9. Lympharic Drainage
• Lateral retropharyngeal lymphnodes a/k/a Nodes
of Rouviere,are the first nodes in the lymphatic
drainage of nasopharnx.
• Upper deep cervical nodes through
retropharyngeal & parapharyngeal LN.
• Spinal accessory chain of nodes in the post.
• Ipsilateral or contralateral.
10. Sinus of morgagni
•Lies b/w the base of the skull and
upper free border of superior
constrictor.
Following structures pass through this
space.
• Eustachian tube
• Levator veli palatini muscle
• Ascending palatine artery
11. Passavant’s Ridge
▪ Mucosoal ridge.
▪ Encircles the post. & ant.
Wall of nasopharyngeal
isthmus.
▪ Raised by
palatopharyngeus muscle.
When soft palate contracts
during deglutition or speech,
it makes firm contact with
passavant’s ridge and cuts
off nasopharynx from
oropharynx.
12. Nasopharyngeal Tonsil
Sub-epithelial collection of
lymphoid tissue
At the junction of roof and
poaterior wall of nasopharynx.
Increases in size upto the age of
6 years and then gradually
atrophies
Tubal tonsil
Collection of sub-epithelial lymphoid tissue
situated at the tubal elevation.
Forms a part of the waldeyer’s ring.
When enlarged due to infection,it causes
eustachian tube occlusion.
13. Nasopharyngeal Bursa
Epithelial lined median recess found within the adenoid mass.
Extends from pharyngeal mucosa to the periosteum of the basiocciput.
Represemts the attatchment of notochord to the pharyngeal endoderm during embryonic life.
When infected, it may be the cause of persistent post nasal discharge or crusting.
Sometimes an abscess can form in the bursa- Thornwaldt’s disease.
Rathke’s Pouch
Represented clinically by a dimple
above the adenoids.
Because the nasopharynx is a hard place to operate on and because other types of treatment are often effective, surgery is seldom the main treatment for patients with nasopharyngeal cancer.
When surgery is used, it is most often to remove lymphnodes in the neck that haven’t responded to other treatments.