title: The surgical plane for lingual tonsillectomy: an anatomic study.
abstract: BACKGROUND
  The presence of a plane between the lingual tonsils and the underlying soft tissue has not been confirmed. The objective of this study is to ascertain the presence and the characteristics about this plane for surgical use.
  
  
  METHODS
  Five cadaver heads were obtained for dissection of the lingual tonsils. Six permanent sections of previous tongue base biopsies were reviewed. Robot assisted lingual tonsillectomy was performed using the dissection technique from the cadaver dissection.
  
  
  RESULTS
  In each of the 5 cadavers, an avascular plane was revealed deep to the lingual tonsils. Microscopic review of the tongue base biopsies revealed a clear demarcation between the lingual tonsils and the underlying minor salivary glands and muscle tissue. This area was relatively avascular. Using the technique described above, a lingual tonsillectomy using TORS was performed with similar findings from the cadaver dissections.
  
  
  CONCLUSIONS
  A surgical plane for lingual tonsillectomy exists and may prove to have a role with lingual tonsillectomy with TORS.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA. eson85@gmail.com.
authors.forename: Eugene L
authors.initials: EL
authors.lastname: Son
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Underbrink
authors.affiliation: Department of Pathology, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA.
authors.forename: Suimin
authors.initials: S
authors.lastname: Qiu
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA.
authors.forename: Vicente A
authors.initials: VA
authors.lastname: Resto
mesh_terms: D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008953:Models, Anatomic; D014066:Palatine Tonsil / Q000473:pathology* / Q000601:surgery; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D014059:Tongue / Q000473:pathology* / Q000601:surgery; D014068:Tonsillectomy / Q000379:methods*
keywords: Lingual tonsil; Lingual tonsillectomy; Surgical plane; Transoral robotic surgery