Lymphatic drainage of the nasal fossae and nasopharynx: Preliminary anatomical and radiological study with clinical implications

BACKGROUND: The lymphatic pathways of the nasal cavity are of enormous clinical importance. To date there has been no accurate radiographic record of these pathways. METHODS: Four halves of the head and neck from 2 fresh human cadavers were studied. RESULTS: The capillary network arises from the mucous membrane of the atrium, the turbinates, the floor of the nasal cavity, and the nasopharynx. They drain into the lateral pharyngeal and retropharyngeal lymph nodes. There is 1 lymphatic communication at the junction of the lateral posterior wall of the turbinates and the nasopharynx and another communication between 2 groups of lymph nodes situated between the origin of the facial artery and the bifurcation of the carotid artery. CONCLUSIONS: A rich avalvular lymph capillary network exists in the mucous membrane and 2 major lymph collecting vessels course through the parapharyngeal space to multiple first tier lymph nodes.