Abstract
Objective: the aim of this work was to determine the pulmonary artery systolic pressure (PASP) in children with hypertrophic tonsils and adenoid and to clarify whether tonsillectomy and adenoidectomy has any effect on (PASP) of these children. Another aim of this study is to find out whether the complications of adenotonsillar hypertrophy are reversible or not and to estimate the time needed for reversibility.
Material and methods: this study was carried out on thirty children with hypertrophied chronic adenotonsillitis causing chronic upper airway obstruction 19 males (63.3%), and 11 females (36.7%) with mean age 6.1±1.8. All patients were subjected to thorough history taking, full clinical examination, plain X- ray on soft tissue neck (lateral view) and chest X-ray (P-A view), and Echocardiography for assessment of (PASP). Adenoidectomy, tonsillectomy or both were carried out for all children. Postoperative evaluation for all patients by general, E.N.T. examination, and cardiac cases were followed by using echocardiography at intervals of one week and four months.
Results: this study showed small adenoid in 6 cases (20%) and large adenoid in 24 cases (80%) detected by plain X-ray soft tissue neck, but there is no cardiomegally of all cases detected by chest X-ray.
It showed also pulmonary hypertension in 8 children (26.7%) detected by echocardiography. There was significant correlation between the severity of snoring and sleep apnea in relation to pulmonary hypertension (P< 0.01, P< 0.05 respectively). Relief of upper airway obstruction was carried out by tonsillectomy, adenoidectomy or both. Snoring and apnea were disappeared in nearly all cases, and also Echocardiography showed improvement of pulmonary hypertension in 75% of cardiac cases one week postoperatively, and all cases were improved after four months postoperatively.
Conclusion: from this study we conclude that adenotonsillar hypertrophy causes higher PASP in children and adenotonsillectomy is an effective therapeutic measure in such patients.
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