Kourelis Konstantinos, Marazioti Antonia, Kourelis Theodoros, Stathopoulos Georgios T
Department of Otolaryngology, Children's Hospital of Patras "Karamandaneio", Erythrou Stavrou 40 Str., 26331 Patras, Achaia Greece.
Laboratory for Molecular Respiratory Carcinogenesis, Department of Physiology, Faculty of Medicine, Biomedical Sciences Research Center, University of Patras, 1 Asklepiou Str., University Campus, 26504 Rio, Achaia Greece.
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):5604-5610. doi: 10.1007/s12070-021-02943-9. Epub 2021 Oct 25.
Diagnosis of Adenotonsillar Hypertrophy (ATH), the leading cause of pediatric Obstructive Sleep Apnea (OSA), depends on physical exam via Brodsky's staging of tonsils. This study investigates the associations of ATH with patient parameters, and balances in-office tonsil hypertrophy appraisal against true organ mass. A prospective cohort was formed of 103 children operated for ATH, and 31 matched controls. Demographic, clinical and tympanographic data, as well as Complete Blood Count (CBC) indices were compared. Absolute and relative to total body weight tonsil specimen mass were correlated with Brodsky's score. Tonsillar size indices were significantly raised in ATH patients. Elevated leukocytes ( = 0.012) and increased neutrophil percentage ( = 0.025) conveyed higher ATH risk. Subjective evaluation of tonsils graded 1 or 2 correlated significantly with absolute ( = 0.001) and relative ( = 0.006) objective measurements. Brodsky's score 3 and 4 displayed marginal significant association with relative ( = 0.050) but not with true ( = 0.989) mass. An occult hematologic inflammatory response was detected in ATH children. Clinical estimation of severely hypertrophic tonsils should be adjusted for total body weight. : NCT03541434 (clinicaltrials.gov).
腺扁桃体肥大（ATH）是小儿阻塞性睡眠呼吸暂停（OSA）的主要原因，其诊断取决于通过布罗德斯基扁桃体分期进行的体格检查。本研究调查了ATH与患者参数之间的关联，并将门诊扁桃体肥大评估与实际器官质量进行了对比。一项前瞻性队列研究纳入了103例接受ATH手术的儿童和31例匹配的对照组。比较了人口统计学、临床和鼓室图数据以及全血细胞计数（CBC）指标。扁桃体标本的绝对质量和相对于总体重的相对质量与布罗德斯基评分相关。ATH患者的扁桃体大小指数显著升高。白细胞升高（=0.012）和中性粒细胞百分比增加（=0.025）提示ATH风险更高。扁桃体主观评估为1级或2级与绝对（=0.001）和相对（=0.006）客观测量结果显著相关。布罗德斯基评分3级和4级与相对质量（=0.050）显示出边缘显著相关性，但与实际质量（=0.989）无关。在ATH儿童中检测到隐匿性血液学炎症反应。对于严重肥大扁桃体的临床评估应根据总体重进行调整。：NCT03541434（clinicaltrials.gov）
