Tonsil Hipertrofisinde Bağ Dokusu ve Lenfoid Dokunun Rolü

Year 2021, Volume: 16 Issue: 2, 159 - 164, 07.07.2021

Mehmet Emre Sivrice , Hasan Yasan , Gamze Erkılınç , Nermin Karahan , Vural Akın

https://doi.org/10.17517/ksutfd.791243

Abstract

Amaç: Bu çalışmada tonsillektomi materyallerindeki mikroanatomik yapı farklılıklarını belirlemek için bağ dokusu ve lenfoid doku oranlarının incelenmesi amaçlanmıştır.

Yöntemler: Tonsillektomi materyalleri 3-13 yaş arası hastalardan toplandı ve üç grup oluşturuldu. Grup 1’de tonsil hacmi 3 cc’den fazla olup rekürren tonsillit öyküsü olan hastalar, grup 2’de tonsil hacmi 3 cc’den fazla olup rekürren tonsillit öyküsü olmayan hastalar ve grup 3’te tonsil hacmi 2 cc’den az olup rekürren tonsillit öyküsü olan hastalar yer aldı. Masson’s Trichrome ile boyanan kesitler bağ ve lenfoid doku açısından değerlendirildi. Python programlama dili kullanılıp piksel sayımı yapılarak bağ dokusu alanlarının yaklaşık oranı hesaplandı.

Bulgular: Ortalama bağ dokusu yüzdeleri grup 1’de 5,45 ± 2,50, grup 2’de 5,45 ± 2,42 ve grup 3’te 10,90 ± 3,41’di. Grup 3’te grup 1 ve grup 2’ye göre anlamlı olarak daha yüksek bağ dokusu oranları tespit edildi (p= 0,001). Lenfoid doku, grup 1 ve grup 2’de grup 3’e göre anlamlı olarak daha yüksekti (p=0,001). Folikül sayıları üç grup arasında anlamlı olarak farklıydı (p=0,032).

Sonuç: Tonsil hipertrofisinin oluşum mekanizması henüz aydınlatılamamıştır. Biz tonsil hacmi arttıkça lenfoid dokunun da arttığı sonucuna ulaştık. Tekrarlayan inflamasyon ile palatin tonsilin mikroanatomik yapıları arasındaki ilişki, önceden tahmin edilen bilgilerden daha karmaşık görünmektedir.

Keywords

Palatin tonsil, hipertrofi, bağ dokusu, lenfoid doku

Supporting Institution

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Project Number

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Thanks

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The Role of Connective and Lymphoid Tissues in Tonsil Hypertrophy

Abstract

Objective: This study aimed to investigate connective tissue and lymphoid tissue ratios in tonsillectomy specimens to determine differences between microanatomical structure.

Methods: Tonsillectomy materials were collected from patients aged 3-13 years and three groups were created. Patients with larger tonsils than 3 cc and had recurrent tonsillitis history were included to the Group 1, larger tonsils than 3 cc without recurrent tonsillitis history were included to the Group 2 and tonsil sizes less than 2 cc with recurrent tonsillitis history were included to the Group 3. Masson’s Trichrome stained slides were evaluated to determine the connective and lymphoid tissues. We use Python programming language and count pixels to calculate the approximate ratio of the connective tissue area.

Results: The mean connective tissue percentages were 5.45±2.50 in group 1, 5.45±2.42 in group 2 and 10.90±3.41 in group 3. There was significantly higher connective tissue ratios in group 3 compared to group 1 and group 2 (p=0.001). Lymphoid tissue was significantly higher in group 1 and group 2 compared to group 3 (p=0.001). Follicle numbers were significantly different among 3 groups (p=0.032).

Conclusion: The mechanism of the tonsillar hypertrophy has not been elucidated, yet. We found that; as long as the tonsil volume increases, lymphoid tissue ratio increases to. Relationship between recurrent inflammation and microanatomical structures of the palatine tonsil seem to be more complicated than previously supposed knowledge.

Keywords

Palatine tonsil, hypertrophy, connective tissue, lymphoid tissue

Project Number

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References

• Ogra PL. Mucosal immune response in the ear, nose and throat. Pediatr Infect Dis J. 2000;19(5):4-8.
• Parker NP, Walner DL. Trends in the indications for pediatric tonsillectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol. 2011;75(2):282-285.
• Hanege FM, Acar GO, Tekin M, Ozkanlı S, Saygı HI. What is the cause of hypertrophia in asymmetric tonsils?. B-ENT. 2016;12(3):175-179.
• Kalcioglu MT, Gurses I, Erdem T. Is the pathological examination of routine tonsillectomy and adenoidectomy specimens necessary? A retrospective study of 559 adenoidectomy and 1132 tonsillectomy specimens and a literature review. B-ENT. 2010;6(2):91-95.
• Sağıroğlu A, Acer N, Okuducu H, Ertekin T, Erkan M, Durmaz E, et al. Palatine tonsil volume estimation using different methods after tonsillectomy. Anat Sci Int. 2017;92(4):500-508.
• Koch RJ, Brodsky L. Qualitative and quantitative immunoglobulin production by specific bacteria in chronic tonsillar disease. Laryngoscope. 1995;105(1):42-48.
• Bieluch VM, Martin ET, Chasin WD, Tally FP. Recurrent tonsillitis: histologic and bacteriologic evaluation. Ann Otol Rhinol Laryngol. 1989;98(5):332-335.
• Alatas N, Baba F. Proliferating active cells, lymphocyte subsets, and dendritic cells in recurrent tonsillitis: their effect on hypertrophy. Arch Otolaryngol Head Neck Surg. 2008;134(5):477-483.
• Zhang PC, Pang YT, Loh KS, Wang DY. Comparison of histology between recurrent tonsillitis and tonsillar hypertrophy. Clin Otolaryngol Allied Sci. 2003;28(3):235-239.
• Yılmaz T, Kocan EG, Besler HT, Yılmaz G, Gursel B. The role of oxidants and antioxidants in otitis media with effusion in children. Otolaryngol Head Neck Surg. 2004;131(6):797-803.
• Bellioni P. Histological changes in chronic allergic tonsillitis. Clin Otolaryngoiatr. 1968;20(2):116-124.
• Endo LH, Vassalo J, Leitão SR. Allergic tonsillitis: histopathological study. Adv Otolaryngol. 1992;47:41-45.
• Zieliński A, Dobek-Smiech J, Fortak W, Brzezińska H, Zakrzewska A. Clinical and histological studies of pharyngeal tonsil in children. Otolaryngol Pol. 1985;39(1):47.
• Sadeghi-Shabestari M, Moghaddam YJ, Ghaharri H. Is there any correlation between allergy and adenotonsillar tissue hypertrophy. Int J Pediatr Otorhinolaryngol. 2011;75(4):589-591.
• Yasan H, Aynali G, Erdogan O, Yariktas M. Does subjective tonsillar grading reflect the real volume of palatine tonsils. Int J Pediatr Otorhinolaryngol. 2011;75(5):618-619.
• Friedman M, Tanyeri H, La Rosa M, Landsberg R, Vaidyanathan K, Pieri S, et al. Clinical predictors of obstructive sleep apnea. Laryngoscope. 1999;109(12):1901-1907.