A New Approach for Evaluating Palatine Tonsillar Hypertrophy in Children Based on Ultrasound: A Pilot Study

Abstract

To develop a novel ultrasound (US) plane to diagnose palatine tonsillar hypertrophy objectively in children. Tonsillar ultrasonography of children (age 2-14 years) who had a clinical diagnosis of tonsillar hypertrophy or not were analyzed retrospectively. Clinical data (including gender, age, body mass index (BMI)), and volume (V) of tonsils measured by the US, were recorded. Furthermore, we found a new US plane to diagnose tonsillar hypertrophy and named it the submental oblique cross-section. In this plane, diameters of the left tonsil, right tonsil, and central oropharynx were designated as T1, T2, and O. Then, we calculated the ratio by the formula (T1 + T2)/O. A total of 172 cases (85 hypertrophy and 87 non-hypertrophy) were included in this study. There were no significant differences in gender (P=.844), age (P=.666), and BMI (P=.089) between the groups. In the non-hypertrophy group, the V of both sides had a positive linear correlation with age or BMI. In contrast, there was no linear correlation between ratio and age or BMI. The area under the curve (AUC) of ratio and V was 0.970 (95%CI: 0.947-0.993) and 0.835 (95%CI: 0.778-0.893) by receiver operating characteristic (ROC) analysis, respectively. The optimal cutoff value of ratio for diagnosis of tonsillar hypertrophy was 2.293 (sensitivity=88.2%, specificity=95.4%). We established a new US section to evaluate tonsillar hypertrophy. This approach could be easily acquired and provide a reference value to guide clinical practice.