mise à jour du 13 mars 2002
  British medical J
1978; 6110; 443-4
 cas cliniques
 Yawning in pharyngeal obstruction
Evans EB, London, GB
The upper airway in sleep: physiology of the pharynx
Ayappa I, Rapaport D


After observing two infants in the early stages of choking, I wish to draw attention to yawning as a symptom of pharyngeal impaction.
In the first infant, aged 11 months, an acute episode of obstruction occured immediately after biting into a piece of raw apple. The infant cried and arched his back, obviously in pain, gagged, and also yawned repeatedly. There was a brief episode of stridor. After 10 min the infant regurgitated several pieces of apple, the largest being about 1 cm long. He was subsequently free of distress and able to swallow food. An x-ray showed slight opacity of the left lung, and at bronchoscopy a small piece of apple was aspirated from that lung.
In the other infant, aged 8 months, the episode was less acute and developed after the infant was given a biscuit. She began to gag and make swallowing motions and, again, yawned repeatedly. After regurgitation of mostly liquid matter the yawning ceased, and after a further 10 min the swallowing ceased and the child appeared perfectly normal.
In both these cases the yawning was marked and continual until the obstruction was relieved, suggesting that it represents vagal stimulation arising from the pharynx. Recognition of the symptom could be important, especially if a physician is telephoned by a mother saying she doesn't know what is wrong with her baby - he seems distressed and keeps yawning. It would be easy to say, "He is just tired-put him to bed."