Lingual tonsils hypertrophy: clinical features and indications for lingual tonsillectomy

Abstract

Objective. To assess clinical features of lingual tonsil hypertrophy (LTH) and indications for LT and it’s safety. Methods. We evaluated 152 consecutive adult patients (65 males, 87 females), with the mean age of 48.02 ±13.29 years with LTH, proven by fibronasolaryngoscopy and who eventually underwent LT with layngoscopic approach. For comparison of clinical features, control group was formed of 50 healthy individuals matched with clinical group by age and gender. All subjects filled out the questionnaires, composed of reflux symptom index (RSI) and Dysphagia Screening Questionnaire (DSQ) questionnaires, validated and verified for use in Lithuania, together with a questionnaire created specifically for this research for gathering sociodemographic data. The LTH grade of all subjects was determined using this grading system: 0 – no lingual tonsil, 1 – tonsils are not in full contact with epiglottis, part of valeculae could be seen, 2 – tonsils are in full contact with epiglottis, valeculae could not be seen, 3 – epiglottis is pushed down and the view of it is interrupted. In the clinical group LT was performed under general anaesthesia and direct micropharyngoscopy with laryngeal microinstruments and electrocoagulator. Indications for operation, procedure time, intraoperative blood loss, post-operative pain for two first days was measured using 100-mm visual analogue scale (0– no pain, 100– extreme pain), complications (post-operative bleeding, edema of epiglottis, infection) were assessed. Results. LTH grade 2 was diagnosed in most of clinical group patients (68%). Previously performed tonsillectomy and diagnosed dysphagia were significantly more frequent in the LTH group in comparison to the control group: 46% vs. 16% (p = 0.002) and 36% vs. 12% (p = 0.009), respectively. A positive moderate correlations between LTH grade and the sums score of RSI and DSQ questionnaires were determined (r = 0.57[...].