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Clinical characteristics of adenotonsillar hypertrophy in children: a retrospective analysis
Liang Wu1, Yingying Li1, Wenbo Chen1
1Department of Otorhinolaryngology, Children's Hospital of Nanjing Medical University, Nanjing City, Jiangsu, China.
Insights
This study identified key indicators for pediatric adenotonsillar hypertrophy (ATH). Age, platelet-to-lymphocyte ratio (PLR), and lowest oxygen saturation (LSaO₂) help assess the severity of ATH in children.
Area of Science:
- Pediatric Otolaryngology
- Respiratory Medicine
- Clinical Diagnostics
Background:
- Adenotonsillar hypertrophy (ATH) is a common condition in children, often leading to significant respiratory and sleep disturbances.
- Understanding the clinical indicators associated with ATH is crucial for accurate diagnosis and management.
- Previous studies have explored various factors, but a comprehensive analysis of distinct indicators for adenoid and tonsillar hypertrophy is needed.
Purpose of the Study:
- To investigate the clinical characteristics of pediatric adenotonsillar hypertrophy (ATH).
- To identify specific clinical indicators related to adenoid hypertrophy and tonsillar hypertrophy.
- To determine factors that correlate with the severity of ATH in children.
Main Methods:
- A retrospective cohort study of 215 children diagnosed with ATH was conducted.
- Demographic data, clinical information, and laboratory parameters were collected.
- Univariate and multivariate analyses were performed to identify significant clinical indicators and their correlations.
Main Results:
- Adenoid-to-nasopharynx (A/N) ratios significantly differed in children with snoring, apnea, and otitis media with effusion (all P < 0.001).
- No significant differences in tonsil-to-pharynx (T/P) ratios were observed across assessed clinical symptoms (P > 0.05).
- Age, lowest oxygen saturation (LSaO₂), platelet distribution width, apnea-hypopnea index, and platelet-to-lymphocyte ratio (PLR) showed significant correlations with A/N and T/P ratios.
Conclusions:
- Adenoid hypertrophy and tonsillar hypertrophy are associated with distinct clinical factors.
- Age, PLR, and LSaO₂ are valuable indicators for assessing the severity of pediatric ATH.
- These findings can aid clinicians in better evaluating and managing children with ATH.
Objective:
To explore the clinical characteristics of adenotonsillar hypertrophy (ATH) in children and determine its related clinical indicators.
Methods:
A retrospective cohort of 215 children with ATH who met predefined inclusion and exclusion criteria was identified from newly diagnosed patients presenting to the pediatric department of the study institution between March 1, 2024, and January 2025. Demographic characteristics, clinical data, and laboratory parameters were collected for subsequent univariate and multivariate analyses.
Results:
The cohort comprised 117 boys and 98 girls with a mean age of 5.81 ± 2.13 years, a mean tonsil-to-pharynx ratio (T/P ratio) of 0.60 ± 0.10, and a mean adenoid-to-nasopharynx ratio (A/N ratio) of 0.76 ± 0.08. Notably, A/N ratios differed significantly between children with and without snoring (0.78 ± 0.10 vs. 0.68 ± 0.04; P = 0.003), apnea (0.81 ± 0.10 vs. 0.75 ± 0.09; P < 0.001), and otitis media with effusion (0.81 ± 0.10 vs. 0.75 ± 0.10; P < 0.001). No significant differences in the T/P ratio were found across the assessed clinical symptoms (P > 0.05). Age, lowest oxygen saturation (LSaO2), and platelet distribution width demonstrated negative correlations with both the A/N ratio and T/P ratio. Conversely, snoring duration, the apnea-hypopnea index, and the platelet-to-lymphocyte ratio (PLR) showed positive correlations with both A/N and T/P ratios. Multivariate analysis of A/N ratios yielded a regression model, with R 2 = 0.793 and F = 88.369 (P < 0.001). The multivariate regression model for the T/P ratio yielded R 2 = 0.210 and F = 10.104 (P < 0.001).
Conclusion:
Adenoid and tonsillar hypertrophy have distinct associated factors, and age, PLR, and LSaO₂ aid in assessing pediatric ATH severity.
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