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Pharyngeal (adenoid) tonsils
Medical expert of the article
Last reviewed: 04.07.2025
The pharyngeal (adenoid) tonsil (tonsilla pharyngeals, s.adenoidea) is unpaired, located in the area of the vault and partly the back wall of the pharynx, between the right and left pharyngeal pockets (Rosenmüller's fossae). In this place there are 4-6 transversely and obliquely oriented thick folds of the mucous membrane. Inside these folds is the lymphoid tissue of the pharyngeal tonsil. Sometimes these folds are very pronounced, so that they hang from the vault of the pharynx behind the choanae and touch the posterior edge of the nasal septum, closing the communication of the nasal cavity with the pharynx. Along the midline of the vault of the pharynx, the folds are low and less thick. Here there is a more or less clearly expressed longitudinal groove. On the surface of the folds in children, numerous small tubercles are visible, in the depths of which there are accumulations of lymphoid tissue - lymphoid nodules. Between the folds there are furrows of varying depths, open downwards, into the lumens of which the ducts of the mucous glands located in the thickness of the folds open. The free surface of the folds is covered with ciliated (multinuclear ciliated) epithelium. Under the epithelial cover in the diffuse lymphoid tissue are lymphoid nodules of the pharyngeal tonsil up to 0.8 mm in diameter, most of which have centers of reproduction. The connective tissue stroma of the tonsil is fused with the pharyngeal-basilar fascia of the pharynx.
The tonsil reaches its largest size at 8-20 years: its length during this period is 13-21 mm, and its width is 10-15 mm.
[ Development and age-related features of the pharyngeal tonsil
The pharyngeal tonsil is formed in the 3rd-4th month of intrauterine life in the thickness of the forming mucous membrane of the nasal part of the pharynx. In a newborn, the tonsil is already well defined - its size is 5-6 mm. Later, the tonsil grows quite quickly. By the end of the year, its length reaches 6-10 mm. Lymphoid nodules in the tonsil appear in the 1st year of life. After 30 years, the size of the pharyngeal tonsil gradually decreases.
Vessels and nerves of the pharyngeal tonsil
The pharyngeal tonsil is supplied with blood by vessels from the branches of the ascending pharyngeal artery. Venous blood flows into the veins of the pharyngeal plexus. The tonsil receives nerve fibers from the branches of the facial, glossopharyngeal, vagus nerves and sympathetic fibers from the periarterial plexuses.
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