Hypertrophy Of Palatine Tonsils Research Articles

Otolaryngological features in a cohort of patients affected with 22q11.2 deletion syndrome: A monocentric survey.

Otorhinolaryngologic manifestations are common in 22q11.2 deletion syndrome (22q11.2DS), but poorly described. This study aimed to better define the ear-nose-throat (ENT) phenotype of 22q11.2DS patients, in the attempt to best detect subjects requiring subspecialist intervention. We enrolled 25 patients affected with 22q11.2DS. Anatomic and functional ENT findings were investigated using clinical, laboratory, and instrumental data. Immunophenotype and frequency of infections were evaluated. Univariate and multivariate analyses were performed. ENT anomalies were found in 88% of patients, and in 20% congenital palate defects required surgery. Adenoid or palatine tonsil hypertrophy was noted in 80% and 48%. Forty-eight percent of subjects had rhinolalia/phonia, severe in half of these. We also found nasal regurgitation or laryngeal penetration/aspiration in 20% and 16%, respectively. Instrumental exams revealed a mild conductive hearing loss in 32% (bilateral in most cases), tympanometric anomalies in 28%, and swallowing abnormalities in 16%. Statistical univariate analysis showed a direct association between rhinolalia/phonia and episodes of laryngeal aspiration (p = .016) and between tympanometric anomalies and increased adenoid volume (p = .044). No association between episodes of food aspiration and palatal anomalies was found. Moreover, no statistically significant association was observed between the number of airway infections and the ENT findings. This study contributes to better define the ENT phenotype in patients with 22q11.2DS, helpful to prevent potential complications. Furthermore, the identification of a subcategory of patients may allow the early adoption of specific speech therapy programs to improve the clinical outcome of 22q11.2DS patients.

Morphofunctional Characteristics of Palatine Tonsils in Children by the Results of Tonsillotomy

The aim was to study the morphofunctional features of palatine tonsils of children aged 2-14 years with hypertrophy of palatine tonsils of 2 nd and 3 rd degree. Material and methods . The palatine tonsils obtained after tonsilotomy in 34 children aged 2-14 years with hypertrophy of palatine tonsils of 2nd and 3rd degree served as a subject of the study. The material was examined using histological, histochemical and morphometric methods. Results . Lymphoid tissue in the examined tonsils is represented by both lymphoid nodules (follicles) and diffusely located lymphoid tissue. In tonsils, the presence of a marked inflammatory process in most of the children examined, despite the absence of a history of angina. Against the background of moderate edema in the vessels of the microcirculatory bed, the stasis of the formed blood elements, focal destruction of the capillary wall, the release of the formed elements of blood into the surrounding connective tissue were noted. All children showed marked lymphoid infiltration of the epithelium and connective tissue, focal destruction of the epithelial layer in the crypts and on the surface of the tonsils. Destructive changes in epithelial cells were mainly manifested in the form of vacuolization of the cytoplasm of epitheliocytes and karyorexis. Among the leukocytes, lymphocytes predominated, in addition to them, plasmocytes, single macrophages, mast cells, and neutrophils were detected. The height of the epithelial layer on the surface and in the crypts increased with increasing age of the children. Thus, in the crypt region, the height of the epithelium in children aged 3 years was 32-37 μm and in children 13 to 14 years, 60 to 70 μm. The proportion of interfollicular connective tissue increased insignificantly with increasing age of children. In children 2-8 years old, hyperplasia of lymphoid tissue was accompanied by an increase in the number and size of lymphoid follicles. Later, the size of follicles decreased with increasing age of children. A significant feature of follicles was the significant development of reactive centers centers of reproduction), in which numerous mitoses were recorded, which indicates the activation of the B-system of immunity.

