Impact of adenotonsillar hypertrophy on craniofacial and general growth: A narrative review

Abstract

The adenoids and tonsils, integral components of Waldeyer's ring, are vital for immune defense during childhood but can cause significant health issues when hypertrophied. This review explores the impact of adeno-tonsillar hypertrophy on pediatric craniofacial development, general growth, and immune function. Enlarged adenoids and tonsils are strongly associated with obstructive sleep-disordered breathing, which can lead to impaired physical growth, cognitive development, and craniofacial abnormalities such as malocclusion and altered mandibular growth. Adeno-tonsillectomy is the primary treatment for pediatric obstructive sleep apnea (PedOSA), with proven benefits in quality of life, respiratory function, and growth. However, residual PedOSA persists in many cases, necessitating long-term follow-up and adjunct therapies. Recent advances in surgical techniques have improved outcomes by reducing postoperative complications. Emerging studies challenge traditional models of lymphoid tissue growth, revealing age-, sex-, and region-specific variations that emphasize the need for personalized treatment strategies. Future research should focus on genetic and environmental factors influencing lymphoid tissue growth, optimizing intervention timing, and evaluating long-term outcomes to enhance pediatric care.