Periamigdalino

Periamigdalino refers to the peritonsillar space, a potential space surrounding the palatine tonsil in the oropharynx. It is part of the tonsillar bed and lies between the tonsil itself and the surrounding pharyngeal muscles and fascia. The space is bounded medially by the tonsillar capsule and the tonsillar bed, laterally by the superior constrictor muscle and the pharyngobasilar fascia, and is bordered anteriorly and posteriorly by the palatoglossal and palatopharyngeal arches, respectively. It communicates with adjacent deep neck spaces, notably the parapharyngeal space, and can be involved in the spread of infection.

Anatomy and contents within the periamigdalino space include the tonsillar tissue with its capsule, adipose tissue, and the neurovascular elements that supply the tonsil. The arterial supply in the region is primarily from the tonsillar artery, a branch of the facial artery, with contributions from the ascending palatine artery. Innervation is mainly via branches of the glossopharyngeal nerve (IX). The space is clinically important because its boundaries allow infections to spread to nearby deep neck spaces.

Clinical significance: infection localized to the periamigdalino space most commonly presents as a peritonsillar abscess (quinsy), characterized by severe unilateral throat pain, fever, muffled voice, trismus, and sometimes deviation of the uvula. Diagnosis is largely clinical, with imaging such as ultrasound or CT reserved for unclear cases or to assess extent. Management typically involves antibiotics and drainage of the abscess; recurrent or complicated cases may require tonsillectomy. Potential complications include spread to the parapharyngeal or retropharyngeal spaces and, rarely, airway compromise.