Department of Otolaryngology - Head & Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
St. Joseph's Healthcare, Western University, 268 Grosvenor Street, London, ON, N6A 4 V2, Canada.
J Otolaryngol Head Neck Surg. 2017 Apr 17;46(1):32. doi: 10.1186/s40463-017-0209-z.
Hypertrophy of the lingual tonsil tissue in the adult patient is thought to contribute to the pathophysiology of obstructive sleep apnea. The underlying etiology of lingual tonsil hypertrophy (LTH) in the adult patient is unclear and likely multifactorial. Previous studies have suggested that the lingual tonsils may undergo compensatory hyperplasia post-tonsillectomy in children, although it is unknown if this occurs or persists into adulthood. The purpose of this study was to determine what factors are associated with LTH in a population of Canadian adults.
Adult patients presenting for consultation to an academic Rhinology/General Otolaryngology practice were eligible for enrollment. Demographic data including age, body mass index (BMI), Reflux Symptom Index (RSI), history of allergy, and history of tonsillectomy was collected via questionnaire. Endoscopic photographs of the base of tongue and larynx were captured. These were graded for LTH and Reflux Finding Scale (RFS) by blinded examiners. Statistical analysis was performed by comparing the mean LTH value to the variables of interest using two-tailed T-test. P < .05 was considered significant.
One hundred two subjects were enrolled. Age ranged from 18 to 78. 28 patients had previous tonsillectomy. This was not associated with a significant increase in lingual tonsil tissue (r = -0.05, p = 0.61). RFS >7 or RSI >13 was considered positive for laryngopharyngeal reflux. There was no difference in LTH based on RSI positivity (p = 0.44). RFS positivity correlated with increased lingual tonsil tissue (p < 0.05). BMI >30 was associated with increased lingual tonsil hypertrophy (p < 0.05).
An elevated body mass index and positive Reflux Finding Score are associated with lingual tonsil hypertrophy in adults. Reflux symptom index, history of allergy and history of childhood tonsillectomy are not associated with LTH.
成人患者的舌扁桃体组织肥大被认为是导致阻塞性睡眠呼吸暂停的病理生理学基础。成人舌扁桃体肥大（LTH）的潜在病因尚不清楚，可能是多因素的。先前的研究表明，儿童扁桃体切除术后舌扁桃体可能会发生代偿性增生，尽管尚不清楚这种情况是否发生或持续到成年期。本研究的目的是确定在加拿大成年人人群中与 LTH 相关的因素。
符合条件的成年患者在学术性鼻科学/普通耳鼻喉科就诊时可参加本研究。通过问卷调查收集人口统计学数据，包括年龄、体重指数（BMI）、反流症状指数（RSI）、过敏史和扁桃体切除术史。采集舌根和喉部的内窥镜照片。由盲法检查者对这些照片进行 LTH 和反流发现量表（RFS）评分。通过比较感兴趣变量的平均 LTH 值与统计学分析，使用双尾 T 检验。p < 0.05 被认为具有统计学意义。
共纳入 102 例患者，年龄 18-78 岁。28 例患者有扁桃体切除术史，但这与舌扁桃体组织的显著增加无关（r = -0.05，p = 0.61）。RFS > 7 或 RSI > 13 被认为是喉咽反流阳性。RSI 阳性与 LTH 无差异（p = 0.44）。RFS 阳性与舌扁桃体组织增加相关（p < 0.05）。BMI > 30 与舌扁桃体肥大相关（p < 0.05）。
升高的体重指数和阳性反流发现评分与成人的舌扁桃体肥大相关。反流症状指数、过敏史和儿童扁桃体切除术史与 LTH 无关。
