Histopathological study of upper versus lower poles of tonsil in chronic tonsillitis among pediatric age group

Authors

  • Sudhakar Rao M. S. Department of Otorhinolaryngology and Head and Neck Surgery, Vijayanagara Institute of Medical Sciences, Ballari, Karnataka, India
  • Apoorva P. Department of Otorhinolaryngology and Head and Neck Surgery, Vijayanagara Institute of Medical Sciences, Ballari, Karnataka, India
  • Bindu Rani K. M. Department of Pathology, Vijayanagara Institute of Medical Sciences, Ballari, Karnataka, India
  • Shadakshari G. Department of Pathology, Vijayanagara Institute of Medical Sciences, Ballari, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20194942

Keywords:

Chronic tonsillitis, Grade of inflammation, Activity of inflammation, Hyperplasia, Histopathological examination

Abstract

Background: To compare the histopathological findings between upper and lower poles of tonsil in pediatric age group keeping in view the local and distant effects of chronic tonsillitis.

Methods: Three relevant parameters, grade of inflammation (GOI), activity of inflammation and hyperplasia were histopathologically examined in the tonsils of n=60 pediatric patients with chronic tonsillitis who underwent tonsillectomy in Department of Otorhinolaryngology and Head and Neck Surgery, VIMS, Ballari, Karnataka, India. These parameters were analyzed and were subjected for statistical analysis.  

Results: In our study, among 60 patients, n=32 (54.2%) were female and n=28 (45.8%) were male. Those aging 5-10 years were n=34 (57.6%) and 11-15 years were n=26 (42.4%). The tonsillar enlargement of grade 3 were present in n=46 patients (77.7%), n= 12 patients (20%) had grade 2 and n=2 patients (1.3%) had grade 4.

Conclusions: The GOI and hyperplasia parameters in our study have highly significant association statistically (p<0.01) in histopathology of upper poles when compared with lower poles both sides. Further, the activity of inflammation when analyzed was more in upper pole when compared with lower poles both sides, However this parameter in left side upper and lower poles of tonsil was not statistically significant . Among the 60 cases studied, in all the cases, the GOI was of high grade and activity of inflammation and hyperplasia was low grade. Chronic tonsillitis and histopathology of chronically infected tonsils becomes an important step in the management of the disease.

Metrics

Metrics Loading ...

References

Jung KY, Lim HH, Choi G, Choi JO. Age-related changes of IgA immunocytes and serum and salivary IgA after tonsillectomy. Acta Otolaryngol Suppl. 1996;523:115-9.

Chole RA, Faddis BT. Anatomical evidence of microbial biofilms in tonsillar tissues:a possible mechanism to explain chronicity. Arch Otolaryngol. 2003;129(6):634– 6.

Messnerand AH, Pelayo R. Pediatric sleep-related breathing disorders. Am J Otolaryngol. 2000;21(2):98–107.

Bista M, Amatya RCM, Basnet P. Tonsillar microbial flora: a comparision of infected and noninfected tonsils. Kathmandu Univ Med J. 2006;13(4):18-21.

Wittlinger J, Stankovic P, Girrbach U, Gradistanac T, Güldner C, Teymoortash A, et al. Hyperplasia and the degree and activity of inflammation in chronic recurrent tonsillitis: a histopathological study. Eur Arch Otorhinolaryngol. 2017;274(7):2927-32.

Mckerrow WS. Diseases of tonsil. In: Gleeson M, Browning GG, Burton MJ, Clarke R, Hibbert J, Jones NS, et al (eds). Scott-Brown's Otorhinolaryngology, Head and Neck Surgery. 7th edtiton. 95th Volume, Newyork, NY: Edward Arnold; 2008: 1219-1228.

Perry M, Whyte A. Immunology of the tonsils. Immunol Today. 1998;19:414–21.

Richardson MA. Sore throat, tonsillitis , and adenoiditis. Med Clin North Am.1999;83:75-83.

Brandtzaeg P. Immune functions and immunopathology of palatine and nasopharyngeal tonsils. In: Benstein JM, Ogra PL (eds). Immunology of the Ear. Newyork, NY: Raven Press; 1987: 63-106.

Gerber, MA. Diagnosis of group a beta-haemolytic streptococcal. J Paediatrics. 1998;27:269-73.

Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH, et al. Efficacy of tonsillectomy for recurrent throat infection in severely affected children: results of parallel randomized and non-randomized clinical trials. N Engl J Med. 1984;310:674-83.

Mitchell RB, Archer SM, Ishman SL, Rosenfeld RM, Coles S, Finestone SA. Clinical Practice Guideline: Tonsillectomy in Children (Update). Am Acad Otolaryngol Head Neck Surg. 2019;160(IS):S1-S42.

Dohar JE, Bonilla JA. Processing of adenoid and tonsil specimens in children: a national survey of standard practices and a five-year review of the experience at the Chil-dren’s Hospital of Pittsburgh, Otolaryngol Head Neck Surg.1996;115:94—7.

Jovic M, Avramovic V, Vlahovic P, Savic V, Velickov A, Petrovic V. Ultrastructure of the human palatine tonsil and its functional significance. Rom J Morphol Embryol Rev Roum Morphol Et Embryol. 2015;56(2):371–7.

Ugras S, Kutluhan A. Chronic Tonsillitis can be diagnosed with Histopathologic findings. Eur J Gen Med. 2008;5(2):95-103.

Hiari MA. Histopathology of the Tonsil- Is it Important. Bahrain Med Bull. 1999;21(2):58-9.

Downloads

Published

2019-10-23

How to Cite

M. S., S. R., P., A., K. M., B. R., & G., S. (2019). Histopathological study of upper versus lower poles of tonsil in chronic tonsillitis among pediatric age group. International Journal of Otorhinolaryngology and Head and Neck Surgery, 5(6), 1646–1651. https://doi.org/10.18203/issn.2454-5929.ijohns20194942

Issue

Section

Original Research Articles