harmonic generation (SHG) and third-harmonic generation (THG) signals, which show detailed structural information regarding the organization of myofibrils that are arranged around the central pharynx region. The combination of two-photon excitation with SHG and THG imaging is a very powerful tool to study cell morphology, microarchitecture, and tissue arrangement in C. elegans.

Description of Rotylenchus urmiaensis n. sp. (Nematoda: Hoplolaimidae) from North-western Iran with a molecular phylogeny of the genus

A new bisexual species ofRotylenchusfrom North-western Iran is described and illustrated based on morphological, morphometric and molecular studies.Rotylenchus urmiaensisn. sp. is characterised by having a truncate lip region with irregular longitudinal striation, lateral field areolated only in pharynx region, stylet length 34-40 μm, vulva positioned at 53-61%, and female tail conoid-rounded to dorsally convex-conoid with 5-10 annuli.Rotylenchus urmiaensisn. sp. appears to be similar toR. striaticeps, from which it may be differentiated morphologically by a slightly shorter body length (870-1269vs1000-1723 μm), shorter stylet (34-40vs39-50 μm), female tail shape (conoid-rounded to dorsally convex-conoidvsrounded), frequency of males (rarevscommon as abundant as females), shorter spicules (39-43vs41-50 μm) and phasmid position (varying from three annuli anterior or three annuli posterior to anusvsat level to seven annuli anterior to anus), and molecularly. The results of phylogenetic analyses based on sequences of D2-D3 expansion region of 28S, ITS-rDNA, 18S rDNA, and the partial cytochrome c oxidase subunit 1 (coxI) mtDNA, confirmed the species differentiation and the close molecular relationship betweenR. urmiaensisn. sp. andR. striaticeps.

A new flexible endoscopy-system for the transoral resection of head and neck tumors

Within the last years transoral robotic surgery (TORS) with endoscopic visualization and surgery has gained importance in the resection of head and neck tumors and is an alternative to transoral laser microsurgery. The further development of transoral endoscopic systems should enhance the surgical options and reduce the surgery related morbidity. Thus, we evaluated a new flexible endoscopy system in cadaver -dissections. In March 2014 we performed all standard procedures of transoral tumor surgery in the oropharynx, hypopharynx and larynx in 3 fresh cadaveric specimens using the Medrobotics Flex(®) System. In a prospective study we analyzed exposure, -visualization, accessibility and resectability of the respective -anatomic regions. All relevant anatomic structures of the pharynx and supraglottic region could be well exposed, visualized and accessed. Tonsillectomies and resections of the soft palate as well as the base of tongue could be performed easily. Supraglottic resections were possible with a good visualization. The piriform sinus could be exposed, and controlled tissue resections were possible-. The vocal cords were accessible and cordectomies could be performed. By combining a robot assisted flexible endoscope with flexible instruments the Flex system facilitates the visualization and accessibility of all relevant anatomic structures of pharynx and larynx. It is a promising system which now has to be further evaluated in clinical trials.

Anatomia da cavidade bucofaringeana de Sorubim trigonocephalus (Siluriformes, Osteichthyes)

Sorubim trigonocephalus Miranda et Ribeiro, 1920 conhecido popularmente como chinelo, é uma espécie migratória, de importância econômica. Bastante apreciado na gastronomia por apresentar sabor agradável e sem ossos intermusculares (espinhos). Os exemplares foram coletados em um trecho no Rio Teles Pires, localizado no município de Alta Floresta/MT. Anestesiados e sacrificados em solução aquosa de benzocaína, fixados com solução de formoldeído a 10%, transferidos para o Laboratório de Anatomia Animal/Unemat para descrição das características da cavidade bucofaringeana. Esta espécie apresentou uma pré-maxila bem desenvolvida e cabeça achatada dorsoventralmente, boca localizada na porção ventral média da cabeça, com fenda bucal ampla. Os lábios superiores apresentaram pigmentação cinza escuro com pequenas áreas claras, sendo mais largos que os inferiores e não apresentaram pigmentação. Foram identificadas quatro regiões dentígeras na porção anterior da cavidade bucal e duas na região da faringe, todas com dentes viliformes. A porção posterior da cavidade bucal era limitada lateralmente por quatro pares de arcos branquiais que decresciam em tamanho do primeiro ao último par, crânio-caudal, formados por dois ramos: o superior, mais curto, e o inferior, mais longo. A cavidade bucofaringeana de S. trigonocephalus se mostrou semelhante à de outros teleósteos descritos na literatura, estando adaptado ao hábito alimentar com dieta carnívoro-ictiofágica e diferindo apenas pela ausência de língua estrutural com pré maxila bem desenvolvida apresentando dentes viliformes.

