Abstract
Objective: This study aimed to investigate connective tissue and lymphoid tissue ratios in tonsillectomy specimens to determine differences between microanatomical structure.
 
 Methods: Tonsillectomy materials were collected from patients aged 3-13 years and three groups were created. Patients with larger tonsils than 3 cc and had recurrent tonsillitis history were included to the Group 1, larger tonsils than 3 cc without recurrent tonsillitis history were included to the Group 2 and tonsil sizes less than 2 cc with recurrent tonsillitis history were included to the Group 3. Masson’s Trichrome stained slides were evaluated to determine the connective and lymphoid tissues. We use Python programming language and count pixels to calculate the approximate ratio of the connective tissue area. 
 
 Results: The mean connective tissue percentages were 5.45±2.50 in group 1, 5.45±2.42 in group 2 and 10.90±3.41 in group 3. There was significantly higher connective tissue ratios in group 3 compared to group 1 and group 2 (p=0.001). Lymphoid tissue was significantly higher in group 1 and group 2 compared to group 3 (p=0.001). Follicle numbers were significantly different among 3 groups (p=0.032).
 
 Conclusion: The mechanism of the tonsillar hypertrophy has not been elucidated, yet. We found that; as long as the tonsil volume increases, lymphoid tissue ratio increases to. Relationship between recurrent inflammation and microanatomical structures of the palatine tonsil seem to be more complicated than previously supposed knowledge.
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