The Frequency of Lingual Tonsil Enlargement in Obese Children

Abstract

Obese children have a high frequency of enlargement of the lingual tonsils with a significantly higher prevalence in those with previous tonsillectomy. Enlarged lingual tonsils may play a role in the pathogenesis of obstructive sleep apnea in obese children.

Sleep-disordered breathing, behavior, and academic performance in Taiwan schoolchildren

“…Several hypotheses also have been proposed for explaining why obese children are at risk of SDB, including reduction of the intrathoracic volume causing lower oxygen reserves [29], impaired ventilatory responses to hypoxia and hypercapnia, hypoventilation because of leptin resistance [30], and central apnea followed by narrowing or collapse of the upper airway [31]. In practice, an important concern is that obese children may have adenotonsillar hypertrophy [32,33], which may reduce the cross-sectional diameter of the upper airway [34]. However, the effect of adenotonsillar hypertrophy was not evaluated in our study.…”

Surgical management of sleep-disordered breathing in children

“…[43][44][45][46] Tongue base surgery Lingual tonsil hypertrophy has been associated with persistent OSA after adenotonsillectomy and is more common in children with obesity or trisomy 21. [47][48][49] Lingual tonsillectomy has been performed in adults with electrocautery, laser, and radiofrequency ablation, and in children, with laser or radiofrequency ablation. Lingual tonsillectomy is performed by retracting the tongue with a clamp or silk stitch, exposing the tongue base with a conventional laryngoscope or GlideScope, marking the site of the lingual arteries and hypoglossal nerves, then ablating the hypertrophic lingual tonsil tissue.…”

“…Lingual tonsillectomy is performed by retracting the tongue with a clamp or silk stitch, exposing the tongue base with a conventional laryngoscope or GlideScope, marking the site of the lingual arteries and hypoglossal nerves, then ablating the hypertrophic lingual tonsil tissue. 48,49 One approach involves a small anterior tongue incision, tunneling posteriorly, and submucosally ablating the hypertrophic tissue. 50 Midline posterior glossectomy has been used in drug-induced sleep endoscopy-directed treatment of pediatric OSA.…”

Hipertrofia de amígdala lingual y apnea obstructiva del sueño en población pediátrica: Una asociación a considerar

“…Los niños obesos tienen una elevada frecuencia de HAL, cercana al 60%, particularmente si han sido sometidos a AA previamente, siendo mayor que en niños no obesos con AOS, o con síndrome de Down y AOS. Debido a la prevalencia actual de obesidad infantil, y su conocido riesgo de presentar AOS, es relevante evaluar si existe HAL en estos pacientes, dentro de los posibles múltiples factores que explican la AOS 11 .…”