Decision making for position-dependent obstructive sleep apnea syndrome on the basis of patient information and physical examinations of the upper airway, acquired on an outpatient basis

Conclusions: Patients with body mass index (BMI) < 25 kg/m2 and obstructive sleep apnea syndrome (OSAS) are highly suspicious for position-dependent OSAS. Diagnosis of position-dependent/position-independent OSAS can be difficult in patients satisfying both ‘BMI >25 kg/m2’ and ‘any of tongue enlargement (TE), palatine tonsil hypertrophy (PTH) and obstruction by Muller’s maneuver (OMM)’. Polysomnography is warranted in such patients.Objectives: The objective was to retrospectively elucidate criteria for differentiating position-dependent OSAS on the basis of patient information and physical examinations of the upper airway obtainable in clinics.Methods: The 643 patients were categorized as positional patients (PPs) or non-positional patients (NPPs). The patient background factors examined were sex, age, BMI, and hypertension. TE, PTH, pharyngeal tonsil hypertrophy, and OMM were evaluated. Cross-validation was performed using even-numbered registrations as the training set group (Group A) and odd-numbered registrations as the test case group (Group B).Results: In Group A, patients with BMI <25 kg/m2 were clearly more frequent among PP than among NPP. In Group A with BMI ≥25 kg/m2, significant differences were found for TE, PTH and OMM. Significant differences were found between 0 and 1/2/3 for number of factors. Results generated from Group A were validated in Group B.

Effects of adenoidectomy and adenotonsillectomy on the components of Waldeyer ring

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;The consolidated effects of adenoidectomy alone and adenotonsillectomy on the Waldeyer ring need to be studied in children. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;This was a clinical trial with a sample size of 100 in each of the two arms [Group A: adenoidectomy alone, Group B: adenotonsillectomy]. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;It was found that the association between adenoid recurrence (Risk 3 times) and palatine tonsil hypertrophy (Risk 11 times) in Group A patients at 3 and 6 months was extremely significant. Whereas lingual tonsil hypertrophy was found to be highly associated with Group B. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;If adenoidectomy alone is performed, there are high chances of hypertrophy of palatine tonsils, lateral pharyngeal bands and a high risk of adenoid recurrence. If adenoidectomy and tonsillectomy are performed together there is some chance of lingual tonsil hypertrophy. Hence it would be prudent to perform both the surgeries simultaneously in most children for better control of chronic infections and obstructive sleep apnoea &lt;/span&gt;symptoms&lt;span lang="EN-IN"&gt;.&lt;/span&gt;&lt;/p&gt;

Impact of adenotonsillectomy on vocal emission in children

IntroductionAdenotonsillectomy is the most common surgery performed by otolaryngologists in pediatric age, and one of the most frequently asked questions about the postoperative period is whether there is a potential for change in vocal pattern of these children. ObjectiveTo evaluate the impact of adenotonsillectomy in the voice emission pattern of children with hypertrophy of palatine and pharyngeal tonsils. MethodsThis is a prospective study in which we carried out perceptual auditory assessments and acoustic analysis of 26 children with adenotonsillar hypertrophy at three time points: before surgery, one month and three months after surgery. The following acoustic parameters were estimated using the Praat software: fundamental frequency, jitter, shimmer, and harmonic–noise ratio. ResultsA statistically significant change was found between shimmer and harmonic–noise ratio during vowel /u/ production between the preoperative and 1st month postoperative time points. No significant differences were detected for acoustic parameters between preoperative analysis and that of the 3rd month post-operation. ConclusionTransient changes in acoustic parameters occur in children with adenotonsillar hypertrophy submitted to adenotonsillectomy, progressing to normalization in the 3rd postoperative month.

Comparison of Speech Motor Function, Articulation, and Phonological Characteristics of Children with and without Palatine Tonsil Hypertrophy

Comparison of Speech Motor Function, Articulation, and Phonological Characteristics of Children with and without Palatine Tonsil Hypertrophy

Acute otitis media in children: Correlation with palatine tonsil size, adenoidectomy and adenotonsillectomy

