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Phenytoin-induced lingual tonsil hyperplasia causing laryngeal obstruction
1Department of Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, New York, USA.
The Annals of Otology, Rhinology, and Laryngology
|August 21, 2001
Summary
Phenytoin sodium can cause lymphoid hyperplasia in Waldeyer's ring, leading to airway obstruction. This case highlights a rare side effect of phenytoin therapy, necessitating surgical intervention.
Area of Science:
- Otolaryngology
- Pharmacology
- Pathology
Background:
- Phenytoin sodium's effects on lymphoid tissue are documented.
- Its impact on Waldeyer's ring lymphoid tissue remains largely unreported in otolaryngology literature.
Observation:
- A 78-year-old woman developed lingual hyperplasia after 4 months of phenytoin for seizures.
- This hyperplasia caused laryngeal obstruction, requiring a tracheotomy.
- No prior history of airway issues or intubation difficulty was noted.
Findings:
- Histopathology confirmed lymphoid hyperplasia without malignancy.
- The lingual tonsillar hyperplasia is attributed to phenytoin therapy, not a pre-existing condition.
Implications:
- This case underscores a rare but serious adverse effect of phenytoin.
- Highlights the importance of considering drug-induced lymphoid hyperplasia in otolaryngology cases.
- Informs clinical management and patient monitoring for phenytoin users.