Grade 4 tonsillar hypertrophy associated with decreased retronasal olfactory function: a pilot study

Abstract

Tonsillar hypertrophy is common in children, but it can also be present in adults. Enlarged tonsils, a significant anatomical barrier, may affect the flow of odor molecules from the oral cavity to the nasal passages, which has not yet been studied. Thus, we aimed to investigate the mass effect of palatine tonsillar hypertrophy on retronasal olfaction. This study was carried out in 146 subjects, with a mean age of 22.1 ± 2.2 years, ranging 20-29 years. An oropharyngeal examination of the participants was completed, and tonsillar hypertrophy was graded according to the subjective tonsil size scale. The participants were divided into four groups according to their tonsil size grading; then, each subject's orthonasal olfactory and retronasal olfactory functions were assessed using "Sniffin' Sticks" and retronasal olfactory testing. There were no differences observed between the groups in terms of age, gender, cigarette smoking, or alcohol consumption. In addition, there was no difference between the groups in terms of "Sniffin' Sticks" subtests and TDI scores. It was determined that the retronasal olfactory scores of the participants with grade 4 tonsil size were significantly lower than the retronasal olfactory scores of the participants with grade 1 tonsil size. The current investigation demonstrates that grade 4 tonsillar hypertrophy has significant negative effects on the retronasal route of olfactory sensing, when compared with grade 1 tonsillar hypertrophy.

Retronasal Olfaction Test Methods: A Systematic Review

“…Croy et al (22) asserted that the ROT is not suitable for daily clinical use but should be particularly beneficial in the case of a taste disorder accompanying olfaction deficiency. Studies investigating the ROT are summarized in Table 1, 1-1, 1-2 (16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36).…”

Olfactory and Gustatory Functions after Anterior Palatoplasty in Patients with Primary Snoring

“…These 2 routes clearly differ in terms of neuronal processing and perception. Pathologies preventing retronasal odors from reaching the olfactory mucosa, such as adenotonsillar hypertrophy, and those resulting in high Mallampati scores alter retronasal olfaction 29‐31 . Increased retronasal olfactory scores may be evidence of an increased retropalatal distance or oropharyngeal isthmus, but this remains to be confirmed either radiologically or using videofluoroscopy and real‐time magnetic resonance imaging sequences.…”