Tonsil
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- For the structure in the cerebellum, see cerebellar tonsil.
The term tonsils most commonly means the palatine tonsils, which can be seen in the back of the human throat. The palatine tonsils and the nasopharyngeal tonsil are lymphoepithelial tissues located near the oropharynx and nasopharynx. These immunocompetent tissues are the immune system's first line of defense against ingested or inhaled foreign pathogens. However, the fundamental immunological roles of tonsils have yet to be understood.[1][2]
Tonsillitis is a disorder in which the tonsils are inflamed (sore and swollen). The most common way to treat it is with anti-inflammatory drugs such as ibuprofen, or if bacterial in origin, antibiotics. Many sufferers treat it by having their tonsils surgically removed by a tonsillectomy.[3][4]
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[edit] Types
Tonsils in humans include, from anterior (front), superior (top), posterior (back), and inferior (bottom):
| Type | Epithelium | Capsule | Crypts | Location |
|---|---|---|---|---|
| Adenoids (also termed "pharyngeal tonsils") | Ciliated pseudostratified columnar (respiratory epithelium) | Incompletely encapsulated | No | Roof of pharynx |
| Tubal tonsils | Ciliated pseudostratified columnar (respiratory epithelium) | Roof of pharynx | ||
| Palatine tonsils | Non-keratinized stratified squamous | Incompletely encapsulated | Long, branched[5] | Sides of oropharynx between palatoglossal and palatopharyngeal arches |
| Lingual tonsils | Non-keratinized stratified squamous | Incompletely encapsulated | Long, unbranched[5] | Behind terminal sulcus (tongue) |
Together this set of lymphatic tissue is known as Waldeyer's tonsillar ring. tonsils can be removed and grow back.
[edit] Growth
Tonsils tend to reach their largest size near puberty, and they gradually undergo atrophy thereafter. However, they are largest relative to the diameter of the throat in young children.
Tonsils can become enlarged (adenotonsillar hyperplasia) or inflamed (tonsillitis) and may be surgically removed in tonsillectomy. This may be indicated if they obstruct the airway or interfere with swallowing, or in patients with frequent recurrent tonsillitis. In older patients, asymmetric tonsils (also known as asymmetric tonsil hypertrophy) may be an indicator of virally infected tonsils, or tumors such as lymphoma or squamous cell carcinoma.
Tonsil enlargement can affect speech, making it hypernasal and giving it the sound of velopharyngeal incompetence.[6] Tonsil size may have a more significant impact on upper airway obstruction for obese children than for those of average weight. [7]
The largest tonsils ever recorded being removed were from a 21 year old man, Justin Werner from Kansas. One of his tonsils measured 2.1 inches (5.3 cm) long, 1.1 inches (2.8 cm) wide, and 0.7 inch (1.8 cm) thick, while the other measured 1.9 inches (4.8 cm) long, 1 inch (2.5 cm) wide, and 0.7 inch (1.8 cm) thick.[8]
[edit] Tonsilloliths
A tonsillolith is material that accumulates on the tonsil. They can range up to the size of a peppercorn and are white/cream in color. The main substance is mostly collagen, but they have a strong unpleasant odor because of hydrogen sulfide and methyl mercaptan and other substances.
[edit] References
- ^ Journal of the Wakayama Medical Society - [Study on functions of tonsils in mucosal immune system of the upper respiratory tract using a novel animal model, Suncus murinus.] - VOL.52;NO.4;PAGE.361-367(2001)
- ^ 'Tonsils and adenoids are immune system glands...' [Harvard Medical School Family Health Guide - Page: 1006 ] - 1995
- ^ Udayan K Shah, MD, Associate Professor of Otolaryngology-Head and Neck Surgery, Jefferson Medical College, Thomas Jefferson University; Director, Fellow and Resident Education in Pediatric Otolaryngology, Attending Surgeon, Division of Otolaryngology, Nemours-AI duPont Hospital for Children
- ^ Tonsils and Adenoids
- ^ a b Lymphatic system at downstate.edu
- ^ Mora R, Jankowska B, Mora F, Crippa B, Dellepiane M, Salami A. (2009). Effects of tonsillectomy on speech and voice. J Voice. 23(5):614-8. doi:10.1016/j.jvoice.2008.01.008 PMID 18468843
- ^ Wang, JH; Chung, YS, Cho, YW, Kim, DY, Yi, JS, Bae, JS, Shim, MJ (2010 Apr). "Palatine tonsil size in obese, overweight, and normal-weight children with sleep-disordered breathing". Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 142 (4): 516–9. doi:10.1016/j.otohns.2010.01.013. PMID 20304270.
- ^ Man's Freakishly Giant Tonsils Break World Record, FOX News, 20 July 2011.
[edit] External links
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