Patterns of adenoid and tonsil growth in Japanese children and adolescents: A longitudinal study

Takayoshi Ishida,Hyung Sik Yoon,Eiichiro Kanda,Shin-Sheng Yang,Takashi Ono,Asuka Manabe

doi:10.1038/s41598-018-35272-z

Takayoshi Ishida, Hyung Sik Yoon + Show 4 more

Open Access

https://doi.org/10.1038/s41598-018-35272-z

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Abstract

Lymphoid tissues, such as adenoids (Ad) and tonsils (Tn), are suggested to undergo hypertrophy during childhood and involution in adulthood. Enlargement of Ad and Tn can cause transient obstruction of the respiratory airways, thus inducing obstructive sleep apnoea. To date, the standard Ad and Tn sizes have not been reported, and there are no explicit objective criteria for evaluating their sizes or deducing whether they have enlarged, reduced, or remained constant over time. Our previous cross-sectional study revealed the age-dependent airway occupation ratio of Ad and Tn in Japanese individuals. We conducted a longitudinal observational study of the Ad and Tn sizes in Japanese individuals aged 6–20 years. Ninety individuals were retrospectively enrolled. The average and standard deviation of the sizes was calculated in 5 age-based groups.

Highlights

80 years ago, Scammon described 4 types of growth curves that represent human growth; this model is still used in various fields
Tonsillectomy and adenoidectomy are common and effective treatments for improving respiratory impairment caused by enlarged Ad and Tn
Ad and Tn size did not decrease among groups, but decreased when compared between lower primary school stage and young adult stage

Summary

Introduction

80 years ago, Scammon described 4 types of growth curves (lymphoid, neural, general, and genital) that represent human growth; this model is still used in various fields. Among these types, the lymphoid type has a unique growth pattern. In clinical orthodontics, many adults who have enlarged Ad and Tn, which have not undergone involution, are encountered. Orthodontists are often confronted with patients in whom hypertrophy of the Ad and Tn is suspected, many of them do not use endoscope in daily clinical practice, cannot diagnose the enlarged Ad and Tn. Endoscopic examination is appropriate for diagnosing hypertrophy of the Ad and Tn, which is one of the risk factors for OSA, while polysomnography (PSG) is the gold standard for diagnosing OSA, but still expensive and time-consuming. The present study aimed to construct growth curves for the Ad and Tn, compare these growth curves, and provide a method to assist physicians in deciding whether to perform adenotonsillectomy

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