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Adenotonsillar hypertrophy and upper airway obstruction in evolutionary perspective
The Laryngoscope
|June 1, 1982
Summary
Fewer children are undergoing tonsillectomy and adenoidectomy, leading to increased instances of airway compromise due to enlarged tonsils and adenoids in children. Improved assessment methods are also enhancing recognition of this condition.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Respiratory Medicine
Background:
- Reduced referrals for tonsillectomy and adenoidectomy (T and A) in children.
- Increased use of antimicrobial therapy for pharyngotonsillitis and otitis media.
- Consequently, more children retain tonsils and adenoids.
Observation:
- Eleven cases of airway compromise due to adenotonsillar hypertrophy were reported.
- Symptoms included snoring, obstructive apnea, enuresis during sleep, and hyponasal speech, oral respiration, and morning headaches during the day.
- Onset was insidious in 8 cases and acute in 3 cases.
Findings:
- Adenotonsillar hypertrophy causing airway compromise appears more prevalent.
- Improved diagnostic methods like polysomnography and acoustic analysis aid in recognition.
- The rise may be due to decreased T and A rates, increased recognition, or both.
Implications:
- Highlights the importance of recognizing airway compromise in children with enlarged tonsils and adenoids.
- Suggests a potential shift in pediatric respiratory and sleep disorder management.
- Emphasizes the need for continued research into the causes and effective treatments for adenotonsillar hypertrophy.