The effects of tonsillectomy and adenoidectomy on pulmonary arterial pressure in children.

摘要

PURPOSE: It is well known that hypertrophic tonsils and adenoids may cause upper-airway obstruction. The aim of this study is to determine the mean pulmonary arterial pressure (mPAP) in children with hypertrophic tonsils and adenoids and to clarify whether tonsillectomy and adenoidectomy (T&A) has any effect on mean pulmonary arterial pressure of these children. MATERIALS AND METHODS: Fifty-two randomly selected children (36 male, 16 female) aged between 4 and 11 (mean 7.7+/-2.5) a with a diagnosis of upper-airway obstruction resulting from hypertrophied tonsils and adenoids were included in our study. Thirty-three children were assigned as controls with similar age and sex distribution with the study groups. Mean pulmonary arterial pressure was measured by using Doppler echocardiography preoperatively and mean 5.4+/-2.9 months postoperatively in all subjects. RESULTS: When the mean pulmonary arterial pressure values of study and control group compared preoperatively, the mean pulmonary arterial pressure levels of the children in the study group were significantly higher than the mean pulmonary arterial pressure levels of the children in the control group (P<.05) (study group mean PAP=23.13+/-7.68, control group mean PAP=16.11+/-7.24) (Levene's test, P<.05). When the preoperative and postoperative results were compared, it was found that there was a statistically significant decrease in mean pulmonary arterial pressures in these 52 children (preoperative mean PAP=23.13+/-7.68, postoperative mean PAP=17.00+/-6.99) (paired sample t test, P<.05). Twenty-seven of the 52 subjects in the study group were pulmonary hypertensive preoperatively. mPAPs of 18 of these children decreased to normal range yielding 9 subjects, and this was also found ststistically significant (McNemar test, P<.001). CONCLUSION: This study showed that obstructive adenoid and tonsillar hypertrophy causes higher mPAP values in children and revealed that T&A is an effective therapeutic measure in such patients.