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Tonsillectomy of access for approach to the glossopharyngeal nerve or an enlarged styloid process

The glossopharyngeal nerve (ninth cranial nerve), which is sensory to the throat and also to part of the ear, is to be found deep to the superior constrictor muscle which is revealed after removal of the tonsils. It is therefore possible to approach the nerve, and to remove it (at least in part) following tonsillectomy. This has occasionally been used as a treatment for neuralgia affecting the glossopharyngeal nerve. It is believed by some otolaryngologists that an elongated styloid process, arising from the temporal bone at the base of the skull, can cause pain in the throat and ear. The styloid process is present in everyone, but in some patients it is considerably longer than normal. Some surgeons approach an elongated styloid process by removing the tonsil and splitting the superior constrictor muscle, and fracture it to remove it in cases of pain in the throat and ear.