Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-30T21:20:07.587Z Has data issue: false hasContentIssue false

Cardiopulmonary functions and adenotonsillectomy: surgical indications need revision

Published online by Cambridge University Press:  27 October 2016

M Mahajan
Affiliation:
Department of Otolaryngology – Head and Neck Surgery (ENT), Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
J S Thakur*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery (ENT), Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
R K Azad
Affiliation:
Department of Otolaryngology – Head and Neck Surgery (ENT), Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
N K Mohindroo
Affiliation:
Department of Otolaryngology – Head and Neck Surgery (ENT), Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
P C Negi
Affiliation:
Department of Cardiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
*
Address for correspondence: Dr Jagdeep S Thakur, Department of Otolaryngology – Head and Neck Surgery (ENT), Indira Gandhi Medical College, Shimla, HP 171001, India E-mail: [email protected]

Abstract

Objective:

To assess cardiac functions in adenotonsillar or tonsillar hypertrophy.

Methods:

A prospective, interventional, academic centre based study was conducted on 25 children with adenotonsillar or tonsillar hypertrophy. All patients underwent pulsed 2-dimensional Doppler echocardiography, pulse oximetry and 12-lead electrocardiography. These assessments were repeated three months later to determine the impact of adenotonsillectomy.

Results:

There were significant differences in mean arterial oxygen saturation, pulmonary flow acceleration time and mean pulmonary artery pressure post-operatively. Adenotonsillectomy led to significant improvements in pulmonary flow acceleration time and pulmonary flow velocity time index, while tonsillectomy resulted in right ventricular early and late diastolic velocity index improvement.

Conclusion:

Upper airway obstruction in children affects cardiac functioning and this can subsequently lead to morbidity and delayed growth. Hence, revision of surgical indications is advocated in adenotonsillar hypertrophy to avoid irreversible damage to cardiopulmonary functions.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the All India Rhinology Society annual conference, 2 December 2015, Bareilly, Uttar Pradesh, India.

References

1 Esteller, E. Obstructive sleep apnea-hypopnea syndrome in children: beyond adenotonsillar hypertrophy [in Spanish]. Acta Otorrinolaringol Esp 2015;66:111–19CrossRefGoogle ScholarPubMed
2 Çetin, M, Yılmaz, M, Özen, S, Bozan, N, Coşkun, Ş. Assessment of pulmonary artery pressure and right ventricular function in children with adenotonsillar hypertrophy using different parameters. Int J Pediatr Otorhinolaryngol 2014;78:1837–42CrossRefGoogle ScholarPubMed
3 Koc, S, Aytekin, M, Kalay, N, Ozcetin, M, Burucu, T, Ozbek, K et al. The effect of adenotonsillectomy on right ventricle function and pulmonary artery pressure in children with adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2012;76:45–8CrossRefGoogle ScholarPubMed
4 Simsek, G, Karacayli, C, Ozel, A, Arslan, B, Muluk, NB, Kilic, R. Blood parameters as indicators of upper airway obstruction in children with adenoid or adenotonsillar hypertrophy. J Craniofac Surg 2015;26:e213–16CrossRefGoogle ScholarPubMed
5 Martha, VF, Moreira Jda, S, Martha, AS, Velho, FJ, Eick, RG, Goncalves, SC. Reversal of pulmonary hypertension in children after adenoidectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2013;77:237–40CrossRefGoogle ScholarPubMed
6 Görür, K, Döven, O, Unal, M, Akkuş, N, Ozcan, C. Preoperative and postoperative cardiac and clinical findings of patients with adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2001;59:41–6Google Scholar
7 Kessler, R, Chaouat, A, Weitzenblum, E, Oswald, M, Ehrhart, M, Apprill, M et al. Pulmonary hypertension in the obstructive sleep apnoea syndrome: prevalence, causes and therapeutic consequences. Eur Respir J 1996;9:787–94Google Scholar
8 Oran, B, Ozturk, K, Çimen, D, Vatansev, H, Bulut, S, Arslan, D. Release of NT-pro brain natriuretic peptide in children before and after adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2013;77:666–9Google Scholar
9 Lee, JH, Yoon, JM, Lim, JW, Ko, KO, Choi, SJ, Kim, JY et al. Effect of adenotonsillar hypertrophy on right ventricle function in children. Korean J Pediatr 2014;57:484–8Google Scholar
10 Talaat, AM, Nahhas, MM. Cardiopulmonary changes secondary to chronic adenotonsillitis. Arch Otolaryngol 1983;109:30–3Google Scholar
11 Hay, DW. Putative mediator role of endothelin-1 in asthma and other lung diseases. Clin Exp Pharmacol Physiol 1999;26:168–71Google Scholar
12 Tatlıpınar, A, Biteker, M, Meriç, K, Bayraktar, , Tekkeşin, , Gökçeer, T. Adenotonsillar hypertrophy: correlation between obstruction types and cardiopulmonary complications. Laryngoscope 2012;122:676–80Google Scholar
13 Marangu, D, Jowi, C, Aswani, J, Wambani, S, Nduati, R. Prevalence and associated factors of pulmonary hypertension in Kenyan children with adenoid or adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2014;78:1381–6Google Scholar
14 Pac, A, Karadag, A, Kurtaran, H, Aktas, D. Comparison of cardiac function and valvular damage in children with and without adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2005;69:527–32CrossRefGoogle ScholarPubMed
15 Odemis, E, Catal, F, Karadag, A, Kurtaran, H, Ark, N, Mete, E. Assessment of cardiac function and rheumatic heart disease in children with adenotonsillar hypertrophy. J Natl Med Assoc 2006;98:1973–6Google Scholar
16 van Staaij, BK, van den Akker, EH, Rovers, MM, Hordijk, GJ, Hoes, AW, Schilder, AG. Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial. BMJ 2004;329:651 CrossRefGoogle ScholarPubMed