Research Article
Year 2023,
Volume: 9 Issue: 5 - September 2023, 1185 - 1193, 04.09.2023
Abstract
Objectives: Adenotonsillar hypertrophy (AH) is a prevalent condition in children that can cause significant complications if left untreated. In this study, we investigated the impact of adenoidectomy on pulmonary function tests (PFTs) and explored the relationship between spirometric parameters in affected children. By evaluating these factors, we can better understand the post-surgical outcomes and the potential benefits of surgical intervention.
Methods: The present study utilized a prospective controlled design to conduct a before and after clinical trial involving 23 children diagnosed with upper airway obstruction resulting from AH. Five specific spirometric parameters were selected to evaluate pulmonary function before and 1-3 months following the adenoidectomy procedure. Additionally, adenoid grade scores and gender differences were recorded for each patient to assess their effect on the lung.
Results: Peak expiratory flow (PEF) (p = 0.002), the first second of expiration (FEV1) (p < 0.001), and the ratio of FEV1/FVC (p = 0.001) significantly increased postoperatively. However, no significant correlations were found between the forced vital capacity (FVC) (p = 0.39) and mid-expiratory forced expiratory flow (FEF25-75) (p = 0.2). Rising of the FVC, PEF, FEV1, and FEV1/FVC was observed in AH grade III patients compared to AH grade IV patients following the surgical intervention, in comparison to the preoperative baseline, especially statistical significance was FEV (p = 0.047), indicating a noteworthy change in lung function.
Conclusions: These findings emphasize the beneficial effects of adenoidectomy on PFTs and highlight that adenoidectomy positively affects the upper and lower airways.
Keywords
Adenotonsillar hypertrophy pulmonary function tests adenoidectomy spirometric parameters upper airway obstruction
References
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Year 2023,
Volume: 9 Issue: 5 - September 2023, 1185 - 1193, 04.09.2023
Abstract
References
- 1. Niedzielski A, Chmielik LP, Mielnik-Niedzielska G, Kasprzyk A, Bogusławska J. Adenoid hypertrophy in children: a narrative review of pathogenesis and clinical relevance. BMJ Paediatr Open 2023;7:e001710.
- 2. Deshmukh P, Lakhotia P, Gaurkar SS, Ranjan A, Dash M. Adenotonsillar hypertrophy and cardiopulmonary status: a correlative study. Cureus 2022;14:e31175.
- 3. Wang H, Qiao X, Qi S, Zhang X, Li S. Effect of adenoid hypertrophy on the upper airway and craniomaxillofacial region. Transl Pediatr 2021;10:2563-72.
- 4. van Kempen MJ, Rijkers GT, Van Cauwenberge PB. The immune response in adenoids and tonsils. Int Arch Allergy Immunol 2000;122:8-19.
- 5. Brambilla I, Pusateri A, Pagella F, Caimmi D, Caimmi S, Licari A, et al. Adenoids in children: advances in immunology, diagnosis, and surgery. Clin Anat 2014;27:346-52.
- 6. Li H, Wang H, Hao H, An H, Geng H. Influences of airway obstruction caused by adenoid hypertrophy on growth and development of craniomaxillofacial structure and respiratory function in children. Comput Math Methods Med 2022;2022:5096406.
- 7. Niedzielska G, Kotowski M, Niedzielski A. Assessment of pulmonary function and nasal flow in children with adenoid hypertrophy. Int J Pediatr Otorhinolaryngol 2008;72:333-5.
- 8. Yadav SP, Dodeja OP, Gupta KB, Chanda R. Pulmonary function tests in children with adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2003;67:121-5.
- 9. Naiboglu B, Deveci S, Duman D, Kaya KS, Toros S, Kinis V, et al. T. Effect of upper airway obstruction on pulmonary arterial pressure in children. Int J Pediatr Otorhinolaryngol 2008;72:1425-9.
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- 11. Abdel-Aziz M. Asymptomatic cardiopulmonary changes caused by adenoid hypertrophy. J Craniofac Surg 2011;22:1401-3.
- 12. Duman D, Naiboglu B, Esen HS, Toros SZ, Demirtunc R. Impaired right ventricular function in adenotonsillar hypertrophy. Int J Cardiovasc Imaging 2008;24:261-7.
- 13. Brown OE, Manning SC, Ridenour B. Cor pulmonale secondary to tonsillar and adenoidal hypertrophy: management considerations. Int J Pediatr Otorhinolaryngol 1988;16:131-9.
- 14. Blum RH, McGowan FX Jr. Chronic upper airway obstruction and cardiac dysfunction: anatomy, pathophysiology and anesthetic implications. Paediatr Anaesth 2004;14:75-83.
- 15. Dayyat E, Kheirandish-Gozal L, Gozal D. Childhood obstructive sleep apnea: one or two distinct disease entities? Sleep Med Clin 2007;2:433-44.
- 16. Kurnatowski P, Putyński L, Lapienis M, Kowalska B. Neurocognitive abilities in children with adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2006;70:419-24.
- 17. Niedzielski A, Chmielik LP, Kasprzyk A, Stankiewicz T, Mielnik-Niedzielska G. Health-related quality of life assessed in children with adenoid hypertrophy. Int J Environ Res Public Health 2021;18:8935.
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- 21. American Thoracic Society. Standardization of Spirometry: 1994 update. Am Rev Respir Dis 1994;152:107-36.
- 22. Knudson RJ, Lebowitz MD, Holberg CJ, Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis 1983;127:725-34.
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- 25. Hira HS, Singh H. Assessment of upper airway obstruction by pulmonary function testing. J Assoc Physicians India 1994;42:531-4.
- 26. Kurnatowski P, Putyński L, Łapienis M, Kowalska B. Physical and emotional disturbances in children with adenotonsillar hypertrophy. J Laryngol Otol 2008;122:931-5.
- 27. Burman D. Sleep disorders: sleep-related breathing disorders. FP Essent 2017;460:11-21.
- 28. Rogha M, Amini J, Raisi M. Pulmonary function after adenotonsillectomy. Iran J Otorhinolaryngol 2016;28:383-8.
- 29. Khalifa MS, Kamel RH, Zikry MA, Kandil TM. Effect of enlarged adenoids on arterial blood gases in children. J Laryngol Otol 1991;105:436-8.
- 30. LoMauro A, Aliverti A. Sex differences in respiratory function. Breathe (Sheff) 2018;14:131-40.
- 31. Choi W, Kwak J, Kwon D, Han S, Jeon YJ. Validity of peak expiratory flow for assessing reversible airflow obstruction. Tuberc Respir Dis 2000;8:522-9.
There are 31 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Otorhinolaryngology |
| Journal Section | Original Articles |
| Authors | |
| Early Pub Date | August 30, 2023 |
| Publication Date | September 4, 2023 |
| Submission Date | August 10, 2023 |
| Acceptance Date | August 29, 2023 |
| Published in Issue | Year 2023 Volume: 9 Issue: 5 - September 2023 |
e-ISSN: 2149-3189
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