Tuesday, December 28, 2010

Killian's Dehiscence, Waldeyer's Ring And Pharyngeal Spaces

Killian's Dehiscence

Inferior constrictor muscle has two parts; thyropharyngeus
with oblique fibres and cricopharyngeus with transverse
fibres. Between these two parts exists a potential
gap called Killian's dehiscence. It is also called the "gateway
of tears" as perforation can occur at this site during
oesophagoscopy. This is also the site for herniation of
pharyngeal mucosa in cases of pharyngeal pouch.

Waldeyer's Ring:

Scattered throughout the pharynx in its subepithelial
layer is the lymphoid tissue which is aggregated at places
to form masses, collectively called Waldeyer's ring. The
masses are:
l. Nasopharyngeal tonsil or the adenoids
2. Palatine tonsils or simply the tonsils
3. Lingual tonsil
4. Tubal tonsils (in fossa of Rosenmuller)
5. Lateral pharyngeal bands
6. Nodules (in posterior pharyngeal wall).

Pharyngeal Spaces

There are two potential spaces in relation to the pharynx
where abscesses can form.
1. Retropharyngeal space, situated behind the pharynx
and extending from the base of skull to the bifurcation
of trachea (see page 246).
2. Parapharyngeal space, situated on the side of pharynx.
It contains carotid vessels, jugular vein, last
four cranial nerves and cervical sympathetic chain

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