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Excessive Reactive Lymphoid Hyperplasia in a Child With Persistent Obstructive Sleep Apnea Despite Previous Tonsillectomy and Adenoidectomy

Acar, Gül Özbilen MD*; Cansz, Harun MD†ı; Duman, Cihan MD; Öz, Büge MD; Ciğercioğullar, Engin MD‡ı

Journal of Craniofacial Surgery: July 2011 - Volume 22 - Issue 4 - p 1413-1415
doi: 10.1097/SCS.0b013e31821cc528
Clinical Studies

Both lingual tonsil and adenoid are the lymphoid tissue members of Waldeyer ring. Enlargement of the lingual tonsil and adenoid occurs in children with persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy relatively frequently.

In this article, we present a case with upper airway obstruction and infection findings because of excessive lingual tonsil and adenoid tissue hyperplasia and, additionally, bilateral multiple cervical lymphadenopathies. The patient had had tonsillectomy and adenoidectomy 8 years ago. Etiopathogenetic mechanisms, clinical, radiologic, histopathologic aspects, and surgical therapeutic options for obstructive sleep apnea related to excessive reactive lymphoid hyperplasia in children are discussed reviewing the literature.

From the *Istanbul Goztepe Training and Research Hospital; and Departments of †Otorhinolarygology and ‡Pathology, Cerrahpaşa Medical School, Istanbul University, Istanbul, Turkey.

Received November 25, 2010.

Accepted for publication January 30, 2011.

Address correspondence and reprint requests to Gul Ozbilen Acar, MD, Ata ¾ Daire: 249 38, Ada Sedef, Cad. 34758, Atasehir, Istanbul, Turkey; E-mail:

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD