INCREASED INCIDENCE OF UPPER RESPIRATORY INFECTIONS
Children with sleep disordered breathing get more frequent upper respiratory infections. Adenoid and tonsillar hypertrophy can be divided into two categories, infection and hypertrophy. Frequent upper respiratory infections cause chronic hypertrophy of the tonsils and adenoidal tissue. Many microbes, viruses, fungi, and bacteria are capable of causing infections of the tonsils and adenoids. Antibiotics can kill some but not all of the pathogens. The cause of the hypertrophy in most cases is low grade infection. The hypertrophic tissue that occludes the airway during the day also contributes to obstruction of the airway at night.
Once the diagnosis of pediatric obstructive sleep apnea has been established the first line treatment is surgical removal of the tonsils and adenoids (adenotonsillectomy). About a dozen studies have consistently reported a cure rate of 80%. This is defined as a disappearance of physical signs and symptoms and normalization of respiratory measures. Post-operative persistence of the disease however remains at 20%.
The results of “watchful waiting” in children with tonsil and adenoid hypertrophy and obstructive sleep apnea may deny these children the potential for behavioral, neurocognitive, hypertensive, and somatic improvement and normal facial growth.
Above is a chart used by healthcare professionals for grading of tonsillar size. Large tonsils can contribute to airway obstruction. Parents, you may want to consult with your pediatrician if your kid's tonsils resemble those on the bottom row.