The effects of adenotonsillectomy on pulmonary arterial pressure by Doppler echocardiography in children

Introduction: Increased upper-air way resistance resulting from hypertrophic tonsils and adenoids can cause intermittent airway obstruction, chronic alveolar hypoventilation, and even severe cardiopulmonary complications like pulmonary hypertension and corpulmonale. The aim of this study is to clarify whether tonsillectomy and adenoidectomy have any effect on mean pulmonary arterial pressure. Materials and Methods: This prospective study was approved by ethic committee. Thirty two randomly selected children (۱۶ male, ۱۶ female) aged between ۳.۵ and ۱۳ (mean ۷.۰۶±۱) with a diagnosis of upper airway obstruction or chronic infections from hypertrophied tonsils and adenoids were included in our study. Mean pulmonary arterial pressure (MPAP) was measured using Doppler echocardiography preoperatively and mean ۴.۲۵±۰.۴۶ months postoperatively in all subjects. Results: Comparing preoperative and postoperative mean pulmonary arterial pressure showed a statistically significant decrease in mean pulmonary arterial pressure in these children (Preoperative mean PAP=۱۹.۳۷±۰.۸۲, postoperative mean PAP= ۱۸.۱۰±۰.۶). (P=۰.۰۰۴). ۱۰ of the ۳۲ subjects in the study group were pulmonary hypertensive preoperatively. MPAPs of ۹ of these children decreased to normal range. (P=۰.۰۰۴). Conclusion: This study showed that obstructive adenoid and tonsillar hypertrophy causes higher MPAP values in children that would be reversible by performing early adenotonsillectomy.

Keywords:

Adenoid , Adenoidectomy , Tonsil , Tonsillectomy , Pulmonary arteries , Pulmonary hypertension , echocardiography