The roles of the anterior tonsillar pillar and previous tonsillectomy on sleep-disordered breathing.

We conducted a study to determine if there is a correlation between inadequate anterior tonsillar pillar support and sleep-disordered breathing. We examined 11 patients with a history of tonsillectomy to ascertain the structural and functional integrity of their anterior tonsillar pillars. All 11 demonstrated a loss of anterior pillar support and collapse of their soft palate to the extent that the soft palate passively pressed against the posterior pharyngeal wall. We conclude that a deficiency of anterior tonsillar pillar support does indeed predispose patients to obstructive sleep apnea syndrome. Knowledge of this correlation can help guide the method of surgical treatment and should reinforce the need to maintain the integrity of the anterior tonsillar pillars.