Thoracic Fraction of Inhaled Fiber Aerosol

Size-selective sampling is a health-related method to collect airborne particles based on penetration of inhaled particles into different regions of the human respiratory tract; thus, it is the most relevant sampling method to correlate health risks with occupational exposure. The current practice of sampling asbestos and other fibers is not a size-selective method. The thoracic size fraction, defined as the portion of inhaled particles that can penetrate through the larynx, has been suggested as the most relevant size-selective sampling method for fiber aerosol. The thoracic fraction is based on 1-deposition of inhaled spherical particles in the human extrathoracic airways for mouth breathing and corrected for the particle inhalability. There is no comparable information for fiber aerosols; therefore, there is no technical basis to ascertain whether the current thoracic fraction definition is suitable for fiber aerosols. No human data are available from controlled experiments of inhaled fiber aerosols for the obvious reason that most fiber materials are potentially hazardous when inhaled. Our approach was to measure penetration of fiber aerosol in realistic human oropharyngeal airway replicas and to compare that with data from spherical particles. We showed that realistic human oral airway replicas (including the oral cavity, pharynx, and larynx regions) provided useful spherical and fiber particle deposition in the human head airway. These data could be used to test the thoracic fraction curves. The spherical penetration is in agreement with human in vivo data used to establish the thoracic fraction curve. Fiber penetrations through the larynx of two human oral airway replicas were higher than those for spherical particles for the same aerodynamic diameter using the same replicas. The thoracic curve as defined for spherical particles, therefore, may not include some fibers that could penetrate to the thoracic region.

Bone and mucosal dosimetry in skin radiation therapy: a Monte Carlo study using kilovoltage photon and megavoltage electron beams

This study examines variations of bone and mucosal doses with variable soft tissue and bone thicknesses, mimicking the oral or nasal cavity in skin radiation therapy. Monte Carlo simulations (EGSnrc-based codes) using the clinical kilovoltage (kVp) photon and megavoltage (MeV) electron beams, and the pencil-beam algorithm (Pinnacle3 treatment planning system) using the MeV electron beams were performed in dose calculations. Phase-space files for the 105 and 220 kVp beams (Gulmay D3225 x-ray machine), and the 4 and 6 MeV electron beams (Varian 21 EX linear accelerator) with a field size of 5 cm diameter were generated using the BEAMnrc code, and verified using measurements. Inhomogeneous phantoms containing uniform water, bone and air layers were irradiated by the kVp photon and MeV electron beams. Relative depth, bone and mucosal doses were calculated for the uniform water and bone layers which were varied in thickness in the ranges of 0.5–2 cm and 0.2–1 cm. A uniform water layer of bolus with thickness equal to the depth of maximum dose (dmax) of the electron beams (0.7 cm for 4 MeV and 1.5 cm for 6 MeV) was added on top of the phantom to ensure that the maximum dose was at the phantom surface. From our Monte Carlo results, the 4 and 6 MeV electron beams were found to produce insignificant bone and mucosal dose (<1%), when the uniform water layer at the phantom surface was thicker than 1.5 cm. When considering the 0.5 cm thin uniform water and bone layers, the 4 MeV electron beam deposited less bone and mucosal dose than the 6 MeV beam. Moreover, it was found that the 105 kVp beam produced more than twice the dose to bone than the 220 kVp beam when the uniform water thickness at the phantom surface was small (0.5 cm). However, the difference in bone dose enhancement between the 105 and 220 kVp beams became smaller when the thicknesses of the uniform water and bone layers in the phantom increased. Dose in the second bone layer interfacing with air was found to be higher for the 220 kVp beam than that of the 105 kVp beam, when the bone thickness was 1 cm. In this study, dose deviations of bone and mucosal layers of 18% and 17% were found between our results from Monte Carlo simulation and the pencil-beam algorithm, which overestimated the doses. Relative depth, bone and mucosal doses were studied by varying the beam nature, beam energy and thicknesses of the bone and uniform water using an inhomogeneous phantom to model the oral or nasal cavity. While the dose distribution in the pharynx region is unavailable due to the lack of a commercial treatment planning system commissioned for kVp beam planning in skin radiation therapy, our study provided an essential insight into the radiation staff to justify and estimate bone and mucosal dose.