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.     

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.     

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.     

Phenytoin-induced lingual tonsil hyperplasia causing laryngeal obstruction

The effects of phenytoin sodium on lymphoid tissue have been known for some time. However, its effect on the lymphoid tissue of Waldeyer's ring is unreported in the otolaryngology literature. We present the case of a 78-year-old woman who was treated with phenytoin for generalized tonic-clonic seizures for 4 months and who subsequently developed lingual hyperplasia that caused laryngeal obstruction eventually requiring a tracheotomy. Of note, no history of airway compromise or difficulty with intubation from a prior operation 20 years ago was reported; these findings suggest that the lingual tonsillar hyperplasia was a consequence of phenytoin therapy and not a preexisting condition. The findings of histopathologic evaluation were consistent with lymphoid hyperplasia without evidence of malignancy. We also report our operative management and follow-up of this rare condition.     

Oropharyngeal tuberculosis. Report of a case in a lingual tonsil

Pharyngeal tuberculosis is very rare and normally appears as an seemingly malignant process. As a result of which it is essential to perform a differential diagnosis before beginning anticancer treatment. We present a clinical case of lingual tonsil tuberculosis. A review is made of the pathogenic mechanisms, the clinical manifestations and the diagnosis of pharyngeal tuberculosis, whose response to treatment with antituberculous drugs proves to be excellent.     

Down's syndrome with lingual tonsil hypertrophy producing sleep apnoea

A 12-year-old girl is presented with Down's syndrome and lingual tonsillitis causing sleep apnoea. In order to overcome her sleep apnoea she adopted a functional sleeping posture. The sleep apnoea was successfully treated by a single staged lingual tonsillectomy without preliminary tracheostomy. A return to a normal sleeping posture occurred spontaneously in the early post-operative period.     

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.     

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.     

Severe upper airway obstruction in children secondary to lingual tonsil hypertrophy

Lingual tonsil hypertrophy in children is a rarely reported disorder. Two cases of severe upper airway obstruction in pediatric patients secondary to marked lingual tonsil enlargement are reported. Both children were effectively treated with lingual tonsillectomy. The surgical technique, using an insulated Bovie tip, is described.     

Mandibular osteotomy and lingual flaps. Use in patients with cancer of the tonsil area and tongue base.

The composite resection operation with sacrifice of a portion of the hemimandible is considered to be the fundamental operation for cancers in the posterior oral cavity. The mandible is resected for cancer control (to ease reconstruction) and perhaps for traditional reasons. Mandibular sacrifice is not always essential for oncologic resection. Access through the mandible is usually required for effective resection of cancers in this region. The lateral mandibular osteotomy approach provides this access in selected patients. The adjacent, remaining portion of the tongue provides 75 to 100 sq cm of thick pliable vascular mucosa that can be used for closing the defects after resection of the cancer in the posterior oral cavity. As much as one half of the tongue can be rotated. If certain precautions are taken, a viable flap can be assured even after radiation treatment or ligation of the ipsilateral lingual artery.     

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.     

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     

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.     

Upper dysphagia due to a chemotherapy resistant Burkitt's lymphoma in a lingual tonsil

The higher incidence of immunosuppressive status is increasing in the last years the diagnosis of tumours of unusual location and behaviour. We present the case of a HIV-seropositive 41 years-old woman, bearing of high dysphagia and pharyngolalic voice. The exploration showed a tumour emerging in lingual tonsil and spreading out to hypopharynx and larynx. No lymph nodes were observed. Its resistance to chemotherapy made necessary its surgical removal.     

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...