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May 19, 1928


Author Affiliations

NEW YORK; Professor of Anatomy, Western Reserve University School of Medicine CLEVELAND

JAMA. 1928;90(20):1610-1614. doi:10.1001/jama.1928.02690470016006

In the modern operation of enucleation of the tonsil, the surgeon finds it easy to strip the upper lobe from its bed, but he encounters an obscure mass of muscular tissue attached to the submerged surface of the tonsil at the junction (below its middle) of the upper and lower lobes.

At this stage he imagines, as a rule, that he has encountered the superior constrictor, which is commonly assumed to be an immediate relation. He ceases dissection and arranges the snare around the lower part of the tonsil, trusting to the automatic action of the wire to complete the operation. The result is imperfect enucleation, for the caprice of the snare may leave muscle attached to the tonsil or it may cut through the lower lobe, leaving a portion in situ.

We propose to show that the superior constrictor is not an immediate relation; that it has no direct

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