A clinical and pathohistological study of the plica triangularis
1960 Volume 6 Issue Supplement3 Pages 183-199
Details
1960 Volume 6 Issue Supplement3 Pages 183-199
In order to know, whether it is advisable or not to resect a plica triangularis in case of tonsillectomy, I have made a clinical and pathohistological study using 12 pieces of specimen taken from patients ranging from 9 to 56 years old.
1) The lymph follicles in the plica triangularis (hereafter P. t. for short), which are in most cases the size of a grain of rice or half and 3 or 4 in number, lie scattered or congregated and a big follicle possesses a fovella approximately in its center.
2) The lymphatic tissue of P. t. is indeed in construction similar to the palatine or lingual tonsil, but what distinguishes it from the palatine tonsil is the way of congregation of the follicles as well as the fact that it is not covered with a capsule, while it is different from the lingual tonsil in that there are fewer mucilage glands just under the follicle.
3) In comparison with the P. t. of a senior, that of a junior is larger in breadth and so is the follicle both in number and size. Therefore, the follicle in the P. t. of a junior is larger and as one grows older it seems to be more and more reduced in size.
4) The pathological changes of the P. t. are the same as those of the palatine tonsil, but they are in general very slight as compared with the latter.
5) Against a narrow P. t. the follicle in a broad one is larger both in number and size. The broad one can be seen in the female more often than in the male, in the junior than in the senior, in a person without a focal infection than in one with it and in the shallow fossa tonsillaris superior than in the deep one. The pathological changes are in high degree in the broad P. t.
6) Between the resected side of the P. t. and the non-resected regarding the afterbleeding and pain after tonsillectomy and the healing state of wound due to operation there were not particular differences observed.
7) If the P. t., especially the well-developed one, be left unresected at the time of tonsillectomy, it may sometimes enlarge itself in a compensatory way afterward, and cause an inflammation or even an abscess. The well-developed P. t. should be therefore, as completely as possible resected.
