What is the anatomy of the tonsils relevant to peritonsillar abscess (PTA)?

Updated: May 09, 2018
  • Author: Jeffrey D Suh, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

The tonsils begin developing early in the third month of fetal life. They arise from the endoderm lining, the second pharyngeal pouch, and the mesoderm of the second pharyngeal membrane and adjacent regions of the first and second arches. The epithelium of the second pouch proliferates to form solid endodermal buds, growing into the underlying mesoderm; these buds give rise to tonsillar stroma. Central cells of the buds later die and slough, converting the solid buds into hollow tonsillar crypts, which are infiltrated by lymphoid tissue.

Both right and left tonsils form part of the circumpharyngeal lymphoid ring. The size of the tonsil varies according to the age, individuality, and pathologic status. At the fifth or sixth year of life, the tonsils rapidly increase in size, reaching their maximum size at puberty. At puberty, the tonsils measure 20-25 mm in vertical and 10-15 mm in transverse diameters.

For more information about the relevant anatomy, see Tonsil and Adenoid Anatomy.


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