Recurrent lingual tonsil hyperplasia

Clinically significant lingual tonsil hypertrophy is a rare entity in children. We describe a child, status postadenotonsillectomy, with recurrent hypertrophy of the lingual tonsil after carbon dioxide laser ablation. Workup was negative for immunodeficiency, cystic fibrosis, and allergies. The findings of examination of multiple biopsy specimens of the tissue suggested follicular hyperplasia, and cytometery showed no evidence of a lymphoproliferative disorder. Empiric treatment with a histamine2-receptor blocker after the sixth carbon dioxide laser ablation prevented lingual tonsil hypertrophy.     

Lingual tonsillectomy: A treatment for inflammatory lesions of the lingual tonsil

Lingual tonsillectomy is a surgical treatment that is seldom performed because lingual tonsillitis is infrequently diagnosed. We have reviewed a group of patients with lingual tonsillitis or lingual tonsil hyperplasia who were treated with lingual tonsillectomy. Lingual tonsil lesions, the anatomy and histology of the lingual tonsil, and surgical approaches to lingual tonsillectomy are discussed.     

Lingual Tonsil Hypertrophy Producing Obstructive Sleep Apnea

The hypertrophy of the lingual tonsil is a rare occurrence in adults. This disorder may cause obstructive sleep apnea (OSA) and also may lead to a life-threatening obstruction of the upper airway. Diagnosis of lingual tonsil hypertrophy in patients with OSA requires a careful examination by advanced technologic methods. The sleep apnea is successfully treated by lingual tonsillectomy, with or without tracheotomy. In this study the case of an adult with OSA caused by lingual tonsil hypertrophy which was treated with lingual tonsillectomy is presented, and the diagnosis and the treatment procedure of such cases are discussed.     

Case of cystic metastasis of lingual tonsil carcinoma diagnosed first as a branchiogenic cyst

We report a case of lingual tonsil carcinoma diagnosed first as a branchiogenic cyst. Histopathological findings showed the possibility of a malignant tumor because there was proliferation of the papillary epithelium of the cyst wall. Blind biopsy of the lingual and palatine tonsil was done and the histological findings revealed a cystic metastatic lymph node from a squamous cell carcinoma (SCC) of the lingual tonsil. The diagnosis of the primary unknown cystic metastatic cervieal SCC requires a thorough examination of the palatine or lingual tonsil when there is no evidence of any vestigial remnant of branchiogenic organ.     

Histological study of human lingual tonsil, especially changes with aging]

The lingual tonsils, in company with the pharyngeal and palatine tonsils, constitute Waldyer's tonsillar ring and function as an immunological organ. However, fewer reports have been published on the lingual tonsil than on the other tonsils. It can hardly be said that changes is the lingual tonsil related to age have been studied in detail. The author reported a qualitative study on both gross and histological findings of the lingual tonsil, focusing on its changes with aging, in 204 autopsied cases (124 males and 60 females). The results of the qualitative observations obtained were as follows: 1. The lingual tonsils were classified into three shapes based on gross findings; flat, prominent and hypertrophic. Most of the hypertrophic tonsils were seen in the group in the 2nd decade and in those aged between the 4th and 6th decade of life. 2. Lymphatic tissues were classified into three types; isolated diffuse, adhesive converged and independent converged types. It was presumed that reconstruction of the lymphatic tissue should occur independently of proliferation of the connective tissue since the lymphatic tissues of the three were not related to aging. 3. Hyperplasia of the connective tissue, which separated the lymphatic tissues, started in the 2nd decade and rapidly increased after the 6th decade. Hyperplasia of the elastic fiber in the capsula also started in the 2nd decade and increased with aging. The results of quantitative observation were as follows: 1. Total area of the lingual tonsil and lymphatic tissues in each slice of the specimen showed two peaks in size in the 2nd and 5th decades. 2. Total sum of the lymphfolliculus had changed with aging in the same manner as mentioned above in "1". The ratios of the lymphfolliculus to the parenchymal tissue and to the lymphepithelial symbiosis had also altered with aging. However, the number of lymphfolliculi per unit was almost constant. A significant difference between the sexes was detected below the 4th decade, when hormonal sexual difference were manifest. 3. Total sum of the area of the crypt increased from the 4th decade onward. From these findings, it is concluded that the lingual tonsil transiently responds to aging from the first to the 2nd decade, when the pharyngeal and palatine tonsils have dominant functions, and becomes active from the 4th to 5th decades, followed by a decrease in function after the 6th decade though its activity persists in elderly individuals.     

Laser surgery in lingual tonsil hyperplasia

Modern techniques have reduced the long existing reluctance to perform lingual tonsillectomy. The results of treatment of hyperplasia of the lingual tonsil with the carbon dioxide laser in 32 patients are presented. After exposure with a special endoscope the lingual tonsil can be vaporized or excised under microscopic control with promising results, far superior to the results obtained with other surgical techniques. Since the success rate of the surgery depends on the diagnostic criteria for applying this therapy, a careful selection of patients is essential.     

