The Incidence and Clinical Symptoms of Palatine Tonsillar Hypertrophy in Elementary School Children

Chae, Sung Won; Choi, Geon; Hwang, Kyu Sung; Lee, Dong Jin; Choi, Chung Sik; Hwang, Soon Jae

Abstract

BACKGROUND AND OBJECTIVES: Snoring and sleep apnea from tonsillar hypertrophy are the main problems for tonsillectomy and adenoidectomy, which are the most frequently performed surgical procedures in the pediatric population. The relative size of the palatine tonsils to the oropharynx gets smaller with increasing age, but little has been studied about the age distribution and the associated change in the clinical symptoms. We attempted to observe the incidence according to age and to determine the relationship between the tonsillar hypertrophy and snoring, and sleep apnea in obese children.
MATERIALS AND METHODS
A total of 2,248 elementary school children in one district of Ansan City were entered in the study. The index of obesity, the presence and degree of tonsillar hypertrophy were determined and the symptoms due to tonsillar hypertrophy were investigated.
RESULTS
The prevalence of tonsillar hypertrophy of grades 3 and 4 was 28.0% at 6yrs and 22.9% at 7yrs. The prevalence decreased dramatically after 10yrs, with the prevalence rate below 10%. The prevalence of palatine tonsillar hypertrophy was significantly higher in obese children than in non-obese children. The most common clinical symptoms determined from questionnaires were sore throat. Although snoring decreased with increasing age, sore throat accompanied by fever was more common with increasing age.
CONCLUSION
The prevalence of palatine tonsillar hypertrophy rapidly decreased after the age of 10. Therefore, we believe that when making a decision to perform a tonsillectomy, the change in size of palatine tonsils with increasing age should be an important factor to consider along with clinical symptoms.