Palatine Tonsil Measurements among Healthy Sudanese Children Using Ultrasonography

Abstract

Background: Palatine tonsils (PT) reach their maximum normal size in early childhood; after puberty and with other body lymphatic tissue, they gradually atrophy. PT are usually easily seen in the oropharynx during the oral examination. However, clinical size assessment is difficult since the tongue's posture may significantly alter its appearance. The aim of this study was to evaluate normal PT size in healthy children by ultrasound using the anteroposterior and transverse diameters and correlate them with age, weight, and gender. Methods and Results: This cross-sectional study was conducted at different nurseries and schools in Khartoum. A random sample of 79 Sudanese children and adolescents (39 males and 40 females) aged 1–15 years, without PT pathology, was examined. The anteroposterior diameter (APD) and transverse diameter (TD) for both tonsils were measured by ultrasound. APD and TD were 1.46±0.16 cm and 1.38±0.16 cm, respectively, for the right PT and 1.51±0.15 cm and 1.40±0.16 cm for the left PT. The APD was significantly higher than the TD on both sides (P<0.01 in both cases). In addition, L(left)PT-APD was significantly greater than R(right)PT-APD (1.51±0.15 vs. 1.46±0.16, P=0.0044). We found a low-to-moderate positive correlation between all PT measurements with children's age and weight (P<0.01). There was no significant association between PT size and gender. Conclusion: Ultrasound is a reliable, simple, noninvasive procedure for estimating PT size in children. Normal PT size correlates with age and weight; however, no correlation is present for gender. Normal PT sizes (APD and TD) in children and adolescents may be predicted based on age and weight using developed equations.