Factors Associated with Hypertrophy of the Lingual Tonsils

Hwang, Michelle S.; Salapatas, Anna M.; Yalamanchali, Sreeya; Joseph, Ninos J.; Friedman, Michael

doi:10.1177/0194599815573224

Cited by 21 publications

(42 citation statements)

References 12 publications

(25 reference statements)

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“…There appears to be a complex interplay with laryngopharyngeal reflux (LPR) emerging as a strong potential contributor to LTH and, subsequently, OSA. Previous authors have also demonstrated an association between LTH and OSA, BMI, age and smoking, but there has not been general agreement [1, 7]. This study adds further support to an association between a positive reflux finding score and BMI with lingual tonsil hypertrophy, but does not support a history of childhood tonsillectomy or age being associated with lingual tonsil size in adults.…”

Section: Discussioncontrasting

confidence: 70%

“…A trend was also seen for a negative correlation with age, but was not statistically significant. This association has also been supported by Friedman’s group in Chicago, where a statistically significant association was found between increasing LTH and decreasing age, RSI >10 and positive smoking status [7]. Interestingly, they did not, however, find an association with BMI, PPI use or allergy medication use.…”

Section: Discussionsupporting

confidence: 65%

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Factors associated with lingual tonsil hypertrophy in Canadian adults

Harris

Rotenberg

Roth

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundHypertrophy of the lingual tonsil tissue in the adult patient is thought to contribute to the pathophysiology of obstructive sleep apnea. The underlying etiology of lingual tonsil hypertrophy (LTH) in the adult patient is unclear and likely multifactorial. Previous studies have suggested that the lingual tonsils may undergo compensatory hyperplasia post-tonsillectomy in children, although it is unknown if this occurs or persists into adulthood. The purpose of this study was to determine what factors are associated with LTH in a population of Canadian adults.MethodsAdult patients presenting for consultation to an academic Rhinology/General Otolaryngology practice were eligible for enrollment. Demographic data including age, body mass index (BMI), Reflux Symptom Index (RSI), history of allergy, and history of tonsillectomy was collected via questionnaire. Endoscopic photographs of the base of tongue and larynx were captured. These were graded for LTH and Reflux Finding Scale (RFS) by blinded examiners. Statistical analysis was performed by comparing the mean LTH value to the variables of interest using two-tailed T-test. P < .05 was considered significant.ResultsOne hundred two subjects were enrolled. Age ranged from 18 to 78. 28 patients had previous tonsillectomy. This was not associated with a significant increase in lingual tonsil tissue (r = −0.05, p = 0.61). RFS >7 or RSI >13 was considered positive for laryngopharyngeal reflux. There was no difference in LTH based on RSI positivity (p = 0.44). RFS positivity correlated with increased lingual tonsil tissue (p < 0.05). BMI >30 was associated with increased lingual tonsil hypertrophy (p < 0.05).ConclusionsAn elevated body mass index and positive Reflux Finding Score are associated with lingual tonsil hypertrophy in adults. Reflux symptom index, history of allergy and history of childhood tonsillectomy are not associated with LTH.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionsupporting

confidence: 65%

Factors associated with lingual tonsil hypertrophy in Canadian adults

Harris

Rotenberg

Roth

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

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“…Lingual tonsil hypertrophy (LTH) is a clinical condition often observed in clinical practice during the inspection of the tongue base region . This lymphatic hypertrophy (LH) is implicated in a variety of airway pathologies, ranging from sleep‐related breathing disorders, lingual tonsillitis, and difficult intubation procedures . Additionally, it is frequently a cause of foreign body sensation in the throat and of pharyngodynia in cases of it inflammation …”

Section: Introductionmentioning

confidence: 99%

“…The etiology regarding the growth of this lymphatic tissue (LT) has not been clearly proved . The few studies about this topic showed that previous adenotonsillectomy, laryngopharyngeal reflux (LPR), and a high body mass index could be correlated to LTH, even if defined data regarding this aspect are not available …”

Section: Introductionmentioning

confidence: 99%

“…Robotic surgery allows blunt dissection of the excessive LT from the muscular plane of the BOT to achieve a complete resection of LT . However, the lingual tonsil LT does not present a capsule dividing it from the underlying tissues, as the palatine tonsils do; therefore, lymphatic cell aggregates may remain after the procedure, especially in the lateral region of the BOT …”

Section: Introductionmentioning

confidence: 99%

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Lingual tonsil lymphatic tissue regrowth in patients undergoing transoral robotic surgery

Iannella

Magliulo²,

Montevecchi

et al. 2018

The Laryngoscope

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Objectives/Hypothesis: To evaluate a possible regrowth of lingual tonsil lymphatic tissue in patients submitted to lingual tonsil resection with transoral robotic surgery (TORS).Study Design: Retrospective Study. Methods: Medical records of patients surgically treated by means of TORS to remove excessive lymphatic tissue of the lingual tonsil were retrospectively reviewed. Postoperative endoscopic data after long-term follow-up were analyzed to investigate possible lymphatic tissue regrowth. Preoperative and postoperative lingual tonsil lymphatic tissue were classified according to the standardized Friedman's grading scale ranging from 0 to 4.Results: Sixty-eight patients (41 male and 27 female; mean age = 51.3 years) were considered suitable for the study analysis. Clinical regrowth was observed in six (8.8%) patients: four (5.9%) and two (2.9%) patients with grade 2 and 3 lymphatic hypertrophy, respectively. No correlation between the grade of regrowth, the time interval from surgery, and the volume of lymphatic tissue removed was found.Conclusions: The lymphatic tissue regrowth after TORS resection appears to be very low.

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