Prevalence of IgE-mediated hypersensitivity in children with adenotonsillar disease

To determine the prevalence of allergy in children with severe adenotonsillar disease and to determine if the persistence of symptoms following tonsillectomy may be related to the allergic state.

A prospective study of a cohort of 108 patients.

Academic tertiary referral medical center.

Consecutive children scheduled to undergo tonsillectomy for obstructive hypertrophy or recurrent infection were eligible to enroll in this study. Over a 17-month period, 108 patients enrolled. One-year follow-up data were obtained on 78% of patients. A group of 59 age-matched controls was used for comparison.

Radioallergosorbent test analysis was performed on all study patients and controls. The study patients had the following surgical procedures: adenotonsillectomy in 61 cases (55%); adenotonsillectomy-myringotomy tubes in 31 cases (28%); tonsillectomy in 14 cases (13%); tonsillectomy-tubes in one case (< 1%); and adenotonsillectomy-unilateral tube in one case (< 1%).

Detection of allergy and postsurgical outcome.

Allergy was detected by radioallergosorbent test analysis in 23 (21%) of the study group and 12 (20%) of the control group. Fourteen patients (17%) reported obstructive symptoms unchanged or worse 1 year following surgery. Three of these children were allergic. Sixteen patients (21%) reported allergic symptoms unchanged or worse following surgery. Three of these children were allergic. In six patients (7%), asthma developed following tonsillectomy. None of these children were allergic.

The prevalence of allergy in children with severe adenotonsillar disease is the same as that of age-matched controls. No relationship was detected between resolution of symptoms following tonsillectomy and the presence of allergy. We found no increased prevalence in the development of asthma following tonsillectomy in the allergic child.