Role of Allergy, Respiratory Infection, and Passive Smoking in Early Onset Adenotonsillar Hypertrophy

Objective: The aim of this study was to examine the relationship between allergic diseases and the time of Adenotonsillar Hypertrophy (ATH) onset. We also investigated whether there is any relationship between upper respiratory tract infection (URTI) or exposure to parental smoking and ATH. Methods: A cross sectional study was conducted in multiple tertiary care centers. We interviewed all parents of subjects aged 1 month to 15 years admitted for adenotonsillectomy from January 2016 to January 2017. The parents were asked questions regarding the time of ATH-related symptom onset, demographic information, allergic history of the child and parents, frequency of URTI, and passive smoking. Results: There were 252 subjects, and the mean age (±SD) was 5.91 ± 3.02 years. The data indicate 63.1% of the early onset group had a significant personal history of allergy. In the late onset group, the incidence was 55.9% (p= 0.261). Additionally, 64.1% of the early onset group subjects had a parental history of allergy. In the late onset group 64.7% of subjects had a parental history of allergy (p= 0.920). Only 8.7% of early onset group and 8.1% of late onset group were exposed to parental smoking (p= 0.857). The incidence of subjects who had URTIs 1-3 times/year was 18.8% in the early group and 32.6% in the late onset group. The incidence of subjects who had URTIs 4-6 times/year was 35.6% and 30.3% respectively. The rates of subjects with more than 6 URTIs per year were 45.5% and 37.1% respectively (p=0.038). In the early onset group the frequency of subjects with atopic dermatitis, bronchial asthma, and food allergy was higher than in the late onset group (p= 0.349, 0.11, 0.015 respectively). However, the frequency of subjects with allergic rhinitis, allergic conjunctivitis and parental allergy was lower than that in the late onset group (p= 0.381, 0.138, 0.920 respectively). Conclusion: Our data indicate only food allergy was significantly associated with early onset ATH. We also found higher frequencies of UTRIs are associated with a higher incidence of ATH. Abbreviations: ATH: Adenotonsillar Hypertrophy; URTI: upper respiratory tract infection; RAST: Radio Allergosorbent Test; AR: Allergic Rhinitis; AC: Allergic Conjunctivitis; AD: Atopic Dermatitis; BA: Bronchial Asthma; FA: Food Allergy