Related Experiment Video

Updated: May 30, 2026

Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue
07:38

Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue

Published on: June 14, 2020

Excessive reactive lymphoid hyperplasia in a child with persistent obstructive sleep apnea despite previous

Gül Özbilen Acar1, Harun Cansz, Cihan Duman

  • 1Istanbul Goztepe Training and Research Hospital, Cerrahpaşa Medical School, Istanbul University, Istanbul, Turkey. gulozbilenacar@gmail.com

The Journal of Craniofacial Surgery
|July 21, 2011
PubMed

Insights

Enlarged lingual tonsil and adenoid tissue can cause persistent obstructive sleep apnea in children, even after prior tonsillectomy and adenoidectomy. This case highlights reactive lymphoid hyperplasia as a cause of upper airway obstruction and infection.

Area of Science:

  • Otolaryngology
  • Pediatric Sleep Medicine
  • Immunology

Background:

  • Waldeyer ring lymphoid tissues, including lingual tonsils and adenoids, play a role in airway immunity.
  • Obstructive sleep apnea (OSA) in children can be associated with lymphoid tissue hypertrophy.
  • Previous tonsillectomy and adenoidectomy do not always resolve persistent OSA.

Observation:

  • A pediatric case presented with upper airway obstruction and infection.
  • The patient had a history of tonsillectomy and adenoidectomy 8 years prior.
  • Excessive lingual tonsil and adenoid hyperplasia, along with bilateral cervical lymphadenopathies, were noted.

Findings:

  • Reactive lymphoid hyperplasia of the lingual tonsil and adenoid can lead to recurrent upper airway obstruction and infection in children.
  • This condition can occur despite previous surgical removal of tonsils and adenoids.
  • Associated cervical lymphadenopathies may indicate a systemic immune response.

Implications:

  • Recurrent lymphoid hyperplasia should be considered in pediatric OSA cases refractory to initial surgery.
  • Further investigation into the etiopathogenesis of reactive lymphoid hyperplasia is warranted.
  • Management strategies may require re-evaluation, potentially including medical or further surgical interventions.

More Related Videos

CO2-Lasertonsillotomy Under Local Anesthesia in Adults05:07

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

Published on: November 6, 2019

Efficient Isolation Protocol for B and T Lymphocytes from Human Palatine Tonsils08:09

Efficient Isolation Protocol for B and T Lymphocytes from Human Palatine Tonsils

Published on: November 16, 2015

Related Concept Videos

Tonsillitis I: Introduction01:30

Tonsillitis I: Introduction

Tonsillitis is inflammation of the tonsils, which are two lymphoid tissue masses at the back of the throat. This condition can cause discomfort and irritation in the throat.
Etiology
Three primary contributing factors have been identified.
Chronic Pharyngitis01:23

Chronic Pharyngitis

Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features01:24

Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features

Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...
Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
Other Pulmonary Disorders01:17

Other Pulmonary Disorders

Respiratory disorders encompass a range of conditions with varying levels of severity. Asthma, marked by chronic airway inflammation and hypersensitivity, is one such condition. It can lead to airway obstruction due to factors like bronchial spasms, mucosal edema, increased mucus secretion, or epithelial damage. Asthma triggers are diverse, ranging from allergens to emotional upset, and treatment focuses on both immediate relief through bronchodilators and long-term inflammation suppression.
Esophageal Achalasia01:27

Esophageal Achalasia

Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...