Sonographic measurement of palatine tonsil volume in children and comparison with actual volume

Abstract

Aim of this study is to compare the palatine tonsil (PT) volume measured with transcervical ultrasonography (TCU) in children with the actual volume to research the correlation with tonsillectomy indications. This prospective study included a total of 67 children, 37 boys and 30 girls, aged from 3-17 years who underwent bilateral tonsillectomy. Cases were divided into two groups based on tonsillectomy indications as chronic tonsillitis (Group 1) and obstructive sleep apnea syndrome (OSAS) (Group 2). The sonographic volume was measured with a 4.8-11.0 MHz linear transducer before tonsillectomy, while the actual volume was measured with the water displacement method. The correlation between both volume values was researched. Partial Correlation test was used to analyze correlations between variables after analysis of SPSS 22.0 program and age and gender factors. The mean ages in Groups 1 and 2 were 115.83±53.2 and 120.6±54.7 months, respectively. The actual and sonographic tonsil volumes in Group 1 were 2.03±0.82 ml and 2.22±0.85 ml (p=0.093), in Group 2 were 5.19±0.83 ml and 5.36±1.06 ml (p=0.074), respectively. In both groups the sonographic volume was correlated with the actual volume (r=0.788 and 0.829, respectively). The measured volumes with both methods were higher in Group 2 (p<0.001). TCU is a reliable, cheap, non-invasive and easily accessed method for evaluation of PT volume. It provides beneficial information about the PT size, anatomy and tonsillectomy indications in children.

Correlation between clinical grading of adenoid or tonsil hypertrophy and adenoid or tonsil volume post adenotonsillectomy: a prospective cohort study

“…[23][24][25] Unfortunately, these procedures are performed as first line surgical operations in the paediatric population who are the susceptible age-group for obstructive adenoidal and or tonsillar disease which are located amongst the highly vascularized and difficult for surgical access regions of the upper aerodigestive tract. 26,27 This was confirmed in this cohort where 86.5% were ≤18 years who were majorly ≤4 years with 63.5%; the age-group with up to 4-5 risks of developing serious to life-threatening airway and post tonsillectomy bleeding complications of the procedure. 26,28 We recorded 81.2% of our cohort with grades III and IV adenoid/tonsil hypertrophy who had adenoidectomy, tonsillectomy or both as similarly reported by other researchers.…”

“…26,27 This was confirmed in this cohort where 86.5% were ≤18 years who were majorly ≤4 years with 63.5%; the age-group with up to 4-5 risks of developing serious to life-threatening airway and post tonsillectomy bleeding complications of the procedure. 26,28 We recorded 81.2% of our cohort with grades III and IV adenoid/tonsil hypertrophy who had adenoidectomy, tonsillectomy or both as similarly reported by other researchers. 29,30 The 1 st and second degrees hypertrophy are often reserved for conservative medical treatment as first line therapy while 3 rd and 4 th degrees have surgery as 1 st line therapy.…”

“…Usually, clinical classifications are often made according to the transverse extension of the tonsil toward the centre of the oropharynx, however; the depth in the lateral aspect and inferior extension toward the hypopharynx are not easily assessed due to the size or position of the tongue and tongue root/base in certain individuals. 26,31 Researchers therefore developed different methods of accurate volume assessments including the trans-cervical ultrasonographic method, the calculation method based on a formula, the Cavalieri, the Ellipsoid and the Archimedes' principle methods; which the latter had been proven to be the most accurate 26,[31][32][33] this informed our choice of the method. Having knowledge of the adenoid/tonsil size/volume would assist the surgeon to predict the extent of surgery to avoid excessive, partial or suboptimal surgery leaving behind remnants with PTH as consequences for both.…”

Relationship of Brodsky Tonsillar Grading in Adults with Age, Gender, and Anthropometric Measurements

“…The advantage of this scale involves easy implementation and less cost whereas certain factors that affect the accuracy of this scale include entrenched tonsils, subjective assessment of the physician, and nearby anatomical structures. Pre-surgical evaluation of tonsillar tissue can be done by imaging modalities like computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound for multidimensional evaluation of pharyngeal anatomy 13 .…”

Role of Ultrasound in Estimation of Palatine Tonsil Volume in Obstructive Sleep Apnea Patients

“…Therefore, it is evident from literature that transcervical ultrasound can be an acceptable imaging technique for the evaluation of tonsillar shape, size, appearance, perfusion, pathology and as well as severity of obstructive sleep apnea by identifying pathological changes of the anatomical structures that basically cause it. 16 It is imperative to review literature and gather authentic information from different researches conducted worldwide to helpphysicians, surgeons and health care providers by providing them evidence based outcome when ordering investigations to their patients, objective ultrasound findings of tonsillar size in OSA.…”