-Case Reports-

An 8-year-old Girl with a Recurrence of Obstructive Sleep Apnea Syndrome Caused by Hypertrophy of Tubal Tonsils 4 Years after Adenotonsillectomy

Makoto Migita¹, Yoshihiro Gocho¹, Takahiro Ueda¹, Hideto Saigusa² and Yoshitaka Fukunaga¹

¹Department of Pediatrics, Graduate School of Medicine, Nippon Medical School
²Department of Head & Neck and Sensory Organ Science, Graduate School of Medicine, Nippon Medical School

Obstructive sleep apnea syndrome affects 1% to 2% of children. It is caused mainly by upper airway obstruction and manifests as snoring and sleep disturbance. Adenotonsillectomy can improve quality of life because airway obstruction occurs when both tonsils and adenoids are enlarged. We describe an 8-year-old girl with a recurrence of obstructive sleep apnea syndrome caused by hypertrophy of the tubal tonsils 4 years after adenotonsillectomy. The findings from this case highlight the importance of 1) identifying hypertrophy of the residual adenoid and compensatory hypertrophy of the tubal tonsils in patients with obstructive sleep apnea syndrome after adenotonsillectomy and 2) determining the optimal timing of adenotonsillectomy with respect to both the severity of obstructive sleep apnea and compensatory hypertrophy of other lymphoid tissue of Waldeyer's ring, as growth of such tissues is most active during the first several years of life.

J Nippon Med Sch 2010; 77: 265-268

Keywords
adenotonsillectomy, obstructive sleep apnea syndrome (OSAS)

Correspondence to
Makoto Migita, MD, PhD, Department of Pediatrics, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
mmigita@nms.ac.jp

Received, April 21, 2010
Accepted, July 26, 2010