The Effect of Tonsil Size on the Obstructive Sleep Apnea in Adults

Park, Jun Young; Choi, Sung Yong; Lee, Jae Wook; Ye, Mi Kyung; Shin, Seung Heon

Abstract

BACKGROUND AND OBJECTIVES
Obstructive sleep apnea (OSA) is a complex disease with multifactorial etiologic factors. The purpose of this study was to compare the tonsil size and weight along with polysomnographic and cephalometric findings and subjective symptoms of adult OSA.
MATERIALS AND METHODS
Tonsil size and weight were measured. Preoperative polysomnographic (PSG) results (AHI, SaO2, sleep efficiency, arousal index), cephalometric findings, objective symptoms [Pittsburgh sleep quality index (PSQI), Stanford sleepiness scale (SSS), and Epworth sleepiness scale (ESS)] were compared according to tonsil size and weight using Spearman rank correlation coefficients. RESULT: Thirty-four adult patients were included. Tonsil size was inversely correlated with minimal oxygen saturation (gamma=-0.394, p=0.034), and tonsil weight was inversely correlated with minimal oxygen saturation (gamma=-0.412, p=0.040) and sleep efficiency (gamma=-0.400, p=0.047) in PSG. In terms of anatomic correlation, tonsil size was correlated with cross sectional area of hypopharynx (gamma=0.377, p=0.048), while tonsil weight correlated with cross sectional area of the tongue (gamma=0.459, p=0.014) and cross sectional area of the soft palate (gamma=0.419, p=0.026). However, tonsil size and weight were not correlated with subjective symptoms of the patients.
CONCLUSION
With limited evidence, adult tonsil size and weight may influence the severity of OSA.