Tonsillar hypertrophy linked to childhood wheeze and snoring.

Tonsillar hypertrophy linked to childhood wheeze and snoring.

In addition to airway inflammation, adenotonsillar hypertrophy is another factor that may increase upper airway resistance and predispose to sleep-disordered breathing (SDB) in childhood. The researchers studied 442 children (average 7.6 years old), who attended the ED for minor ailments or were referred for recurrent wheezing. They used parental questionnaires on symptoms of SDB (snoring), wheezing, use of inhaled bronchodilators or corticosteroids, tonsillectomy, and history of chronic disease. The children also underwent clinical examinations and the size of their tonsils was measured by inspection of the oropharynx. After accounting for factors such as age, gender, body mass index, and passive smoking, the researchers found that a history of wheezing was significantly associated with the presence of tonsillar hypertrophy and habitual snoring, at odds ratios (ORs) of 2.23 and 1.73, respectively. A history of wheezing was significantly associated with the presence of snoring in children with tonsillar hypertrophy (OR=2.76), but not in those without. The authors concluded that children with history of wheezing have more frequently tonsillar hypertrophy than those without wheezing.
Editor's comment: Children with a history of wheezing are more likely to have tonsillar hypertrophy which may partly explain the association between asthma and obstructive sleep-disordered breathing (SDB) in childhood.

Kaditis AG, Kalampouka E, Hatzinikolaou S et al. Associations of tonsillar hypertrophy and snoring with history of wheezing in childhood. Pediatric Pulmonology 2010; 45(3):275-280.