Objective – The objective of the survey was to assess the role and importance of the hypertrophy of palatine tonsils and previously performed adenoidectomy and adenotonsillectomy for the incidence of the acute otitis media in children. Materials and methods – The prospective and controlled study was carried out among 160 patients of both genders, aged between 6 months and 7 years, with an acute otitis media, during a 12-month period. The control group consisted of 40 examinees who had not been diagnosed with this disease. Clinical assessment of the palatine tonsil size was performed according to the degree of obstruction of the isthmus faucium: hypertrophy - grade I (both palatine tonsils obstruct up to ½ of the isthmus faucium), and hypertrophy - grade II (both palatine tonsils obstruct more than ½ of the isthmus faucium). Patients were stratified by age into three groups: 3 - 11 months, 1 - 2.5 years and 2.6 - 7 years. The association between antibiotic therapy and new cases of adenotonsillar infections was evaluated. Follow-up audiological examinations were conducted. The study was carried out on the basis of a questionnaire survey. Results – Adenoidectomy was performed in 8.3% of examinees with acute otitis media, adenotonsillectomy in 7.5%, while 84.2% of examinees were not treated with any of the above mentioned surgical procedures. No statistically significant differences were found compared to the control group (p=0,213). The palatine tonsils were eutrophic in 26.8% of the examinees with the acute otitis media, 55.4% had hypertrophy - grade I, and 17.9% hypertrophy - grade II. The differences between the observed groups were statistically significant (p=0.019). Conclusion – The hypertrophy of palatine tonsils was statistically significantly more prevalent in examinees with acute otitis media compared with the control group. This kind of level of significance was not recorded regarding previously performed adenoidectomy and adenotonsillectomy.

Influence of radiofrequency surgery on architecture of the palatine tonsils.

Radiofrequency surgery is a widely used modern technique for submucosal volume reduction of the tonsils. So far there is very limited information on morphologic changes in the human tonsils after radiofrequency surgery. We performed histopathological study of tonsillectomy specimens after previous bipolar radiofrequency induced thermotherapy (RFITT). A total of 83 patients underwent bipolar RFITT for hypertrophy of palatine tonsils. Tonsil volume reduction was measured by 3D ultrasonography. Five patients subsequently underwent tonsillectomy. Profound histopathological examination was performed to determine the effect of RFITT on tonsillar architecture. All tonsillectomy specimens showed the intact epithelium, intact germinal centers, normal vascularization, and no evidence of increased fibrosis. No microscopic morphological changes in tonsillectomy specimens after bipolar RFITT were observed. RFITT is an effective submucosal volume reduction procedure for treatment of hypertrophic palatine tonsils with no destructive effect on microscopic tonsillar architecture and hence most probably no functional adverse effect.

Association between clinical signs and symptoms related to sleep-disordered breathing in mouth breathers school children

Introduction Sleep-disordered breathing (SDB) is one of the causes of morbidity in children. The symptoms of SDB in children are varied and difficult to diagnose, especially in mouth breathing children (MB). The aim of this study was to associate the clinical signs of the MB and the self-perception of their symptoms related to SDB, focusing on nasal, sleep and masticatory problems. Materials and methods From a previous study, a sample of 73 pre-selected MB derived from elementary schools, aged 7–14 years old, was reevaluated about the presence of anatomical and functional facial and dental occlusion changes, the temporomandibular joint (TMJ) and posture alterations and breathing pattern abnormalities. Concomitantly, a questionnaire about symptoms of SDB was applied to the MB. This instrument contains 16 questions about TMJ, nasal and sleep problems. From 42 clinical variables reevaluated, 19 were selected by the Binomial test where the cutoff point was the average of the variables’ prevalence. Afterwards, we used the logistic regression through Backward method and the Wald test to verify the association between these clinical variables and the 16 questions from the questionnaire. Results For TMJ symptoms the clinical variables were significant to: lack of lip closure, Class II malocclusion, deviation from interocclusal position, overbite, forward head position and palatine tonsil hypertrophy. For the nasal symptoms the clinical variables were significant to: turbinate hypertrophy and deviation from interocclusal position. Lastly, for the sleep symptoms the clinical variables were significant to: turbinate hypertrophy, palatine tonsils hypertrophy, deviation from interocclusal position, lack of lip seal, obstructive Mallampati index (III and IV), and protrusion deviation. Most significant finds were those related to the sleep symptoms: mouth breathing and obstructive Mallampati index were related to complaints of snoring, waking up during the night and sleeping were related with the mouth open; mouth breathing and palatine tonsils hypertrophy were related to complaints of sleep problems and daytime sleepiness. Conclusion This study showed that craniofacial, upper airway and postural abnormalities are associated with an increased risk of SDB in mouth breathers children. Acknowledgements Management of Vitoria City, ES, Brazil.

