Cardiopulmonary functions and adenotonsillectomy: surgical indications need revision

J Laryngol Otol. 2016 Dec;130(12):1120-1124. doi: 10.1017/S0022215116009129. Epub 2016 Oct 27.

Abstract

Objective: To assess cardiac functions in adenotonsillar or tonsillar hypertrophy.

Methods: A prospective, interventional, academic centre based study was conducted on 25 children with adenotonsillar or tonsillar hypertrophy. All patients underwent pulsed 2-dimensional Doppler echocardiography, pulse oximetry and 12-lead electrocardiography. These assessments were repeated three months later to determine the impact of adenotonsillectomy.

Results: There were significant differences in mean arterial oxygen saturation, pulmonary flow acceleration time and mean pulmonary artery pressure post-operatively. Adenotonsillectomy led to significant improvements in pulmonary flow acceleration time and pulmonary flow velocity time index, while tonsillectomy resulted in right ventricular early and late diastolic velocity index improvement.

Conclusion: Upper airway obstruction in children affects cardiac functioning and this can subsequently lead to morbidity and delayed growth. Hence, revision of surgical indications is advocated in adenotonsillar hypertrophy to avoid irreversible damage to cardiopulmonary functions.

Keywords: Adenoids; Cardiac Failure; Hypertrophy; Palatine Tonsil; Pulmonary Hypertension; Tonsillitis.

Publication types

  • Clinical Trial

MeSH terms

  • Adenoidectomy*
  • Adenoids / pathology
  • Adenoids / surgery
  • Adolescent
  • Airway Obstruction / complications
  • Airway Obstruction / physiopathology
  • Airway Obstruction / surgery*
  • Blood Flow Velocity
  • Blood Pressure
  • Child
  • Child, Preschool
  • Cohort Studies
  • Echocardiography, Doppler
  • Electrocardiography
  • Female
  • Humans
  • Hypertrophy
  • Hypertrophy, Right Ventricular / diagnostic imaging*
  • Hypertrophy, Right Ventricular / etiology
  • Hypertrophy, Right Ventricular / physiopathology
  • Male
  • Oximetry
  • Palatine Tonsil / pathology
  • Palatine Tonsil / surgery
  • Prospective Studies
  • Pulmonary Artery
  • Pulmonary Circulation*
  • Tonsillectomy*
  • Tricuspid Valve Insufficiency / diagnostic imaging*
  • Tricuspid Valve Insufficiency / etiology
  • Tricuspid Valve Insufficiency / physiopathology