The Association of Reflux and Lingual Tonsil Hypertrophy: A Systematic Review

Abstract

Objectives: Evaluate the association between lingual tonsil hypertrophy (LTH), gastroesophageal reflux disease (GERD), and laryngopharyngeal reflux (LPR). Methods: A systematic literature search was performed using MEDLINE and the Cochrane Library databases through July 2013 to identify original research articles examining the effects of GERD or LPR on LTH in both adults and children. Only original research articles in English were retrieved using the keywords “reflux and lingual tonsil,” “reflux and base of tongue hypertrophy,” “laryngopharyngeal reflux and lingual tonsil,” “LPR and lingual tonsil,” and extraesophageal reflux and lingual tonsil.” Results: Out of 33 studies that matched the search criteria, 5 studies in adults and 3 studies in children met the inclusion criteria. In adults, one study noted a significantly increased prevalence of LTH in patients with signs and/or symptoms of LPR (62.4%) versus patients without signs and/or symptoms of LPR (29.3%). Four studies noted an increase in the severity of LTH in the presence of signs or symptoms of LPR. In the pediatric population, all 3 studies noted a positive association between the presence of LPR and GERD and the presence of LTH (30%-70%). Conclusions: The results of this systematic review suggest an association between LTH and reflux in both adults and children. This study is limited by heterogeneity in methodology and definitions of LTH and reflux between included studies. Further investigation is needed to characterize the clinical entity of LTH as well as the nature of the relationship between LTH and reflux disease.