Pharyngeal Tonsil: Structure, Function & Diseases

The pharyngeal tonsil. in technical language also Tonsilla pharyngealis, belongs to the tonsils and thus to the lymphatic system of the body. It serves the immune defense, but can also lead to various diseases and ailments.

What is the pharyngeal tonsil?

The pharyngeal tonsil is a tonsil located behind the nose on the roof of the throat, which has the task of warding off pathogens that have entered through the nose. It is present in all mammals. In humans, like all tonsils, it is important for immune defense mainly during the first years of life.

Anatomy and structure

Like all tonsils, the pharyngeal tonsil is composed of lymphoid tissue, tissue in which lymphocytes are produced or proliferated. The lymphatic system is divided into primary and secondary lymphatic systems. The tonsils belong to the secondary lymphatic system, which is colonized by the lymphocytes formed in the organs of the primary system. These are multiplied there and made available to the immune defense. The pharyngeal tonsil is located at the back of the roof of the throat and, unlike the palatine tonsils, is not visible when the mouth is open. Ear, nose and throat physicians can examine the pharyngeal tonsil using special instruments. The surface of the tonsils is fissured. In addition to food residues, bacteria also collect in the indentations, which are fought by the lymphocytes present in the tonsils. Based on these bacteria, the lymphocytes “learn” how to defend themselves against various pathogens. Compared to the palatine tonsil, the depressions on the pharyngeal tonsil are less pronounced.

Function and tasks

In accordance with their affiliation with the body’s lymphatic system, the function of the pharyngeal tonsils is to support immune defense. Together with the palatine, lingual, and tubal tonsils, they form the lymphatic pharyngeal ring, whose task is to defend against pathogens that have entered through the mouth or nose. The tonsils are most important for the immune defense of children. After the age of 8 and especially during puberty, their activity decreases significantly, but remains to a lesser extent until the end of life. The pharyngeal tonsils primarily serve as a defense against pathogens that have entered through the nose. Because they are comparatively less furrowed, fewer bacteria can accumulate than in the palatine tonsil. However, because the lymphocytes need a large number of different bacteria to learn the immune defense, the importance of the pharyngeal tonsil for the organism is smaller than that of the strongly furrowed palatine tonsil. However, the less furrowed pharyngeal tonsil itself has a small advantage: because fewer pathogens can accumulate, it is less often the focus of inflammatory processes. The frequently occurring tonsillitis (inflammation of the tonsils) usually affects the palatine tonsils.

Diseases

The main disease is a severe enlargement of the pharyngeal tonsil. In common parlance, this is also called a “polyp”. This occurs primarily in children; in adults, the adenoid usually recedes to the point that it does not cause any symptoms. The term “polyp” should therefore not be confused with the polyps of the paranasal sinuses that occur in adults. In technical language, the enlargement of the pharyngeal tonsil is called “adenoid”. An enlargement of the adenoid usually progresses without direct pain and can therefore only be detected by observing the other symptoms. However, these only appear in the case of a severely enlarged pharyngeal tonsil. Slight enlargements are normal due to the frequent defense against infections and often regress on their own. They also serve to strengthen the immune system through the learning processes of the lymphocytes. Problems usually occur between the ages of 2 and 6. An enlarged adenoid makes it difficult for the child to breathe through the nose. This in turn leads to more germs entering the throat due to increased mouth breathing. This leads to frequent flu-like infections, which in turn leads to a lot of activity of the tonsil and its swelling. Tooth and jaw misalignments can also result from increased mouth breathing. Similarly, nighttime snoring in children may indicate an enlarged pharyngeal tonsil that is obstructing nasal breathing. Another consequence of an enlarged pharyngeal tonsil is the closure of the opening to the middle ear. This makes hearing more difficult. Especially in young children, this can lead to impaired speech development.But problems caused by poor hearing are also preprogrammed in older children, especially school-age children. The child seems inattentive and has difficulty concentrating. This is exacerbated by impaired nighttime breathing. In addition to the hearing problems mentioned, an enlarged pharyngeal tonsil, which closes the opening to the middle ear, can also lead to frequent and long-lasting middle ear infections. If the symptoms described occur frequently or permanently in a child, an ear, nose and throat specialist should be consulted. If necessary, removal of the enlarged pharyngeal tonsil is necessary. Due to the rather subordinate role of this tonsil, this is also possible without major damage to the immune system. Exact causes for the severe enlargement of the pharyngeal tonsil are not yet known. However, observations show that certain factors influence the disease. In addition to genetic factors and frequent flu infections, malnutrition, especially diets too rich in carbohydrates, is often associated with this disease. In addition, it has been observed that removed adenoids can grow back on a high-carbohydrate diet and cause problems again. However, the disease usually resolves itself as the tonsils regress during puberty.

Typical and common diseases of the tonsils

  • Angina tonsillaris
  • Scarlet fever
  • Pfeiffer’s glandular fever
  • Diphtheria
  • Chronic tonsillitis