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Tonsil Cancer

Understanding the Anatomy

The tonsils are part of the oropharynx, which is the part of the throat located at the back of the mouth. The nasopharynx is located above while the hypopharynx is situated below.

4a throat overview

The tonsils are the ball-shaped structures at the back and on the sides of the throat. They can cause younger people problems such as infections and snoring. They are made up of lymphoid tissue (tissue that has infection-fighting cells). One of the most common surgeries in the U.S. is removal of tonsils when they get large in children and cause recurrent infection or a sleeping disorder known as obstructive sleep apnea. Interestingly, removing the tonsils does not seem to hinder the body’s ability to fight infections (you have many back-up systems to fight infections in the body). In general, each of the tonsils should be about the same size (though in some people they are slightly different in size).

02a_mouthsites

There is a ring of tonsil-like tissue that is located in the side walls and base of tongue portions of the oropharynx. The adenoid tissue, located on the roof of the nasopharynx, completes the superior portion of the tonsillar rings known as the Waldeyer’s ring.

Structures related to the tonsils include:

  • Anterior tonsil pillar: This is the fold of tissue just in front of the tonsil. It is also called the palatoglossus because it goes from the soft palate above down to the tongue.
  • Posterior tonsil pillar: This is the fold of tissue just behind the tonsil. It is also called the palatopharyngeus because it goes from the soft palate above to the pharynx wall on the back.
  • Glossotonsillar sulcus: This is the bottom part of the palatine tonsil where it blends into the lingual tonsil tissue. It is basically an area between the tonsil and the base of tongue.

 

 

References

1 Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tân PF, Westra WH, Chung CH, Jordan RC, Lu C, Kim H, Axelrod R, Silverman CC, Redmond KP, Gillison ML. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 2010 Jul 1;363(1):24-35. doi: 10.1056/NEJMoa0912217. Epub 2010 Jun 7.

2 Blot WJ, McLaughlin JK, Winn DM, et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer research. Jun 1 1988;48(11):3282-3287.

3 D'Souza G, Kreimer AR, Viscidi R, et al. Case-control study of human papillomavirus and oropharyngeal cancer. The New England journal of medicine. May 10 2007;356(19):1944-1956.

4 Moreno-Lopez LA, Esparza-Gomez GC, Gonzalez-Navarro A, Cerero-Lapiedra R, Gonzalez-Hernandez MJ, Dominguez-Rojas V. Risk of oral cancer associated with tobacco smoking, alcohol consumption and oral hygiene: a case-control study in Madrid, Spain. Oral oncology. Mar 2000;36(2):170-174.

5 Koivunen P, Rantala N, Hyrynkangas K, Jokinen K, Alho OP. The impact of patient and professional diagnostic delays on survival in pharyngeal cancer. Cancer. Dec 1 2001;92(11):2885-2891.

6 Roistacher SL, Tanenbaum D. Myofascial pain associated with oropharyngeal cancer. Oral surgery, oral medicine, and oral pathology. May 1986;61(5):459-462.

7 Rogers SN, Vedpathak SV, Lowe D. Reasons for delayed presentation in oral and oropharyngeal cancer: the patients perspective. The British journal of oral & maxillofacial surgery. Jul 2011;49(5):349-353.

8 Spiro RH, Thaler HT, Hicks WF, Kher UA, Huvos AH, Strong EW. The importance of clinical staging of minor salivary gland carcinoma. Am J Surg. 1991 Oct;162(4):330-6.

9 Krause CJ, Carey TE, Ott RW, Hurbis C, McClatchey KD, Regezi JA. Human squamous cell carcinoma. Establishment and characterization of new permanent cell lines. Arch Otolaryngol. Nov 1981;107(11):703-710.

10 Licitra L, Perrone F, Bossi P, et al. High-risk human papillomavirus affects prognosis in patients with surgically treated oropharyngeal squamous cell carcinoma. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. Dec 20 2006;24(36):5630-5636.

11 Eveson JW, Cawson RA. Tumours of the minor (oropharyngeal) salivary glands: a demographic study of 336 cases. Journal of oral pathology. Jul 1985;14(6):500-509.

12 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 7, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

13 Jan JC, Hsu WH, Liu SA, Wong YK, Poon CK, Jiang RS, Jan JS, Chen IF. Prognostic factors in patients with buccal squamous cell carcinoma: 10-year experience. J Oral Maxillofac Surg. 2011 Feb;69(2):396-404.

14 Sinha P, Lewis JS Jr, Piccirillo JF, Kallogjeri D, Haughey BH. Extracapsular spread and adjuvant therapy in human papillomavirus-related, p16-positive oropharyngeal carcinoma. Cancer. 2012 Jul 15;118(14):3519-30.

15 Pradhan SA, Rajpal RM. Marginal mandibulectomy in the mangement of squamous cancer of the oral cavity. Indian J Cancer. 1987;24;167-171.

16 Maddox WA, Urist MM. Histopathological prognostic factors of certain primary oral cavity cancers. 1990 Dec;4(12):39-42; discussion 42, 45-6.

17 Piccirillo JF, Costas I, Reichman ME. Chapter 2: Cancers of the Head and Neck. Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.