Mouth breathing in children with learning disorders

Given the importance of studying the causes of learning disorders, we designed this case-control study to assess the nasal cavity volume, pharyngeal and palatine tonsils in children with and without learning disabilities. MethodA total of forty-eight children were enrolled in the study: twenty-four coming from the Center for Evaluation and Early Stimulation (CADEP), in which the criterion is the school failure of at least two consecutive years; and twenty-four students with normal learning - which made up the control group. The children were submitted to ENT examination (history, physical examination) and specific tests (acoustic rhinometry, cavum radiography). ResultsThe results showed that students with learning disabilities have a higher prevalence of pharyngeal tonsil hypertrophy: p < 0.001, and palatine tonsil hypertrophy: p < 0.001. The average volume of the nasal cavities showed no statistically significant association with learning difficulties (p = 0.75). ConclusionBased on this study, we concluded that children with adenotonsillar hypertrophy have more learning difficulties when compared to children without such hypertrophy.

Aspectos do sistema estomatognático pré e pós-adenotonsilectomia

To verify the speech therapy aspects of the stomatognathic system, including phonoarticulatory structures (lips, tongue, and soft palate) and swallowing, respiratory, speech, and phonation (vocal quality and resonance) functions, before and after undergoing adenotonsillectomy. The study included 22 children, 17 males and 5 females, aged between 5 and 10 years, suffering from hypertrophy of palatine and adenoid tonsils, with surgical indication for adenotonsillectomy and with no previous speech therapy. The speech-language pathology evaluation was performed before surgery and during the period between 1 and 6 months after adenotonsillectomy. It consisted of an evaluation of structures (lips, tongue, and soft palate) and of swallowing (liquid), respiration (mode), speech, and phonation (voice quality and resonance) functions. To evaluate vocal quality and resonance, 15 participants with the postoperative evaluation carried out in a period from 1 to 2 months were considered. There were differences regarding nasal respiratory mode, lips closed at rest posture, changed tongue tonus, adequate mobility of the soft palate, changed tongue posture during liquid swallowing, and absence of interposition compensatory mechanism of lips in swallowing. Reduction in the frequency of distortion processes was also found. With regard to speech, little improvement in vocal quality and resonance was seen. Following adenotonsillectomy, some structures and functions can spontaneously readapt or improve. However, most children needed to be referred to speech therapy for readapting stomatognathic structures and the assessed functions.

266 A QUESTIONNAIRE TO EXAMINE CORONARY ARTERY DISEASE AND THE HIGH RISK FOR SLEEP APNEA IN BERLIN

cally significant difference between the genders was the fasting glucose levels, which were higher in the males (p=0.047). Both neck circumference and BMI were not significantly different, either between the genders or between the OSAS and non-OSAS groups. Polysomnography identified several factors that were significantly different between the OSAS and non-OSAS groups: apnea index (p<0.01), minimum oxihemoglobin saturation (p<0.01) and arousal index (p<0.01). None of the findings upon polysomnography, however, were statistically different between the genders. The only UA anatomical alteration that showed a statistically significant difference between the OSAS and non-OSAS groups was palatine tonsil hypertrophy of degrees III and IV (p<0.01). In addition, the UA modified mallampati index of classes III and IV displayed a tendency towards a difference between the OSAS and non-OSAS groups (p=0.05). Conclusions: OSAS occurred more often in the obese children in this study, which was in agreement with other studies that have shown an association between obesity and OSAS. No association, however, was established with the degree of obesity. Allergic rhinitis, as diagnosed by the RAST laboratory assay, was not correlated with the presence of OSAS. Palatine tonsil hypertrophy was the only anatomical UA alteration that was correlated with the presence of OSAS, demonstrating that, even in a group of obese children, this particular anatomical feature occurs frequently in individuals with OSAS.

