Improved somatic growth following adenoidectomy and tonsillectomy in young children. Possible pathogenetic mechanisms

Abstract

The effect of Adenotonsillectomy on somatic growth was studied prospectively in 57, randomly selected children (31 boys, 26 girls), aged 5.03+/-1.32 (mean+/-1SD) years. The indication for surgery was adenotonsillar hypertrophy with or without recurrent infections. Weight, height, triceps skinfold thickness, and Body Mass Index were measured prior to the operation and 6-13 months afterwards. Weight was significantly improved following T&A in all children. The improvement in height was significantly only for children under 5 years. In an attempt to uncover the pathogenetic mechanisms, lactic acid, pyruvic acid, somatomedin-C (IGF-I), growth hormone(GH), insulin, glucose, pH, hemoglobin (Hbeta). and white cell count (WBC) were also determined in the last 18 children, prior to and 6-8 months post operatively. For the comparison of pre and post operative values the paired t test was applied. Although the values of GH and IGF1 did not significantly increase post-op the IGF-1/GH ratio increased, possibly indicating improved IGF1 generation. There was also a rise in Hbeta values and a lowering of WBC, probably reflecting the lower frequency of infections. All other metabolic indices did not change. In conclusion, linear grow post-Adenotonsillectomy improved in children aged <5 years and was associated with improved with IGF-1/GH ratio, increased Hbeta values and decreased in WBC.

Growth After Adenotonsillectomy for Obstructive Sleep Apnea: An RCT

“…Significant increases in height z scores after adenotonsillectomy for pediatric OSAS have been reported in many studies, 3,11,14,16,18 but not others. 9,12 Our results demonstrated no significant differences between the eAT and WWSC groups with regard to postoperative height, although in the eAT group there was a significant increase in the height z score after 7 months.…”

“…[1][2][3][4][5] Adenotonsillar hypertrophy is the primary cause of OSAS in children, and is usually treated with adenotonsillectomy (AT). AT has been reported to accelerate weight [6][7][8][9][10][11][12][13][14] in children with baseline failure to thrive (FTT), 1,3,4,15 normal weight patients, 9,11,14,[16][17][18][19][20] obese individuals, 9,13,16,21,22 and infants. 10 The majority of studies also have demonstrated an increase in the height growth rate after AT for OSAS, 3,6,11,17,23,24 but other studies reported no significant differences.…”

Çocuklarda kronik adenotonsiller hipertrofinin büyüme üzerine etkilerinin adenotonsillektomi öncesi ve sonrası dönemde değerlendirilmesi

“…In the study performed by Vontetsianos (34) in which the follow-up period after adenotonsillectomy was 6-13 months, weight SDS values and height SDS values (especially in children younger than 5 years of age) were found to be significantly increased after operation.…”

“…Excessive obstruction and presence of additional problems including laryngomalacia and Down syndrome increase this rate (33,34,35).…”

Dental Arch Dimensions of Nigerian Children with Hypertrophied Adenoids

“…GH is released in a pulsatile fashion over a 24-h period, with the highest GH values being associated with the onset of slow-wave sleep. It has been shown that a reduced amount of slow-wave sleep occurs in children with adenoid hypertrophy and that this results in a decrease in sleep-associated GH secretion (22). Other studies, however, found larger mandibular widths and larger mandibular arch lengths in adenoid subjects (5).…”