Tonsillar hyperplasia and recurrent tonsillitis: clinical-histological correlation

Reis, Luciana Guedes Vilela; Almeida, Élia Cláudia de Souza; Silva, Juliano Carvalho da; Pereira, Gilberto de Araújo; Barbosa, Valdirene de Fátima; Etchebehere, Renata Margarida

doi:10.5935/1808-8694.20130108

Cited by 28 publications

(38 citation statements)

References 12 publications

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“…In adulthood, there is only a small amount of lymphatic tissue remaining. 2 Enlargement of the palatine tonsils is associated with substantial ill health consequences in the paediatric population. These include swallowing difficulties, pain and/or discomfort, airflow limitation, and OSA.…”

Section: Resultsmentioning

confidence: 99%

“…1 Palatine tonsils are part of the Waldeyer's lymphatic ring, responsible for the first line of defense against pathogens because it is located at the entrance of the air and digestive tracts. 2 The lymphatic ring is also composed of the pharyngeal, lingual and torus tubarius tonsils, and the lymphatic tissue scattered throughout the posterior oropharyngeal wall, with the function of collecting antigenic information. 2 The lymphatic tissue is not usually apparent in early childhood, but gradually evolves with hypertrophy and hyperplasia and reaches its largest size between 2 and 5 years of age.…”

Section: Introductionmentioning

confidence: 99%

“…2 The lymphatic ring is also composed of the pharyngeal, lingual and torus tubarius tonsils, and the lymphatic tissue scattered throughout the posterior oropharyngeal wall, with the function of collecting antigenic information. 2 The lymphatic tissue is not usually apparent in early childhood, but gradually evolves with hypertrophy and hyperplasia and reaches its largest size between 2 and 5 years of age. Its involution, which has unknown cause, starts at puberty.…”

Section: Introductionmentioning

confidence: 99%

“…In adulthood, there is only a small amount of lymphatic tissue remaining. 2 The full role the ring plays in human physiology and immunology and its effects on the immune system both local and systemic are not yet completely understood. 2 Enlargement of the palatine tonsils is associated with substantial ill health consequences in the paediatric population.…”

Section: Introductionmentioning

confidence: 99%

“…2 The full role the ring plays in human physiology and immunology and its effects on the immune system both local and systemic are not yet completely understood. 2 Enlargement of the palatine tonsils is associated with substantial ill health consequences in the paediatric population. These include swallowing difficulties, pain and/or discomfort, airflow limitation, and obstructive sleep apnea (OSA).…”

Section: Introductionmentioning

confidence: 99%

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Clinical correlation between tonsillar hypertrophy and tonsillitis

Hubballi

Nayaka

Koujalagi

2019

Int J Otorhinolaryngol Head Neck Surg

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Background: Tonsillar hypertrophy is a common clinical condition seen by an otorhinolaryngologist. Tonsils undergo hypertrophy due to recurrent infection or as a part of generalized lymphoid hypertrophy. The aim of this study is to clinically correlate the association between tonsillar hypertrophy and acute/chronic tonsillitis.Methods: 100 patients attending the Oto-Rhino-Laryngology Department at Vijayanagar Institute of Medical Sciences, Ballari, Karnataka with complaints of tonsillitis acute, chronic, acute on chronic, other ENT symptoms and asymptomatic patients were assessed for tonsillar enlargement using Brodsky Tonsillar Grading scale for tonsillar hypertrophy. Results: Out of the 100 patients with tonsillar enlargement and the symptoms at presentation we observed a statistically significant (p=0.0001) irrespective of the severity of the infection to the tonsillar hypertrophy graded according to Brodsky tonsillar grade.Conclusions: It is a common prudence that most of the general public and majority of general physicians are of the opinion that tonsillar grades are related to clinical pathology. Our study reveals tonsillar hypertrophy and severity of clinical disease are not directly proportional hence our study indicates management of acute or chronic tonsillitis cannot be influenced by the grade of tonsillar enlargement. We can consider tonsillar enlargement as a guide for prognostic evaluation. We were unable to find any literature regarding our objective of study. Hence this study can be considered as a stepping stone for further in depth clinical studies.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical correlation between tonsillar hypertrophy and tonsillitis

