Influence of Waldeyer's ring hypertrophy on snoring and sleep apnea

Severe adenotonsillar hypertrophy can be the main cause of nocturnal respiratory affections, as confirmed by the improvement of symptoms seen after adenotonsillectomy. Unsuccessful surgical treatment can be due to craniofacial morphological alterations. Hypotony of the pharyngeal muscles could also be responsible together with tonsil hypertrophy. In our study, we enrolled 125 patients (87 males and 38 females), aged from 3 to 8 years, suffering from chronic snoring. All the patients underwent adenotonsillectomy. The follow-up was carried out at 2, 4 and 6 months after the operation. Snoring and nocturnal apneas were no longer present in almost all the patients. Overnight polysomnography remains the gold standard diagnostic test for obstructive sleep apnea syndrome, but its feasibility in clinical practice is debated. Rhinomanometry, which gives an objective evaluation of ventilatory nasal function, acoustic rhinometry, which measures the cross-section in fixed nasal areas, and nasal mucociliary transport time can be considered useful tests to evaluate the cause of respiratory obstruction.