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Grade 4 tonsillar hypertrophy associated with decreased retronasal olfactory function: a pilot study.

Melih Cayonu1, Murat Salihoglu, Aytug Altundag

  • 1Department of Otorhinolaryngology, Amasya University Training and Research Hospital, Kirazlıdere, Amasya, 05100, Turkey, melihcayonu@yahoo.com.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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Enlarged palatine tonsils, known as tonsillar hypertrophy, can impair retronasal olfaction. Severe hypertrophy (grade 4) significantly reduces the ability to smell odors via the retronasal route compared to mild hypertrophy (grade 1).

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Area of Science:

  • Otolaryngology
  • Olfactory Neuroscience
  • Anatomy

Background:

  • Tonsillar hypertrophy is a common condition affecting both children and adults.
  • Enlarged tonsils can act as an anatomical barrier, potentially impacting airflow and molecule transport.
  • The effect of tonsillar hypertrophy on retronasal olfaction has not been previously investigated.

Purpose of the Study:

  • To investigate the impact of palatine tonsillar hypertrophy on retronasal olfactory function.
  • To assess whether the size of enlarged tonsils correlates with olfactory deficits.

Main Methods:

  • 146 subjects aged 20-29 years underwent oropharyngeal examination to grade tonsillar hypertrophy.
  • Participants were categorized into four groups based on tonsil size (grade 1-4).
  • Orthonasal and retronasal olfactory functions were evaluated using the "Sniffin' Sticks" test and specific retronasal olfactory testing.

Main Results:

  • No significant differences in age, gender, smoking, or alcohol consumption were found between groups.
  • Orthonasal olfactory function (Sniffin' Sticks subtests and TDI scores) did not differ across tonsil size grades.
  • Retronasal olfactory scores were significantly lower in participants with grade 4 tonsillar hypertrophy compared to those with grade 1.

Conclusions:

  • Grade 4 tonsillar hypertrophy negatively impacts retronasal olfactory sensing.
  • The physical obstruction caused by severely enlarged tonsils may impede odorant molecule delivery to olfactory receptors via the retronasal pathway.