Lymphovascular Drainage

Lymph vessels from the nasopharynx, oropharynx, hypopharynx and the tonsils drain to Level II nodes in the upper deep cervical chain either directly or via the retropharyngeal groups (Figure 19.1). Bilateral drainage is common with nasopharyngeal, hypopharyngeal and laryngeal lesions.

Vallecula

Oropharyngeal limit

Aryepiglottic fold

Elevation of mucosa by apex of left arytenoid cartilage

Base of pyriform fossa

Left false cord

Ventricle Left vocal cord

Vallecula

Hyoid bone

Thyrohyoid membrane

Superior cornu of thyroid cartilage

^^^Pyriform fossa

Cut portion of cricoid lamina Inferior cornu of thyroid cartilage Tracheal rings

Hyoid bone

Thyrohyoid membrane

Superior cornu of thyroid cartilage

^^^Pyriform fossa

Cut portion of cricoid lamina Inferior cornu of thyroid cartilage Tracheal rings a

Anterior

Anterior commissure

Paraglottic space

Glottis

Paraglottic space

Glottis

Lamina of thyroid cartilage

Arytenoid cartilage

Hypopharyngeal mucosa

Pyriform fossa

Lamina of thyroid cartilage

Arytenoid cartilage

Hypopharyngeal mucosa

Pyriform fossa

Posterior b

Figure 153. Laryngectomy specimen. (a) Idealised view of laryngectomy specimen opened from posterior. (b) Coronal section through larynx at level of vocal cords.

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