A 7-year-old develops brisk secondary haemorrhage 6 hours after tonsillectomy. The surgeon identifies the bleeding vessel in the tonsillar bed. The principal arterial supply of the palatine tonsil comes from which vessel?

• A Ascending pharyngeal artery
• B Tonsillar branch of the facial artery ✓
• C Descending palatine artery
• D Dorsal lingual artery

Explanation

The tonsillar branch of the facial artery is the chief and largest supply to the palatine tonsil; it pierces the superior constrictor to enter the lower pole of the tonsil. Ascending palatine and ascending pharyngeal arteries, the dorsal lingual artery and the descending palatine artery contribute smaller twigs, so they are plausible distractors but never the dominant source. This heavy facial artery supply explains why tonsillar haemorrhage can be profuse and why the facial artery lies close to the surgical bed.

Reference: Gray's Anatomy for Students, 4th ed.

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