Do pre-adenotonsillectomy echocardiographic findings change postoperatively in children with severe adenotonsillar hypertrophy.

Abstract

Hypertrophy of adenotonsillar tissue is one of the most common problems in childhood age and causes upper airway obstruction and even obstructive sleep apnea symptoms in severe forms. The aim of this study is to evaluate the changes of pre-adentonsillectomy echocardiographic findings after operation.From August 2007 to November 2008, 55 children with adenotonsillar hypertrophy and obstructive-sleep symptoms (aged 3-11آ years old of which 35 were males and 20 females) were randomly selected. Preoperatively echocardiography was performed for all patients by the pediatric cardiologist. In control group 55 children who referred to otolaryngology clinic because of non adenotonsillar related disease evaluated. One month and six months after operation, patients with positive findings were followed up and again echocardiography was performed separately.No complaints of apnea were reported. Tonsillar grades of all cases were type III or IV. The preoperative mean pulmonary arterial pressure levels of the 4 (7.3%) children were higher than normal range (25آ mmآ Hg) and it decreased significantly after operation (Pآ <آ 0.000) (Preoperative MPAPآ =آ 32آ آ±آ 3آ mmآ Hg, and six months postoperative follow up, MPAPآ =آ 11آ آ±آ 5آ mmآ Hg). All the patients' parents complained about severe open mouth snoring, agitated sleep and hyperpnoea of their children. The preoperative tricuspid regurgitation pressure level of 7 children was higher than normal range and it decreased significantly after operation (Pآ <آ 0.000 preoperative TRآ =آ 34آ آ±آ 8آ mmآ Hg postoperative TRآ =آ 19آ آ±آ 6آ mmآ Hg). AC/ET in these seven patients were lower than 0.4. In control group echocardiography findings are normal.Severe chronic hypertrophic adenotonsillar tissue caused higher tricuspid regurgitation pressure and mean pulmonary arterial pressure.