The lingual tonsil. A neglected symptomatic structure?

Surgical treatment of the lingual tonsil is seldom performed because problems attributable to chronic lingual tonsillar hypertrophy are infrequently diagnosed. We have reviewed a series of 25 patients with symptoms from enlarged lingual tonsils. The variety of presentation of lingual tonsillar lesions and the methods of surgical treatment are discussed.     

鼻内镜下微波凝固配合养阴利咽汤治疗舌扁桃体肥大的临床观察

目的观察微波凝固配合养阴利咽汤治疗舌扁桃体肥大的临床疗效.方法门诊舌扁桃体肥大治疗患者216例,随机分成三组,一组采用微波凝固配合养阴利咽汤联合治疗(综合治疗组),二组为单纯微波凝固(微波组),三组为单纯养阴利咽汤服用(养阴利咽汤组),比较分析三组的疗效.结果综合治疗组患者微波引起的咽干、咽痛等咽部不适症状很快得到缓解,总有效率为93.1%,微波治疗组和养阴利咽汤组总有效率分别为73.6%和61.1%,综合治疗组与微波凝固组、养阴利咽汤组之间疗效差异有显著性意义(P＜0.05).结论综合治疗舌扁桃体肥大疗效显著,值得临床推广应用.     

Obstructive lingual tonsil hypertrophy in recurrent thyroglossal duct cyst

The association between recurrent thyroglossal duct cyst (TGDC) and obstructive lingual tonsil hypertrophy has not previously been discussed. We present the case of a 7-year-old child whose medical and surgical course was complicated by these synchronous factors. The aim of this report is to present the risk factors for recurrence of TGDC and the unique challenge that concurrent lingual tonsil hypertrophy and airway obstruction present to management of patients.     

Abscess of the lingual tonsil.

Abscess of the lingual tonsil is an unusual entity that may cause diagnostic difficulty. The pathophysiologic mechanism of formation was correlated with normal posterior tongue histology in a case of lingual tonsillar abscess.     

Massive lymphoid hyperplasia presenting with obstructive sleep apnea secondary to lingual and palatine tonsil hyperplasia

Lingual tonsil hyperplasia is a rare condition that may cause obstructive sleep apnea (OSA). In the management of OSA, the lingual tonsils should be evaluated during the otorhinolaryngologic examination. We report the case of a 66-year-old man with findings of upper airway obstruction secondary to excessive lingual and palatine tonsil hyperplasia and with MRI findings of bilateral cervical lymphadenopathy. We review the clinical, radiologic, and histopathologic aspects of this case, and we discuss the surgical options for treating massive reactive lymphoid hyperplasia in conjunction with OSA.     

Pathological characteristics of the epiglottis relevant to acute epiglottitis

Objective

The characteristic swelling of acute epiglottitis is thought to be caused by histological factors in the epiglottis. We investigated the relationships between histological findings and the pathology of acute epiglottitis.

Methods

We examined 23 autopsy cases. For 16 of these, histological assessments were performed. In the remaining 7 subjects, physiological saline was injected at the lingual tonsil.

Results

These histological findings revealed abundant laryngeal glands on the laryngeal surface compared with the lingual surface. With regard to the blood vessels and lymphatic vessels, more of these vessels tended to be apparent on the lingual surface compared with the laryngeal surface. In each of the physiological saline injected subjects, almost no swelling of the lingual tonsil occurred, but the lingual surface of the epiglottis was swollen, and morphological changes had occurred that resembled those in acute epiglottitis.

Conclusion

Periepiglottic tissues are rich in lymphatic tissues, and it appears easy for inflammation to spread to the epiglottis itself via the gland's own rich networks of blood and lymphatic vessels. In addition, according to the video observation, it appeared that the liquid ingredient that exudes at the inflamed the lingual tonsil may cause swelling the lingual surface of the epiglottis.     

Cryosurgical treatment of the lymphoid tissue of Waldeyer's ring

The role of cryosurgery in the treatment of tonsil disease is an unresolved issue. Initial favorable reports failed to provide the necessary incentives for larger well-controlled studies. Bacteriologic and immunologic response to the cryosurgical treatment of tonsils remains unclear. Without appropriate studies, cryosurgery has been relegated to a backup status for conventional tonsil surgery. At present, cryogenic treatment of lymphoid tissue is generally limited to tonsillectomy in patients with blood dyscrasias; elimination of palatine tonsil regrowth and posterior pharyngeal lymphoid hyperplasia; and occasional laryngeal and lingual tonsillectomy.     

Narrow Band Imaging for lingual tonsil hypertrophy and inflammation,in laryngo-pharyngeal reflux disease

European Archives of Oto-Rhino-Laryngology - The objective of this study is to analyse the relationship between the endoscopic signs of laryngo-pharyngeal reflux, the lingual tonsil hypertrophy...     

