Tonsillar enlargement in apparently healthy adults in a rural community in Nigeria

Abstract

Background: Tonsillar enlargement could worsen airway obstruction thereby causing apnea and hypoventilation. This is rarely investigated especially in developing country, hence this study which was aimed at determining the prevalence of enlarged palatine tonsils and comparing the degree of obstruction with selected anthropometric measurements in healthy adults in a rural community.
Methods: A cross-sectional study of apparently healthy adults (≥ 18 years) in Oyo community, South Western Nigeria. The participants were selected using multistage random sampling technique. Interviewer assisted structured questionnaire was administered to obtain information on age, gender, occupation, history of smoking and snoring. Ear, nose and throat examination was done and Brodsky grading of tonsil documented. The neck circumference (cm), weight (kilogram) and height (meter) were measured and their Body Mass Indices (BMI) calculated. The data was analysed using IBM- Statistical Package for Social Sciences (SPSS) version 20 and text of association between tonsillar grade, and BMI and Neck circumference was performed using Chi Square.
Results: Participants were 408 subjects, consisting 202 (49.5%) males and 206 (50.5%) females, the mean age was 37 ± 15.2 years. One hundred and fifteen (28.2%) participants had enlarged Palatine tonsils of which; 70 (17.2%) had grade 1 enlargement, 33(8.1%) had grade II enlargement, and 12(2.9%) had grade III enlargement. None of the participants had grade IV tonsillar enlargement. The Mean Body Mass 2 Index was 24.32 ± 4.50 kg/m and mean neck circumference was 34.08 ± 2.70cm. Palatine tonsillar enlargement was significantly associated with young age (p = 0.01), female gender (p = 0.02), and neck circumference (p =0.01), but not with high BMI (P = 0.06).
Conclusion: Tonsillar enlargement is prevalent, and it is associated with young age, and female gender, but not with Body Mass Index and neck circumference.

Keywords: Adults, Body mass index, Gender, Neck circumference, Palatine Tonsil