Hubballi

Nayaka

Koujalagi

2019

Int J Otorhinolaryngol Head Neck Surg

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3T MRI characteristics of the palatine tonsil in brachycephalic dogs

et al. 2021

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Background Investigation of the MRI characteristics of the palatine tonsil in brachycephalic dogs in 3T high‐field system. Methods Eighty‐five brachycephalic dogs and 37 normocephalic dogs were divided into five groups: group 1 French bulldogs (FBs) with neurological clinical signs (n = 37), group 2 FBs with brachycephalic obstructive airway syndrome (BOAS) (n = 22), group 3 pugs with neurological clinical signs (n = 17), group 4 pugs with BOAS (n = 9) and group 5 normocephalic dogs (n = 37). Cross‐sectional area and volume measurements were performed, and tonsillar margination and contour, shape, signal intensity and homogeneity/heterogeneity of the palatine tonsils were evaluated and compared. Results Cross‐sectional area and volume measurements of the tonsils showed no significant differences between brachycephalic and normocephalic dogs with the exception of the dogs of group 2 (FB BOAS), which showed relatively high volume and large cross‐sectional area in comparison to other groups. In 87% of the brachycephalic animals, the tonsils were well defined. A smooth contour was detectable in 91.8% and a rounded shape in 94.7% of brachycephalic dogs. Signal intensity was assessed as hyperintense in relation to the musculature and iso‐ to hyperintense to the soft palate. Heterogeneous appearance was described in 86.9% of the brachycephalic animals. Conclusions The MRI characteristics of the tonsils of brachycephalic dogs do not differ considerably from those of normocephalic dogs. In FBs with distinct clinical signs of obstructive airway syndrome, increase in cross‐sectional area and volume of the tonsils was detected.

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Hyperplasia and the degree and activity of inflammation in chronic recurrent tonsillitis: a histopathological study

Wittlinger

Stankovic

Girrbach

et al. 2017

Eur Arch Otorhinolaryngol

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Postoperative haemorrhage following tonsillectomy occurs in 5.98% of all cases with up to 10 deaths reported annually in Germany. When comparing tonsillectomy (TE) and tonsillotomy (TT), the same long-term frequency of ENT infections is displayed in children and young adults. However, taking postoperative haemorrhaging into account, TT is more favourable. Chronic tonsillitis is one of the most common indications for TE in the adult population; however, a histopathological characterization may reveal objective criteria and provide a foundation for routinely performing TT in adults too. Three essential parameters hyperplasia (HP), grade of inflammation (GOI) and activity of inflammation (AOI), which are responsible for, and associated with a clinically relevant disease were histopathologically examined in the tonsils of 100 adult patients with chronic recurrent tonsillitis. The parameters were analysed and compared separately in the pharyngeal and basal parts of the tonsils as well as in three sections (upper and lower pole of the tonsil, middle part) as this may influence the indication for TT. The comparison of the basal and pharyngeal portions displayed a significant difference in the GOI and the HP in all three sections: grade 2 HP as well as GOI were more commonly found in the basal than pharyngeal portions (p> 0.001). AOI (grade 2) displayed the same properties in the middle section (p < 0.002), but did not reach statistical significance in the cranial and caudal sections (p = 0.107 and p = 0.186). An overabundance of grade 1 GOI, AOI, and HP was seen in the pharyngeal sections. The results show that two out of three relevant parameters that demonstrate histopathological changes in recurrent inflamed tonsils have a significantly stronger presence in the basal section of the tonsil as opposed to the pharyngeal section. The processes initiated by inflammation next to the surface responsible for a clinically relevant recurrent tonsillitis seem to cause stronger reactions in the deep follicular portion of the tonsils.

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Tonsillar hyperplasia and recurrent tonsillitis: clinical-histological correlation

Abstract: This study suggests that the number of germinal centers is the only histopathological criterion that can be used to differentiate the two groups.

Cited by 28 publications

References 12 publications

Clinical correlation between tonsillar hypertrophy and tonsillitis

Clinical correlation between tonsillar hypertrophy and tonsillitis

3T MRI characteristics of the palatine tonsil in brachycephalic dogs

Hyperplasia and the degree and activity of inflammation in chronic recurrent tonsillitis: a histopathological study

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