Short-term effect of adenotonsillectomy on growth and nutritional anthropometric parameters of children with obstructive adenotonsillar enlargement

Abstract

Background: Obstructive adenotonsillar enlargement is known to cause failure to thrive in children. The effect of adenotonsillectomy is not well documented on the growth of affected children. The study was carried out to investigate the effect of adenotonsillectomy on growth of children with obstructive adenotonsillar enlargement. It was a quasi-experimental study consisting of 62 children (≤ 12 years) with obstructive adenotonsillar enlargement and 62 healthy controls. Variables measured at baseline, sixth week and 13th week post adenotonsillectomy, were weight, height, mid-upper arm circumference, and triceps skinfold thickness. The percent of weight-forage and height-forage were, respectively, calculated by dividing the child's weight and height by the median expected weight and height (i.e., the 50th percentile) based on the child's chronological age. The obtained weight-forage and height-forage values were used to determine the presence of failure to thrive and stunting, respectively. Results: Majority (70.6%) of the patients with malnutrition were from a low socioeconomic class. At baseline, failure to thrive and stunting were found among 17 (26.4%) cases and 11 (17.7%) controls, but the proportion reduced to six (9.7%) and three (4.8%), respectively, at the 13th week post adenotonsillectomy. There was a steady increase in weight-forage , height-forage , mid-upper arm circumference, and triceps skinfold thickness in both cases and controls from baseline to the 13th week. However, there was a significant difference in percentage variation of these variables between the two groups. Conclusions: Adenotonsillectomy improved the growth of children with obstructive adenotonsillar enlargement and hence recommended in cases with failure to thrive and stunting.

Serum Biomarkers after Adenotonsillectomy for Pediatric OSA: A Systematic Review and Meta‐Analysis

“…(1) Studies with population of children aged 18 years and below with polysomnographically diagnosed OSA, (2) Full-text studies, (3) Administration of adenotonsillectomy, (4) Clinical studies that reported changes in serum biomarkers after soft-tissue surgery for OSA, (5) published in a peer-reviewed journal, and (6) written in English. Exclusion criteria were (1) Case reports, reviews, or letters, (2) Abstracts or conference proceedings, (3) no pre-and post-operative comparisons for biochemical markers, (4) OSA diagnosed based on clinical history or questionnaires only, that is, not polysomnographically diagnosed OSA, (5) Adenotonsillar hypertrophy or snoring without OSA, (6) No distinction between results from non-surgical and surgical interventions, and (7) Not a serum biomarker.…”

“…2 Left untreated, this poses significant cardiovascular risks, 3,4 and predisposes children to metabolic disorders. 5 Furthermore, it may impede childhood development and growth 6 and leads to neurocognitive issues such as impaired attention and memory, hyperactivity, poor academic performance, and even psychiatric problems like depression. [7][8][9] Particularly, untreated severe OSA is a contributor to cardiovascular morbidity in children and has been demonstrated to cause bi-ventricular dysfunction, 10 blood pressure lability, 11 and endothelial dysfunction.…”

“…Left untreated, this poses significant cardiovascular risks, 3,4 and predisposes children to metabolic disorders 5 . Furthermore, it may impede childhood development and growth 6 and leads to neurocognitive issues such as impaired attention and memory, hyperactivity, poor academic performance, and even psychiatric problems like depression 7–9 …”

Anatomical Variables as Predictive Factors of Intra-Operative Residual during Adenoidectomy

“…Along with, obstructive sleep disorder, snoring, persistent rhinorrhea, as well as hyponasal speech, nasal blockage is one of the main symptoms they come with. Hyperplastic adenoids, on the other hand, can be colonized by bacteria and may serve as a source of chronic illness (1,2) . Obstruction of the upper airway, particularly during sleep, can cause distress to the respiratory system and a host of related problems.…”