Pterygopalatine Fossa and Palate - LO 5

5. Where are the palatine tonsils located? What are the important anatomical associations to consider during tonsillectomies?

The palatine tonsils are sometimes referred to as “the” tonsils, and are located in the lateral wall of the oropharynx. They are located in tonsillar fossae, between the palatoglossal and palatopharyngeal arches. The tonsillar fossa (bed) is formed by the pharyngobasilar fascia and the superior pharyngeal constrictor.

There are numerous neurovascular relationships that must be considered for surgeries in this area, such as tonsillectomies.

- Tonsillar a. (branch of facial a.): closely associated with palatoglossal arch
- External palatine v.: closely associated with superior portion of tonsillar fossa
- Glossopharyngeal n. (CN IX): closely associated with lateral portion of tonsillar fossa
- Internal carotid a.: variable; may be lateral to palatine tonsil

The palatine tonsils drain into superior deep cervical lymph nodes, particularly the jugulodigastric nodes, and have an extensive arterial supply derived from the external carotid a. branches (tonsillar a., dorsal lingual brs. of lingual a., and branches from ascending pharyngeal a.). The palatine (and pharyngeal) tonsils are commonly removed during tonsillectomies.

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