Factors Associated with Hypertrophy of the Lingual Tonsils

Abstract

Objectives: Identify factors that may be associated with lingual tonsil hypertrophy (LTH). Methods: Retrospective chart review identified 380 patients from August 2013 to January 2014 with graded lingual tonsils, documented during routine flexible laryngoscopy. Lingual tonsils were graded using a 0 to 4 scale: 0 = complete absence of lymphoid tissue, 1 = lymphoid tissue scattered over tongue base, 2 = lymphoid tissue covers entirety of tongue base with limited thickness, 3 = lymphoid tissue 5 to 10 mm in thickness, 4 = lymphoid tissue >1 cm in thickness (above tip of epiglottis). Reflux symptom index (Reflux Symptom Index (RSI)–collected during patient intake), presence of obstructive sleep apnea (OSA; confirmed by polysomnogram), smoking habits, and basic demographics were gathered. Ï•2 and linear multi-variate regression analyses were used to identify significant correlating demographics with LTH. Results: Overall, 59.5% were male with a mean age of 50.2 ± 16.5 years and body mass index (BMI) of 30.1 ± 18.0. Ï•2 analysis revealed no significant relationship between OSA and LTH ( P = .059). When RSI was stratified to ≥10 or <10, a Cochran-Armitage test supported the trend hypothesis that as RSI increases lingual tonsil grading increases. Significant univariate correlates included age ( r = –0.307, P < .001) and smoking ( r = 0.186, P = .002). Multivariate regression revealed the combination of age and smoking ( r = –0.297, P < .001) to be a significant correlate. Conclusions: LTH does not seem to be associated with OSA in this group of patients. Abnormal RSI may be a factor associated with increased lingual tonsil thickness. Younger patients who smoke are more likely to have LTH.