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Tonsillar Artery

arteria tonsillaris

The tonsillar artery arises from the facial artery and penetrates the superior pharyngeal constrictor to supply the palatine tonsil from its inferior pole. The tonsil receives additional supply from the dorsal lingual artery (inferior), the ascending palatine artery (superior), the ascending pharyngeal artery (posterior), and the lesser palatine artery (superior), creating a rich anastomotic blood supply that explains the profuse haemorrhage potential of tonsillar surgery.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The tonsillar artery is the dominant blood supply to the inferior tonsil and is ligated or cauterised during tonsillectomy at the inferior pole. Post-tonsillectomy haemorrhage (PTH) in the first 24 hours (primary) results from tonsillar artery or branch slippage; secondary PTH at 5-10 days results from eschar separation over the tonsillar fossa vessels. Primary PTH requires immediate return to theatre for haemostasis. The superior tonsil blood supply from the ascending palatine artery must also be controlled at the upper pole.

Pathology

Common Injuries & Conditions

Primary Post-Tonsillectomy Haemorrhage from Tonsillar Artery

Primary post-tonsillectomy haemorrhage within 24 hours from tonsillar artery slippage produces active bleeding into the oropharynx requiring emergency return to theatre for direct vessel coagulation or ligation under general anaesthesia; the risk is higher with dissection techniques than with electrocautery but all techniques carry a 1-4% primary PTH rate.