Pediatric oropharyngeal microbiome: Mapping in chronic tonsillitis and tonsillar hypertrophy

Background: Tonsillar hypertrophy is a common clinical condition seen by an otorhinolaryngologist. Tonsils undergo hypertrophy due to recurrent infection or as a part of generalized lymphoid hypertrophy. The aim of this study is to clinically correlate the association between tonsillar hypertrophy and acute/chronic tonsillitis.Methods: 100 patients attending the Oto-Rhino-Laryngology Department at Vijayanagar Institute of Medical Sciences, Ballari, Karnataka with complaints of tonsillitis acute, chronic, acute on chronic, other ENT symptoms and asymptomatic patients were assessed for tonsillar enlargement using Brodsky Tonsillar Grading scale for tonsillar hypertrophy. Results: Out of the 100 patients with tonsillar enlargement and the symptoms at presentation we observed a statistically significant (p=0.0001) irrespective of the severity of the infection to the tonsillar hypertrophy graded according to Brodsky tonsillar grade.Conclusions: It is a common prudence that most of the general public and majority of general physicians are of the opinion that tonsillar grades are related to clinical pathology. Our study reveals tonsillar hypertrophy and severity of clinical disease are not directly proportional hence our study indicates management of acute or chronic tonsillitis cannot be influenced by the grade of tonsillar enlargement. We can consider tonsillar enlargement as a guide for prognostic evaluation. We were unable to find any literature regarding our objective of study. Hence this study can be considered as a stepping stone for further in depth clinical studies.

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Subtotal intracapsular tonsillectomy may be the first choice for tonsillectomy in children

Journal of International Medical Research ◽

10.1177/03000605211011930 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110119

Author(s):

Jie Wang ◽

Pan-hong Dang ◽

Huan-huan Chang ◽

Zi-han Wang

Keyword(s):

Quality Of Life ◽

Postoperative Pain ◽

Chronic Tonsillitis ◽

Tonsillar Hypertrophy ◽

Obstructive Sleep ◽

First Choice ◽

Scale Scores ◽

The Face ◽

Intracapsular Tonsillectomy

Objective To investigate the effect and prognosis of subtotal intracapsular tonsillectomy. Methods All children (n=162) with tonsillar hypertrophy and chronic tonsillitis were randomly divided into two groups: tonsillectomy (n=75) and subtotal intracapsular tonsillectomy (n=87). Tonsillectomy: the tonsillar tissue was completely removed along with the tonsillar capsule. Subtotal intracapsular tonsillectomy: 80% to 90% of the tonsils and the complete epithelium of the tonsillar crypts were removed without damaging the tonsillar capsule. The Face, Legs, Activity, Cry, and Consolability (FLACC) and parents’ postoperative pain measure (PPPM) scales were used to evaluate postoperative pain, and the obstructive sleep apnea (OSA)-18 questionnaire was used to assess the children’s postoperative quality of life. The patients were followed-up for 2 years. Results 1. The FLACC and PPPM scales indicated that the children’s postoperative pain after subtotal intracapsular tonsillectomy was significantly less than that of children undergoing tonsillectomy. 2. The OSA-18 scale scores indicated that subtotal intracapsular tonsillectomy significantly improved the children’s quality of life. 3. Two years after subtotal intracapsular tonsillectomy, no patients required reoperation. Conclusion Subtotal intracapsular tonsillectomy may be the first choice for tonsillar hypertrophy and chronic tonsillitis patients.

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Palatine Tonsilloliths and Actinomyces: A Multi-institutional Study of Adult Patients Undergoing Tonsillectomy

Otolaryngology ◽

10.1177/0194599820921392 ◽

2020 ◽

Vol 163 (4) ◽

pp. 743-749

Author(s):

Simone Arvisais-Anhalt ◽

Andrew Quinn ◽

Justin A. Bishop ◽

Cynthia S. Wang ◽

Ron B. Mitchell ◽

...

Keyword(s):

Treatment Strategies ◽

Clinical History ◽

Adult Patients ◽

Chronic Tonsillitis ◽

Second Primary ◽

Tonsillar Hypertrophy ◽

Recurrent Tonsillitis ◽

Retrospective Case ◽

Primary Driver ◽

Pathology Reports

Objective To better characterize associations between Actinomyces and tonsillolith versus nontonsillolith tonsillectomy specimens. Study Design Bi-institutional retrospective case-case study. Setting University and county hospital. Subjects and Methods Adult patients with a clinical history of tonsilloliths who underwent tonsillectomy from January 2006 to December 2018 were included. Patients undergoing tonsillectomy for tonsillar hypertrophy and chronic tonsillitis were identified as comparative cases. Similarly, patients with ipsilateral oropharyngeal cancer (OPC) who underwent contralateral tonsillectomy of a normal-appearing tonsil for prophylaxis against a second primary cancer were also included as comparative cases. Results The study population comprised 134 patients who underwent tonsillectomy: 62 tonsillolith and 72 nontonsillolith (tonsillar hypertrophy, n = 30; chronic tonsillitis, n = 30; normal-appearing contralateral tonsil in patients with ipsilateral OPC, n = 12). Actinomyces was reported in 11% of the patients with tonsilloliths on initial pathology reports but in 95% after re-evaluation (n = 54 of 57). Actinomyces prevalence was significantly higher in patients with tonsilloliths as compared with patients with recurrent tonsillitis (73%, n = 22 of 30, P < .001) and normal-appearing contralateral tonsils in patients with ipsilateral OPC (58%, n = 7 of 12, P < .001). Actinomyces prevalence was not significantly different between patients with tonsilloliths and tonsillar hypertrophy (83%, n = 25 of 30, P = .11). Conclusion The prevalence of Actinomyces in tonsillolith tonsil specimens is high; however, Actinomyces routinely colonizes nontonsillolith tonsil specimens. Therefore, Actinomyces is unlikely to be the primary driver of tonsillolith pathogenesis, and Actinomyces-targeted treatment of tonsilloliths may not be effective. Treatment strategies addressing tonsilloliths should be further investigated.

