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THE FORM of the nasopharyngeal space has a wide range of individual variation. The sagittal diameter in the infant may be nearly as long as in the adult. The vault may be extremely round or it may point upward sufficiently to form the contour of a Gothic arch. Most adenotomes are made to fit the normally shaped nasopharynx. Some operative failures may be accounted for on the basis of these morphologic deviations. A promontory formed by the atlas, visible and palpable at the level of the palate, is sometimes associated with a tubercle which may interfere with the blade and cause complication. Also, tortuosity of the internal carotid artery occasionally occurs in this area and should be routinely looked for.
These factors, though infrequently met, nonetheless exist as possibilities and must be borne in mind. They provide sufficient reason for thorough survey of the operative field in any case in
NEIVERT H, KALLEN LA. COMBINED PALATE RETRACTOR AND TONGUE PROTRACTOR. AMA Arch Otolaryngol. 1951;53(6):675–676. doi:10.1001/archotol.1951.03750060070012
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