Histological differences between brachycephalic and normocephalic dog palatine tonsils.

Abstract

OBJECTIVE: To compare the histological morphology of palatine tonsils from brachycephalic and normocephalic dogs. MATERIAL AND METHODS: Surgically resected palatine tonsils from 116 dogs undergoing corrective surgery for brachycephalic obstructive airway syndrome (BOAS) were received from a veterinary specialist clinic. Control tonsils were opportunistically collected at autopsy from 11 normocephalic dogs that died of diseases unrelated to the upper respiratory tract. The tonsils were sectioned longitudinally and prepared using standard histological techniques. Digital microscopy was used to obtain standardised measurements of tonsillar epithelium and lymphoid follicles, and the means of these measurements were then compared between the two groups. RESULTS: Epithelial width and lymphoid follicle area were significantly greater for brachycephalic tonsils. Mean epithelium width was 48&#xa0;% thicker (p&#xa0;<&#xa0;0.0001) and mean lymphoid follicle area was 52&#xa0;% larger (p&#xa0;=&#xa0;0.0019) for brachycephalic tonsils compared to normocephalic controls. Inflammation, indicated by neutrophil migration within the epithelium, was found in 54&#xa0;% of brachycephalic tonsils but was absent in controls (p&#xa0;=&#xa0;0.0012). CONCLUSIONS: Significant histopathological differences were found in brachycephalic palatine tonsils compared to normocephalic controls. Changes identified in brachycephalic tonsils included lymphoid and epithelial hyperplasia, and neutrophilic inflammation, which we postulate are secondary to airway irritation caused by BOAS. As these pathological changes in the tonsils are potentially reversible, we hypothesise that they may resolve if the primary BOAS abnormalities are surgically corrected, rendering tonsillectomy unnecessary. Therefore, further research is needed to understand how hyperplastic tonsillar tissue responds to correction of primary BOAS abnormalities, and if tonsillectomy is a necessary component of BOAS corrective surgery.