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Apoptosis in chronic tonsillitis and tonsillar hypertrophy

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2014.12.005 ◽

2015 ◽

Vol 79 (2) ◽

pp. 191-195 ◽

Cited By ~ 6

Author(s):

Merih Önal ◽

Taner Yılmaz ◽

Elif Bilgiç ◽

Sevda Fatma Müftüoğlu ◽

Oğuz Kuşçu ◽

...

Keyword(s):

Chronic Tonsillitis ◽

Tonsillar Hypertrophy

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Tonsillar Microbiota: a Cross-Sectional Study of Patients with Chronic Tonsillitis or Tonsillar Hypertrophy

mSystems ◽

10.1128/msystems.01302-20 ◽

2021 ◽

Vol 6 (2) ◽

Author(s):

Shengru Wu ◽

Lalle Hammarstedt-Nordenvall ◽

Mattias Jangard ◽

Liqin Cheng ◽

Sebastian Alexandru Radu ◽

...

Keyword(s):

16S Rrna Gene Sequencing ◽

Research Area ◽

Cross Sectional Study ◽

Immune Defense ◽

Oral Microbiome ◽

Chronic Tonsillitis ◽

Rrna Gene ◽

Tonsillar Hypertrophy ◽

Cross Sectional ◽

Microbial Biomarkers

ABSTRACT Chronic tonsillitis (CT) and tonsillar hypertrophy (TH) are common tonsillar diseases that are related to infection and inflammation. Little is known about tonsillar microbiota and its role in CT and TH. This study aims to identify palatine tonsillar microbiota both on the surface and in the core tissues of CT and TH patients. In total, 22 palatine tonsils were removed and collected from CT and TH patients who underwent surgery. The surface and core microbiota in the tonsils of CT and TH patients were compared using 16S rRNA gene sequencing of V3-V4 regions. Differential tonsillar microbiotas were found in the CT versus TH patients and surface versus core tissues. Further, a higher relative abundance of bacterial genera, including Haemophilus, Streptococcus, Neisseria, Capnocytophaga, Kingella, Moraxella, and Lachnospiraceae [G-2] in patients with TH and Dialister, Parvimonas, Bacteroidales [G-2], Aggregatibacter, and Atopobium in patients with CT, was observed. Of these, the differential genera of Dialister, Parvimonas, and Neisseria served as key factors in the tonsillar microbiota network. Notably, four representable tonsillar microbial types were identified, with one, consisting of a higher abundance of Haemophilus and Neisseria, exclusively detected in the TH patients. This study analyzed the different tonsillar microbiota from the surface and core tissues of CT and TH patients. Several bacteria and various microbial types related to CT and TH were identified, along with potential bacterial networks and related immune pathways. IMPORTANCE The human microbiota has been shown to be functionally connected to infectious and inflammation-related diseases. So far, only limited studies had been performed on tonsillar microbiota, although tonsils play an essential role in the human immune defense system and encountered numerous microorganisms. Our work presented different tonsillar microbiota from surface and core tissues of chronic tonsillitis (CT) and tonsillar hypertrophy (TH) patients. Notably, one tonsillar microbiota type, which contains a higher abundance of Haemophilus and Neisseria, was only detected in the TH patients. Furthermore, certain bacteria, such as Haemophilus, Neisseria, Dialister, and Parvimonas, may serve as microbial biomarkers to discriminate CT patients from TH patients. These data provide important microbiota data in the tonsillar research area and are highly useful for researchers both in the oral microbiome field and clinical field.

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Helicobacter pylori in the tonsillar tissue: a possible association with chronic tonsillitis and laryngopharyngeal reflux

The Journal of Laryngology & Otology ◽

10.1017/s0022215117000597 ◽

2017 ◽

Vol 131 (6) ◽

pp. 549-556 ◽

Cited By ~ 9

Author(s):

N Siupsinskiene ◽

I Katutiene ◽

V Jonikiene ◽

D Janciauskas ◽

S Vaitkus

Keyword(s):

Helicobacter Pylori ◽

Laryngopharyngeal Reflux ◽

Chronic Tonsillitis ◽

Control Group ◽

Tonsillar Hypertrophy ◽

Posterior Commissure ◽

Tissue Samples ◽

Tonsillar Tissue ◽

Significant Relationships ◽

H Pylori

AbstractObjective:To identify Helicobacter pylori infection in tonsillar tissue samples from patients undergoing tonsillectomy for chronic tonsillitis versus tonsillar hypertrophy, and to assess the possible relationships between H pylori and patients’ sociodemographic data and laryngopharyngeal reflux.Methods:In this prospective study, 97 patients who underwent tonsillectomy were divided into the following 2 groups: patients with chronic tonsillitis (n = 62) and patients with tonsillar hypertrophy (control group; n = 35). H pylori infection in the tonsillar biopsy samples was identified using histochemical and rapid urease tests.Results:The incidence of H pylori infection was significantly higher in the chronic tonsillitis group (56.5 per cent) compared to the control group (31.4 per cent). Similar findings were obtained for both subgroups of adults (68.6 vs 42.3 per cent) and children (40.7 vs 0.0 per cent). Significant relationships between a positive H pylori finding and laryngopharyngeal reflux related signs of vocal fold oedema, diffuse laryngeal oedema and hypertrophy of the posterior commissure were revealed.Conclusion:H pylori infection may be related to chronic tonsillitis and laryngopharyngeal reflux.

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