Association between adenotonsillar hypertrophy and sickle cell disease in adolescents

Aim of the study
To assess the association between sickle cell disease and adenotonsillar hypertrophy in adolescents.

Material and methods
The study group consisted of adolescents aged between 12 and 16 years with sickle cell disease. The control group consisted of adolescents of the same age group who did not have this disorder. The adolescents underwent oropharyngoscopy and transnasal endoscopy. The palatine tonsils were classified according to Brodsky’s criteria, and those with grade three or four were considered hypertrophic. Regarding the pharyngeal tonsil, two criteria were adopted. It was considered obstructive when there was minimal occlusion of the choanae of 50%, and when the obstruction was equal to or greater than 70%. Adenotonsillar hypertrophy was diagnosed when the pharyngeal tonsils and/or palatine tonsils were obstructive.

Results
In the study group, 31.3% of the adolescents had hypertrophic palatine tonsils, and in the control group, 2.6% exhibited that condition (p < 0.001). With respect to the pharyngeal tonsils, when the criterion of minimal obstruction of the choanae was 50%, 54.2% of the adolescents of the study group and 15.8% of the control group were diagnosed with hypertrophy (p < 0.001). When the criterion for minimal occlusion of the choanae was 70%, the frequency was 35.4% in the study group, and 7.9% in the control group (p = 0.004). Regarding adenotonsillar hypertrophy, when the criterion of the occlusion of the choanae was 50%, it occurred in 58.3% of the adolescents of the study group and 18.4% of the control group (p < 0.001). When the criterion for minimal obstruction of the choanae was 70%, it was observed that adenotonsillar hypertrophy occurred in 45.8% of the adolescents of the study group and in 10.5% of the control group (p < 0.001).

Conclusions
Adenotonsillar hypertrophy was associated with sickle cell disease in adolescents.