Case

A 7-year-old was referred to an ear-nose-throat (ENT) specialist after having recurrent episodes of tonsillitis every year since the age of 3. The parents are concerned as this is the fifth bout of palatine tonsillitis the child has had in the last year and are asking what they should do.  

Question 2/3 - What landmarks will you use to identify the region of the palatine tonsils for the tonsillectomy?

Click on your selected option(s) below  (correct = 1, over-thinking = 2+)

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Incorrect. The stylopharyngeus muscle runs from the styloid process into the pharynx, this is more inferior than the oral region and would not be a useful landmark.  

Correct! This muscle forms a distinct arch at the more posterior point in the oral cavity running from the palate to the pharynx. The palatine tonsil on the lateral wall of the oral cavity are just anterior to the palatopharyngeal fold.

Incorrect. The styloglossus muscle runs from the styloid process into the tongue from the lateral sides. This is relatively deep so it would not make a discernable superficial landmark and is too lateral.

Correct! The palatoglosus muscle makes a distinct arch running from the palate to the tongue (glossus). The palatine tonsils on the lateral walls of the oral cavity are just posterior to this arch.

Incorrect. The genioglosus muscle arises from the inside of the mandible near the chin and fans out into the tongue forming the bulk of the tongue musculature. This location is too anterior to the tonsils to be useful as a landmark.