Assessing the impact adenotonsilectomy has on the lives of children with hypertrophy of palatine and pharyngeal tonsils

SummaryThe hypertrophy of the palatine and pharyngeal tonsils is extremely common in children, being one of the most frequent causes of visits to otolaryngologists and such problem can impair the child’s quality of life. Aim: to evaluate the impact of adenotonsillectomy on the lives of children with hypertrophied tonsils. Materials and methods: Contemporary longitudinal cohort study. A specific questionnaire used to evaluate the quality of life - OSD-6, was given to seventy five parents or guardians of children previously submitted to adenotonsillectomy, before the surgery and thirty days afterwards. Results: The adenotonsillectomy provided a significant reduction in the questionnaire score. Discussion: Snoring and nasal obstruction were the symptoms with the highest scores. There is a great concern from the parents with the snoring of the children and a poor statistic correlation between the degree of obstruction degree and a worse quality of life. Conclusion: Adenotonsillectomy causes a relevant impact in the quality of life of children with tonsil hypertrophy.

Analiza wskazań ortodontycznych do leczenia operacyjnego przerostu pierścienia Waldeyera u dzieci w materiale Kliniki Otolaryngologii i Instytutu Stomatologii CMUJ w Krakowie

The lymphatic system of a child's throat has got a special role to play. It is the first line of contact for a developing organism with antigens in the environment. For a particular group of children Waldeyer ring hyperplasia is much bigger than it is for a usual group of patients. And that's what causes different illnesses The analysis of ortodonthic indications for surgical treatment of adenotomy and tonsillotomy. The research was conducted on a group of hospitalized children in the Otorhinolaryngologic and in Stomatology Departament of Jagiellonian University Hospital in Krakow. The were treated for pathologic hypertrophy of adenoid and palatine tonsils. The analysis of occlusion disorder was carducted and the assessment of surgical and orthodontic treatment was performed. In the years 2002-2006 in the Otorhinolaryngologic and in Stomatology Departament of Jagiellonian University Hospital in Krakow 24 children were being treated for pathologic hypertrophy of adenoid and/or palatine tonsils accompanied by an occlusion disorder. Adenotomy with or without tonsillotomy is one of the most frequently performed surgical operations on children. Throughout many years the indications for this procedure were infringed. Nowadays the operation is being performed mainly because of the rhinological and/or otological indications for the pathologic hypertrophy of adenoid and/or palatine tonsils. There is also another indication although it is less frequently used. This indication is an occlusion disorder which needs to be treated orthodontically.

Oral appliance therapy for a child with sleep apnea syndrome due to palatine tonsil hypertrophy

Adenotonsillar hypertrophy is the most common cause of sleep apnea syndrome (SAS) in childhood. An adenotonsillectomy is the first line of treatment for most children with SAS. An 11-year-old boy with palatine tonsillar hypertrophy (Mckenzie Grade III) and mandibular retrusion was presented. We conducted orthodontic treatment using an oral appliance for the child for two years, as a result of which his SAS was cured. Among children with SAS who have significant maxillofacial structural anomalies, orthodontic treatment may be one effective treatment option.

