The pharyngeal recess (fossa of Rosenmuller) is the bilateral lateral recess of the nasopharynx, posterior and lateral to the opening of the Eustachian tube. It is a slit-like space bounded anteriorly by the torus tubarius and posteriorly by the lateral nasopharyngeal wall. The fossa is lined by the nasopharyngeal mucosa and submucosa with extensive lymphoid tissue.
| Location | Side wall of the nasopharynx, behind the opening of the auditory tube |
|---|---|
| Parts |
|
| Nerve Supply | Pharyngeal branch of the maxillary nerve, V2 (sensory) |
| Blood Supply | Ascending pharyngeal artery; Pharyngeal branch of the maxillary artery |
| Lymphatic drainage |
|
A slit-like recess of the upper pharynx next to the auditory tube opening. It is the most common starting point of nasopharyngeal carcinoma.
The pharyngeal recess is the primary site of origin of nasopharyngeal carcinoma (NPC), the most common malignancy in Southeast Asian populations. Early tumours in the fossa of Rosenmuller may be asymptomatic or produce only unilateral Eustachian tube dysfunction (glue ear). Diagnosis requires nasopharyngoscopy with biopsy of the recess under topical anaesthesia. Lateral skull base invasion from the recess into the carotid space and skull base foramina produces cranial nerve palsies. Radiation therapy targets both recesses.
Nasopharyngeal carcinoma originating in the fossa of Rosenmuller presents as an asymptomatic recess mass producing unilateral serous otitis media from Eustachian tube obstruction or as cervical lymphadenopathy at the posterior triangle; nasopharyngoscopy confirms the primary and biopsy provides histological diagnosis for definitive chemoradiation therapy.
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