Dynamic MRI diagnosis of sleep-disordered breathing

According to the obstructive site, the different types of obstructive-type sleep-disordered breathing are classified as the soft palate type, palatine tonsil type, soft palate and depressed lingual root type, depressed lingual root type and epiglottis type. In this study, we conducted dynamic MRI examinations of the oral, pharyngeal and lingual root sites in patients with obstructive sleep-disordered breathing, and studied the usefulness of MRI as a diagnostic tool for the examination of such obstructive sites.     

Epstein-Barr virus DNA is not increased in tonsillar carcinoma

Epstein-Barr virus (EBV) is a known oncogenic virus associated with a wide variety of cancers, including nasopharyngeal carcinoma. Waldeyer's ring, a collection of lymphoid tissues, includes the nasopharynx, pharyngeal, and lingual tonsils. To determine if EBV plays a causative role in carcinomas arising from other tissues in Waldeyer's ring, we examined pharyngeal tonsillar carcinomas for evidence of EBV infection. As previously reported, DNA was extracted from 53 consecutive tonsil cancers, as well as from age- and gender-matched non-cancerous tonsillectomy specimens. Three different sets of primers for discrete exons of EBV were then used to determine if active or latent EBV infection was expressed in the extracted DNA using the polymerase chain reaction (PCR). All positive bands were then sequenced to confirm the presence of amplified EBV fragments. None of the samples showed evidence for active EBV infection. In primers demonstrating latent infection, 1 of 53 (1.9%) of tumors were positive, versus 6 of 53 (11.3%) of the controls. These results indicate that EBV expression is not increased in DNA from tonsil cancers and that EBV infection does not have a causal relationship with tonsil cancer.     

低温等离子治疗舌扁桃体肥大所致的咽异感症

目的：探讨鼻内镜辅助下等离子射频消融术治疗舌扁桃体肥大所致的咽异感症的临床疗效。方法：应用30。鼻内镜下低温等离子射频消融术治疗307例舌扁桃体肥大患者,观察术区创面生长情况、术后疼痛、术中术后出血情况及术后疗效。结果：咽部异物感主观症状VAS评分从术前的（9．3±0．6）分降至术后的（3．7±2．4）分,差异有统计学意义（P〈0．05）。本组患者治愈率为84．4％,显效率为6．8％,有效率为4．6％,总有效率为95．8％。术后30~45d自膜脱落,无明显疼痛。术中平均出血量为（5．2±2．4）m1;术后11例（3．6％）患者继发出血;随访6～36个月无复发。结论：鼻内镜辅助下等离子射频消融术治疗舌扁桃体肥大所致的咽异感症是一种寄仝右杆的治疗青法．值得临床r椎广     

儿童原发扁桃体弥漫大B细胞淋巴瘤1例并文献复习

目的 探讨儿童原发扁桃体弥漫大B细胞淋巴瘤的临床表现、诊断策略、病理检查及免疫组化特点.方法 回顾2021年1月收治的一例原发扁桃体弥漫大B细胞淋巴瘤的患儿临床资料,通过中国知网CNKI和万方数据库检索国内关于儿童原发扁桃体恶性B细胞淋巴瘤的相关文献,并进行数据分析.结杲患儿,男,10岁4个月,因咽部不适5个月,伴软腭...     

Quality of life and health status in pediatric tonsil and adenoid disease

OBJECTIVE: To assess the baseline global health status and quality of life (QOL) in children with tonsil and adenoid disease. DESIGN: Cross-sectional multicenter survey series. SETTINGS: A tertiary academic pediatric specialty hospital and a tertiary academic hospital in 2 different cities. PATIENTS AND OTHER PARTICIPANTS: Consecutive series of 55 parents of children who were seen for tonsil and adenoid disease. INTERVENTION AND METHOD: Cross-sectional survey of the health status of affected children to assess their QOL and its relationship to tonsil and adenoid disease. MAIN OUTCOME MEASURES: Quality-of-life subscale scores of affected children on the Child Health Questionnaire version PF28 (CHQ-PF28); comparisons of population data from healthy normal children and children with asthma and juvenile rheumatoid arthritis. RESULTS: The overall health status and QOL of children with tonsil and adenoid disease is significantly worse than those of healthy normal children, as demonstrated by lower mean scores on several CHQ-PF28 subscales, including general health, physical functioning, behavior, bodily pain, and parental impact (emotional). In addition, the general health perception of children with tonsil and adenoid disease is similar to the perceptions of children with asthma and juvenile rheumatoid arthritis, but several aspects of health status, as measured by CHQ-PF28 subscale scores, were significantly worse in children with tonsil and adenoid disease. CONCLUSION: The health status impact of tonsil and adenoid disease appears to be quite significant, particularly in aspects related to the parental impact of the child's disease.