Factors associated with hypertrophy of the lingual tonsils in adults with sleep-disordered breathing.

IMPORTANCE

This study shows factors affecting lingual tonsil hypertrophy (LTH) in sleep-disordered breathing.

OBJECTIVE

To identify the factors associated with LTH in adults with sleep-disordered breathing.

DESIGN

Retrospective analysis.

SETTING

Academic tertiary referral center.

PARTICIPANTS

Ninety-seven adult patients with obstructive sleep apnea, who visited the Department of Otorhinolaryngology sleep clinic, were included from February 2009 through August 2011.

INTERVENTIONS: All patients underwent WatchPAT (peripheral arterial tone) examination, endoscopic examination of the upper airway, simple skull lateral radiography, and cine magnetic resonance imaging (MRI) sleep study of the upper airway tract.

MAIN OUTCOMES AND MEASURES: Prognostic factors indicating LTH in adults with sleep-disordered breathing.

RESULTS

A total of 97 subjects were included in this study. The median (interquartile range) apnea hypopnea index was 16.5/h (7.6/h-27.5/h). The median (interquartile range) thickness of the lingual tonsils as measured by MRI was 3.6 mm (1.9-5.2 mm) and 4.9 mm (2.9-6.7 mm) in the midline and paramidline of the tongue base, respectively (P < .001). Laryngopharyngeal reflux (reflux finding score >7) was present in 32 patients. The endoscopic grade of LTH agreed with the radiographic grade (κ = 0.731; P < .001). Lingual tonsil thickness as measured by MRI was correlated with the endoscopic grade of LTH (P < .001). Multivariate analysis revealed that laryngopharyngeal reflux (P < .001) and body mass index (P = .046) were independently significant factors associated with LTH as measured by MRI.

CONCLUSIONS AND RELEVANCE: Reflux finding score and body mass index were significantly associated with LTH in adults with sleep-disordered breathing, whereas the respiratory parameters were not associated with LTH.