Clinical characteristics of adenotonsillar hypertrophy in children: a retrospective analysis

Objective To explore the clinical characteristics of adenotonsillar hypertrophy (ATH) in children and determine its related clinical indicators. Methods A retrospective cohort of 215 children with ATH who met predefined inclusion and exclusion criteria was identified from newly diagnosed patients presenting to the pediatric department of the study institution between March 1, 2024, and January 2025. Demographic characteristics, clinical data, and laboratory parameters were collected for subsequent univariate and multivariate analyses. Results The cohort comprised 117 boys and 98 girls with a mean age of 5.81 ± 2.13 years, a mean tonsil-to-pharynx ratio (T/P ratio) of 0.60 ± 0.10, and a mean adenoid-to-nasopharynx ratio (A/N ratio) of 0.76 ± 0.08. Notably, A/N ratios differed significantly between children with and without snoring (0.78 ± 0.10 vs. 0.68 ± 0.04; P = 0.003), apnea (0.81 ± 0.10 vs. 0.75 ± 0.09; P < 0.001), and otitis media with effusion (0.81 ± 0.10 vs. 0.75 ± 0.10; P < 0.001). No significant differences in the T/P ratio were found across the assessed clinical symptoms ( P > 0.05). Age, lowest oxygen saturation (LSaO 2 ), and platelet distribution width demonstrated negative correlations with both the A/N ratio and T/P ratio. Conversely, snoring duration, the apnea–hypopnea index, and the platelet-to-lymphocyte ratio (PLR) showed positive correlations with both A/N and T/P ratios. Multivariate analysis of A/N ratios yielded a regression model, with R 2 = 0.793 and F = 88.369 ( P < 0.001). The multivariate regression model for the T/P ratio yielded R 2 = 0.210 and F = 10.104 ( P < 0.001). Conclusion Adenoid and tonsillar hypertrophy have distinct associated factors, and age, PLR, and LSaO₂ aid in assessing pediatric ATH severity.