Involvement of Epstein-Barr virus (EBV)-encoded latent membrane protein (LMP)-1 in the potentiation of Cε mRNA expression in human tonsil-derived cells

The aim of our study was to investigate a possible correlation between Epstein-Barr virus (EBV) infection status, including its latent gene expression, and expression of allergy-related genes in human tonsil-derived cells. In the tonsil-derived cells from the patients undergoing routine tonsillectomies for palatine tonsil hypertrophy or tonsillar focal infection, the presence of EBV DNA and mRNA expressions of latent membrane protein (LMP)-1, C epsilon chain, and activation-induced cytidine deaminase (AID) were detected by PCR and RT-PCR analysis, respectively. Of all the 12 patients, PCR products amplified from EBV DNA BamHI W fragment were detected in the tonsils from the 10 patients (83.3%). LMP1 mRNA expressions were confirmed in the six patients (50%). Both LMP1 mRNA expressions and EBV DNA were detected in the five patients. EBV DNA, but not LMP1 mRNA expression, was detected in the five patients. LMP1 mRNA expression, but not EBV DNA, was detected in one patient. In one patient, neither EBV DNA nor LMP1 mRNA expression was confirmed. C epsilon mRNA expressions were confirmed in all the 12 patients along with AID mRNA expressions. The degree of C epsilon mRNA expression, however, varied with the patients. The Fisher's exact probability test revealed a statistically significant correlation between LMP1 and C epsilon gene expressions, indicating that C epsilon mRNA expression level was significantly higher in the LMP1 positive samples than in the negative samples. On the other hand, there was no significant correlation between AID and LMP1 mRNA expressions. Thus, EBV infection is a notable factor capable of exacerbating allergic inflammation.

Obese obstructive sleep apnea patients with tonsil hypertrophy submitted to tonsillectomy

The physiopathology of obstructive sleep apnea-hypopnea syndrome (OSAHS) is multifactorial and obesity has been shown to be one of the main factors correlated with its occurrence. In obese patients with anatomical alterations of the upper airways it is often difficult to predict success for surgical correction since obesity is a limiting factor. Therefore, the aim of the present study was to evaluate the results of tonsillectomy in a specific group of patients, i.e., obese OSAHS patients with tonsil hypertrophy. Seven OSAHS patients with moderate obesity with obstructive palatine tonsil hypertrophy were submitted to tonsillectomy. All patients were submitted to pre- and postoperative appraisal of body mass index, otorhinolaryngology examination and polysomnography. Patients' average age was 36.4 +/- 10.3 years and average preoperative body mass index was 36.6 +/- 6.3 kg/m(2). Postoperative weight did not differ significantly from preoperative weight (P = 0.27). Average preoperative apnea and hypopnea index (AHI) was 81 +/- 26/h and postoperative AHI was 23 +/- 18/h (P = 0.0005). Average preoperative minimum oxyhemoglobin saturation (SaO2 min) was 69 +/- 14% and the postoperative value was 83 +/- 3% (P = 0.038). In relation to AHI, 6 (86%) of the 7 patients studied showed a reduction of 50% in relation to preoperative level and of these, 4 (57%) presented AHI of less than 20%. Only one patient presented a reduction of less than 50% in AHI, but even so showed improved SaO2 min. Tonsillectomy treatment for OSAHS in obese patients with obstructive palatine tonsil hypertrophy caused a significant reduction in AHI, with improvement in SaO2 min. This procedure could be eventually considered as an option of treatment for obese OSAHS patients with significant tonsil hypertrophy when continuous positive air pressure therapy is not possible as the first choice of treatment.

Análise histopatológica de produtos de adenotonsilectomia de janeiro de 2001 a maio de 2003

