The Relationship Between Tonsillar Size and Neutrophil-to-Lymphocyte Ratio in Children With Recurrent Tonsillitis.
In total, 236 children who underwent tonsillectomy with a diagnosis of recurrent tonsillitis were included. The patients were divided into four groups according to the tonsillar sizes.
Group A was consist of 56 children with grade 1 tonsil size, while group B, C and D was consist of 58, 70 and 52 children with grade 2, 3 and 4 tonsil size, respectively. Pre-operative NLR values of all groups were compared with measurements in the post-operative third month.
In group A, pre-operative NLR levels were 1.76±0.92, while post-operative NLR were 1.74±1.53. No statistically significant difference in NLR values was observed between pre- and post-operatively in group A (p=0.864). In group B, pre-operative NLR levels were
1.56±1.14, while post-operative NLR were 1.29±0.65.
In group C, pre-operative NLR levels were 1.48±1.47, while post-operative NLR were 1.22±0.79. In group D, pre-operative NLR
levels were 1.44±1.52, while post-operative NLR were 1.19±0.96. Post-operative NLR values were significantly lower than pre-operative NLR values in both groups B, C, D (p=0.012, p=0.036, p=0.043, respectively).
Acute tonsillitis is usually diagnosed by clinical acute inflammatory manifestations such as hyperemic tonsils, exudation, and ulceration. Approximately 5 to 17% of cases are bacteriological which is mostly group A beta-hemolytic streptococci, although the most common etiological agent is viral.
As previously described by Paradise, recurrent tonsillitis is defined as seven episodes within one year or five episodes in the preceding two years and more or three episodes in the preceding three years and more.
Many factors are blamed for the development of recurrent tonsillitis. These include patient incompliance, premature cessation of antibiotherapy, inadequate antibiotic absorbance, bacterial tolerance, bacterial load, bacterial biofilms, and immune system deficiencies.
Otolaryngol Open J. 2016; 2(5): 120-124. doi: 10.17140/OTLOJ-2-127
