Tonsil volume and allergic rhinitis in children

Tonsil hypertrophy (TH) is very common in children. Previously, it has been reported that an inverse relationship exists between adenoid hypertrophy (AH) and allergic rhinitis (AR). This study aimed to investigate the possible relationship between tonsil volume and AR diagnosis in a group of children complaining of upper airways obstruction. Globally, 171 children (91 boys; mean age, 6.6 years) were studied. Clinical visit, nasal endoscopy, and skin-prick test were performed in all patients. TH and anterior nasal obstruction were graded using the Friedman’s classifications. Adenoid volume was graded using the Parikh’s classification. Fifty-eight children (33.9%) had relevant TH (grades 3–4); 77 children (44.94%) had AR. There was a strong correlation (gamma 0.564; p 0.001) between TH and AH. Tonsil volume was inversely associated with AR diagnosis (odds ratio [OR], 0.314). Risk factors for TH were intense mucosal inflammation (pale mucous membranes) and AH (OR, 3.54 and 2.856, respectively). This study shows that large tonsils are negatively associated with allergy, whereas intense inflammation is a risk factor for TH; AH may be frequently associated with TH. (Allergy Rhinol 5:e137–e142, 2014; doi: 10.2500/ar.2014.5.0095) The palatine tonsils are part of the lymphoid tissuethat surrounds the pharynx: collectively defined as the Waldeyer’s ring. Tonsils physiologically serve as a defense against inhaled antigens (microbes, allergens