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Lingual Tonsil Enlargement and Childhood Obesity: Is There a Correlation?

April 16, 2008
Written by: , Filed in: Pediatric Radiology
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The objective of a recent study was to evaluate the frequency of enlargement of the lingual tonsils in obese children.

The study has concluded that obese children have a high frequency of enlargement of the lingual tonsils that may play a role in the pathogenesis of obstructive sleep apnea.

Participants
In this prospective study, children were recruited from a sleep treatment center for MRI as part of a research protocol. Inclusion criteria were age between 14 and 20 years, and obesity was defined as a body mass index >95th percentile. Exclusion criteria included weight >375 pounds, craniofacial deformities, orthodontic hardware, and pregnancy.

Methodology
The size of the tonsil was measured on sagittal fast spin echo inversion recovery in the oblique anterior-posterior dimension. The measurements were performed by a pediatric radiology fellow with review by a faculty member.

Markedly enlarged was defined as a transverse diameter >10 mm. Subjects were divided into two groups: those who had a prior tonsillectomy and adenoidectomy and those who did not.

Pediatric Diagnostic Imaging

The Society for Pediatric Radiology
Pediatric Diagnostic Imaging program features the advances and diversity of pediatric imaging by reviewing state-of-the-art clinical material and advanced cutting-edge research presentations. This program presents a group of international experts who discuss state-of-the art diagnostic imaging and the outlook for the future direction of the specialty.
Read more or order:  Pediatric Diagnostic Imaging

Results of the Study
71 subjects were recruited; 62% had visualized and measurable tonsils, and in 14%, they were markedly enlarged. The frequency of the lingual tonsils being present and the frequency of the lingual tonsils being markedly enlarged were greater in the group with previous tonsillectomy and adenoidectomy.

Conclusions
Obese children have an increased incidence of both the presence and marked enlargement of the lingual tonsils. Enlargement of the lingual tonsils may be one of the contributing factors to the development of obstructive sleep apnea in obese subjects.

Reviewer’s Comments
This is particularly true in obese children who have previously undergone palatine tonsillectomy and adenoidectomy.

Author: Basil Hubbi, MD

Reference
Guimaraes CVA, Kaira M, et al. The Frequency of Lingual Tonsil Enlargement in Obese Children.
AJR Am J Roentgenol; 2008; 190 (April): 973-975:

Pediatric Diagnostic Imaging

The Society for Pediatric Radiology
Pediatric Diagnostic Imaging program features the advances and diversity of pediatric imaging by reviewing state-of-the-art clinical material and advanced cutting-edge research presentations. This program presents a group of international experts who discuss state-of-the art diagnostic imaging and the outlook for the future direction of the specialty.
Read more or order:  Pediatric Diagnostic Imaging
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