External Carotid Artery Branches — MFDS Part 1 MCQ

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HardAnatomy (Head & Neck)External Carotid Artery BranchesMFDS Part 1

During extracapsular palatine tonsillectomy, a vessel entering the tonsillar bed after piercing the superior pharyngeal constrictor is divided, producing brisk arterial bleeding. From which branch of the external carotid artery does this tonsillar vessel usually arise?

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Correct answer: D — Facial artery

The correct answer is D, the facial artery. Its tonsillar branch passes towards the tonsillar bed and pierces the superior pharyngeal constrictor, making it vulnerable during extracapsular dissection. The facial artery also commonly gives rise to the ascending palatine artery, but these are distinct vessels; the original explanation incorrectly treated them as synonyms. The ascending pharyngeal artery supplies the pharyngeal wall and contributes smaller tonsillar branches but is not the usual parent of the vessel described. The lingual artery contributes through dorsal lingual branches, while the maxillary artery contributes through lesser palatine branches. The superior thyroid artery does not provide a significant arterial supply to the palatine tonsil.

Reference: Cicek C et al. Endoscopy-assisted high cervical anterolateral retropharyngeal approach to clivus: a cadaveric study, Figure 2C, 2024. https://pubmed.ncbi.nlm.nih.gov/31019605/