Oropharynx

The oropharynx lies behind the oral cavity. It is bounded superiorly by the soft palate and inferiorly by a hypothetical

Fig. 4.3 Incidence and mortality rates for tumours of the oral cavity and pharynx (excl. nasopharynx), all ages, in males. Age-standardized rates (ASR, world standard population) per 100,000 population and year. From J. Ferlay et al., Globocan 2000 {730}.

horizontal line level with the tip of the epiglottis. Anteriorly are the isthmus of the fauces and the posterior third of the tongue, and the lateral wall is formed by the palatopharyngeal arches and the palatine tonsils. The posterior wall contains the pharyngeal tonsils. The palatine tonsils are two masses of lymphoid tissue situated in the triangular recess (tonsillar sulcus) between the anterior and posterior faucial pillars. They extend from the soft palate to the dorsum of the tongue. The surface is convoluted and deep clefts or crypts can penetrate almost its full thickness. The bulk of the tonsil consists of lymphoid tissue arranged in nodules or follicles. There are no afferent lymphatics and no subcapsular sinuses. Squamous cell carcinomas at this site can invade deeply into the underlying tissues, base of tongue and lateral pharyngeal wall. They also have a particular tendency to extend upwards into the nasopharynx. The soft palate is a mobile, muscular flap attached to the posterior edge of the hard palate and extending to a free margin posteriorly. The uvula forms a small, conical, midline process. The oral surface of the soft palate is covered by non-keratinized stratified squamous epithelium and contains many minor mucous glands. The uvula contains mainly fat and a few muscle fibres but minor salivary glands may also be seen and occasionally salivary gland tumours develop at this site.

The pharyngeal part of the tongue is immobile and has a bossellated surface due to the presence of underlying lym-phoid tissue forming the lingual tonsils. Minor salivary glands are also present.

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