A 45-year-old man with a complaint of ear pain and difficulty hearing is diagnosed with tonsillitis. Otoscopic examination reveals fluid in the middle ear cavity. Hypertrophy of which of the following structures would be most likely to compromise the drainage of the auditory tube?

The pharyngeal tonsil is situated in a slit-like space, the pharyngeal recess, in the nasopharynx behind the opening of the auditory (eustachian) tube, and a pharyngeal tonsil in this location can lead to blockage of the drainage of the auditory tube. The lingual tonsil is located in the posterior aspect of the tongue, whereas the palatine tonsil is contained within the tonsillar fossa between the palatoglossal and palatopharyngeal arches. An enlargement of the lingual tonsil or the palatine tonsil will not occlude the auditory tube due to their location in the oropharynx. The superior pharyngeal constrictor would not be involved in occlusion of the auditory tube because it is located more posteriorly. The uvula is drawn upward during deglutition and prevents food from entering the nasopharynx; it does not block the auditory tube.