What is the Pharyngeal Tonsil?

Pharyngeal Tonsil: Structure, Function & Role in Immune Defence

The pharyngeal tonsils are a vital part of our immune system. It stands over the nasal passages like a guardian for diligently protecting the body from infections that threaten your health. It keeps our immune system strong, which helps to respond against pathogens.

What is the pharyngeal tonsil?

The pharyngeal tonsil is a cluster of lymphoid tissue located in the midline and top of the nasopharynx. This location lies at the level of the occipital bones and the sphenoid. An enlarged version of this pharyngeal tonsil is called the adenoid hypertrophy. The table below highlights key facts about pharyngeal tonsils:

How Do the Pharyngeal Tonsils Work?

A primary function of the pharyngeal tonsil is to fight infections. Here is the list of basic functions:

• It contains white blood cells that possibly travel through the adenoids and target and trap the germs.
• The pharyngeal tonsil receives its sensory nerve supply primarily from the maxillary division of the trigeminal nerve (CN V2) via the pharyngeal branch of the pterygopalatine ganglion, in addition to contributions from the glossopharyngeal (CN IX) and vagus (CN X) nerves via the pharyngeal plexus..
• It produces proteins in the blood to fight unrecognisable invaders in the body.
• It receives its arterial supply primarily from branches of the ascending pharyngeal artery and the facial artery (via the ascending palatine branch). Lesser contributions may come from the maxillary artery and the dorsal lingual arteries.

Can You See the Pharyngeal Tonsils?

No, the pharyngeal tonsil (adenoid) is not visible through the mouth with a mirror. It is located high in the throat, behind the nose and above the soft palate. The tonsils visible when you open your mouth wide are the palatine tonsils. The adenoid can only be visualized using specialized medical equipment. Hence, you can see pharyngeal tonsils through medical examinations and equipment, and these are:

• Nasal Endoscopy: During this test, a rigid or flexible tube with a light and a camera is inserted into the nose to visualise the pharyngeal tonsil and the nasal cavity.
• Imaging Examination: This clinical examination may involve X-rays, MRI or CT scans to visualise the sinuses and condition of the pharyngeal tonsils and nasal passages.

Seeing the pharyngeal tonsils may help you or your healthcare professional diagnose tonsillitis infection or adenoid hypertrophy.

What are the conditions that affect the pharyngeal tonsil?

These tonsils can enlarge and become inflamed when your body tries to fight certain infections. Further, common conditions that affect pharyngeal tonsils are:

• Upper respiratory infections affect the sinuses, nose and throat.
• Ear infections cause congestion or swelling of the nasal passages.
• Tonsil stones are small yellow or white lumps in the tonsils that cause pain and bad breath.
• Mononucleosis, a viral infection, causes sore throat and swollen pharyngeal tonsils.
• Peritonsillar abscess, an infection that affects the pharyngeal tonsils and causes breathing difficulties

What are the clinical signs of an affected pharyngeal tonsil?

You may experience breathing difficulties and nasal congestion as primary symptoms of infections. Apart from these, you may face:

• Sore throat
• Mouth breathing
• Sense blockage or pressure in your ears
• Snoring
• Bad breath
• Headache
• Loss of appetite
• Sleeping trouble
• Increased neck swelling
• A whistling noise in the throat while breathing
• Drinking and eating difficulties
• Difficulty in swallowing saliva

Enlargement of these tonsils often occurs in children and causes an atypical facial appearance. This includes signs, including an elongated face, hypoplastic maxilla, elevated nostrils, prominent incisors and a short upper lip.

How to Treat Pharyngeal Tonsils?

Doctors focus on determining and treating such underlying conditions. Common recommended treatment options may involve:

• Nasal corticosteroid spray or antihistamine drugs to treat enlarged pharyngeal tonsils due to allergies.
• Doctors may suggest antibiotics, such as amoxicillin and penicillin, to treat inflamed adenoids from bacterial infection.
• Naproxen, acetaminophen, or ibuprofen medications reduce symptoms of infectious conditions, fever, and pain.
• Adenoidectomy is a surgical option to remove the pharyngeal tonsil with a medical instrument or cautery.

The pharyngeal tonsils are a mass of lymphoid tissues located at the roof of the nasopharynx within the mucosa. It receives antigens that enter from the external environment through ingestion and inhalation.

Upper respiratory infection, ear infections, tonsil stones, peritonsillar abscess, and mononucleosis are common health conditions that can affect the tonsil. Nasal endoscopy and X-rays, MRI or CT scans help to visualise pharyngeal tonsils and measure the progression of infections.