Superior constrictor muscle attachment12/31/2023 ![]() ![]() Lingual tonsils and lymphoid aggregations close to the epiglottisĭue to the close proximity of the palatine tonsil with the surrounding spaces including parapharyngeal, retropharyngeal, masticator, and parotid spaces, the tumors and inflammation of the tonsil commonly spread into these spaces and result in secondary lesions. Įustachian tube tonsils (Gerlach’s tonsils) This annular-shaped lymphoid ring contains four types of tonsils in a fixed position. As part of MALT, the tonsils serve as a protection ring including nasopharynx-associated lymphoid tissue (NALT), which is known as Waldeyer’s tonsillar ring, around the entrance of the upper aerodigestive tract to start the initial immunological barrier to infections. Due to the penetration of benign or malign lesions of the tonsil into the lateral wall of the pharynx, transoral robotic approach to this region is necessary to identify the surgical anatomic landmarks which are required to perform safe and effective surgical intervention.Īs part of secondary lymphoid organs, mucosa-associated lymphoid tissue (MALT) is an aggregate of unencapsulated lymphoid tissue that is located diffusely in the mucosa of the aerodigestive tract and consists of the tonsils, vermiform appendix, and Peyer’s patch. ![]() Recent medical studies reported that a detailed understanding of the anatomic risk factors in upper airway obstruction allows to predict treatment response to surgical intervention. Knowledge of the surgical anatomy of the tonsils and variations of the neurovascular and muscular structures around it allows optimal choice of surgical technique to avoid iatrogenic complications during tonsillectomy. Because of the tonsil enlargement during childhood, upper airway obstruction and obstructive sleep apnea syndrome are mostly seen. Particularly, the palatine tonsils are the largest of the tonsils with deep branching crypts and contain B and T lymphocytes and M cell which plays a role in the uptake and transport of antigens. Waldeyer’s ring is composed of the pharyngeal, tubal, palatine, and lingual tonsils acting as secondary lymphoid tissues. Hyoepiglottic ligament - connects the hyoid bone to the anterior aspect of the epiglottis.The tonsils represent a circular band of mucosa associated with lymphoid tissues, Waldeyer’s ring, which is located at the entrance of the upper aerodigestive tract, with a significant role in the immune defense system.Thyrohyoid membrane - originates from the superior border of the thyroid cartilage and attaches to the posterior surface of the hyoid bone and the greater horns.Stylohyoid ligament - extends from the styloid process of the temporal bone to the lesser horn of the hyoid bone.They act to support the position of the hyoid in the neck. There are three main ligaments that attach to the hyoid bone - stylohyoid, thyrohyoid and hyoepiglottic. Indeed, it acts as a site of attachment for many muscles in the neck: Oral Cavity and Pharynx The hyoid bone is unique in the fact that it does not articulate with any other bones, and is suspended in place by the muscles and ligaments that attach to it. Fig 2 - The major parts of the hyoid bone - body, greater horn and lesser horn. ![]()
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