As tonsilas palatinas e faríngeas são agregados encapsulados incompletos de nódulos linfóides em contato direto com o epitélio de revestimento do trato aerodigestivo. TIPO DE ESTUDO: Estudo retrospectivo baseado na revisão de prontuários dos pacientes submetidos a adenotonsilectomias no Hospital de Clínicas da Faculdade de Medicina de Marília durante o período de janeiro de 2001 a maio de 2003. OBJETIVO: Relatar o perfil dos pacientes e as principais alterações histopatológicas em 250 pacientes com hipertrofia de tonsilas palatinas e faríngea, infecções de repetição ou ambos. MATERIAL E MÉTODOS: Análise histopatológica de 250 pacientes submetidos a adenotonsilectomia ou tonsilectomia entre adultos e crianças. RESULTADOS: Dos 250 pacientes, 117 (46,8%) são do sexo feminino e 133 (53,2%) masculino. A idade média foi de 7,3 anos e variou de 2 a 34 anos. A principal indicação cirúrgica foi a concomitância de infecções de repetição e hipertrofia de tonsilas palatinas e faríngea, sendo que em 160 (64%) foram classificadas em 3+/4+. Em 205 (82%) pacientes foi encontrada hiperplasia linfóide ou linfóide folicular. 45 (18%) também apresentaram inflamação aguda supurativa focal. Dentre estes, 2 pacientes tiveram cistos de inclusão epidermóide, outros 2 com colônias de Actinomyces sp e 1 paciente com lesão compatível com Doença da Arranhadura de Gato. DISCUSSÃO: Os dados apresentados neste trabalho nos mostram uma possível relação das tonsilites de repetição com as hipertrofias tonsilas palatinas e faríngea. CONCLUSÃO: O exame anatomopatológico de rotina das tonsilectomias apresenta uma relação custo/benefício negativa, no entanto, por problemas de ordem legal, ético, fica o médico sujeito à solicitação desse exame.

Histological analysis of tonsillectomy and adenoidectomy specimens - January 2001 to May 2003

SummaryPalatine and nasopharyngeal tonsils are nonencapsulated nodular masses of lymphoid tissue of the respiratory and digestive tract epithelium.Study designRetrospective clinical study based on the revision of medical records of patients who underwent tonsillectomy and adenoidectomy at Hospital das Clínicas, Medical School, Marília in the period between January 2001 and May 2003.AimAnalysis of patients' profile and main pathological changes in 250 patients with palatine and nasopharyngeal tonsil hypertrophy, recurrent infections or both.Material and MethodHistological review of 250 patients who underwent tonsillectomy and adenoidectomy among adults and children.ResultsOut of 250 subjects, 117 (46.8%) were female and 133 (53.2%) were male patients. Mean age was 7.3 years, ranging from 2 to 34 years. Main surgical indication was concomitant presence of recurrent infections and hypertrophy of nasopharyngeal and palatine tonsils. Among these patients, 160 (64%) were classified as grades III to IV hypertrophy. Lymphatic or follicular lymphatic hyperplasia was observed in 205 patients (82%); focal inflammation was verified in 45 (18%) subjects. Among those, 2 patients presented squamous cell cysts, 2 had Actinomyces sp colonies and 1 cat scratch disease. Discussion: The results presented in this study suggested a possible correlation between recurrent tonsillitis and palatine tonsil hypertrophy.ConclusionRoutine histological study of tonsillectomy and adenoidectomy specimens has a low cost-benefit rate, although, due to legal and ethical issues, physicians may request this type of examination.

Studies on redox substances in tonsil.--Relation between thiol compounds and vitamin C in tonsils- (author's transl)

In the series of investigation on the function of tonsils, the authors have reported in details on the individual redox substances in tonsilar tissue. In this study, the relationship between each component has been discussed. Each redox substance was measured as follows:glutathione and the thiol compound by the enzyme-spectrophotometrical method and the DTNB colorimetry; vitamin C by nitrophenyl hidrazine (DNP) method.The reduced glutathione and reduced vitamin C exhibited the positive correlation in palatine and pharyngeal tonsils. When the age of the patients was considered, the positive partial correlation was observed between these two substances. Positive correlation was also found in inflammatory stage or in chronic tonsillitis. Furthermore, the positive partial correlation existed with the degree of hypertrophy of palatine tonsils and the fluctuation of blood ASO titers, and the multiple correlation was found with ages in tubal tonsils.The oxidative glutathione and oxidative vitamin C revealed the negative correlation in hypertrophied tonsils, and in the non-inflammatory stage. The multiple correlation was found with ages particularly in palatine tonsils and in tubal tonsils, and the positive partial correlation was also shown with ages in tubal tonsils.When evaluating the ratio between oxidative and reduced glutathione and that of oxidative and reduced vitamin C, the multiple correlation with ages in palatine tonsils was indicated.No relations were found between the thiol compounds except glutathione and total vitamin C.