A patient has extremely enlarged palatine tonsils. You suggest surgical removal of the tonsils, but you do explain that there is a small risk of the surgery, which may result in which of the following?
Correct Answer: Loss in the ability to taste in the posterior one-third of the tongue and perhaps some difficulty in swallowing
Description: The palatine tonsil sits in the lateral wall of the oropharynx in the palatine arch posterior to the palatoglossus muscle and anterior to the palatopharyngeus muscle. In the bed of the palatine tonsil runs the glossopharyngeal CN (IX) that carries afferent information back to the brain regarding both general sensation and the special sense of taste from the posterior one-third of the tongue. The glossopharyngeal nerve is at risk for being cut during tonsillectomy. The ability to taste in the anterior two-thirds of the tongue is not at risk because that information is carried by the lingual nerve, below the tongue. The ability to protrude your tongue is provided by innervation from the hypoglossal nerve, which innervates all the intrinsic tongue muscles and lies below the tongue and is not a risk. Neither the ability to open your jaw wide nor to move your jaw from side to side is controlled by the mandibular division of the trigeminal CN (V), which does not course near the palatine arch and would not be at risk.
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