Adenotonsillar hypertrophy: Correlation between obstruction types and cardiopulmonary complications

Tatlipinar, Arzu; Biteker, Murat; Meriç, Kaan; Bayraktar, Gülüm Ivgin; Tekkeşin, Ahmet İlker; Gökçeer, Tanju

doi:10.1002/lary.22508

Cited by 31 publications

(33 citation statements)

References 25 publications

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“…In a recent study by Tatlipinar et al (17) showed that mean pulmonary artery pressure and right ventricle myocardial performance index were higher in patients with adenoid hypertrophy and adenoid and tonsil hypertrophy in comparison with the normal group. Also, Koc et al (15) demonstrated that adenotonsillectomy improved right ventricle performance and reduced mean pulmonary artery pressure in children with adenotonsillar hypertrophy.…”

Section: Discussionmentioning

confidence: 94%

The Cardiac effect of Rapid Maxillary expansion Patients with Maxillary Deficiency

Erdem¹,

Doruk²,

Sarıkaya³

et al. 2014

Acta Med Anatol

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Objectives: The aim of this study is to evaluate the effect of rapid maxillary expansion (RME) on patients with maxillary deficiency to the cardiologic parameter. Methods: A total of 12 patients (4 male and 8 females) with maxillary deficiency and bilateral cross-bite were selected to this study group. Before RME 24 h Holter monitoring of electrocardiography was used on patients. The prevalence analysis of arrhythmias, mean heart rate (MHR) and ventricular premature contraction (VPC) analysis was assessed over a 24-h period. Six months after achieving successfully expansion the Holter procedure was repeated again on patients. Results: VPC count per day and MHR, detected on 24 h ambulatory electrocardiography, showed significant statistical difference was present in pre and post-treatment periods. (VPC; 54.25±69.56/day, 6.50±5.98/day p<0.05; MHR; 108±12/day, 82±8/day p<0.05: respectively). Conclusions: The patients with maxillary deficiency may have been a potential with cardiologic abnormalities. The expansion may improve the cardiac problems by expansion. To our knowledge, this is the first report about this subject; this may be a basis for future large randomize studies.

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Section: Discussionmentioning

confidence: 94%

The Cardiac effect of Rapid Maxillary expansion Patients with Maxillary Deficiency

Erdem¹,

Doruk²,

Sarıkaya³

et al. 2014

Acta Med Anatol

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“…A previous study demonstrated that the size of both the adenoid and tonsil was significantly correlated with OSA and cardiopulmonary complications 16 , 17) . Therefore, we selected patients with grades III-IV of ATH confirmed using the method of Cohen and Konak and the Brodsky scale.…”

Section: Discussionmentioning

confidence: 98%

Effect of adenotonsillar hypertrophy on right ventricle function in children

et al. 2014

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PurposeChronic upper airway obstruction causes hypoxemic pulmonary vasoconstriction, which may lead to right ventricle (RV) dysfunction. Adenotonsillar hypertrophy (ATH) is the most common cause of upper airway obstruction in children. Therefore, we aimed to evaluate RV function in children with ATH.MethodsTwenty-one children (male/female, 15/6; mean age, 92.3¡¾39.0 months; age range, 4-15 years) with ATH and 21 healthy age- and gender-matched controls were included in this study. Tricuspid annular plane systolic excursion and RV myocardial performance index were measured by transthoracic echocardiography. Further, the plasma level of N-terminal of probrain natriuretic peptide (NT-proBNP), an indicator of RV function, was determined.ResultsThe snoring-tiredness during daytime-observed apnea-high blood pressure (STOP) questionnaire was completed by the patients' parents, and loud snoring was noted in the ATH group. The plasma NT-proBNP level was significantly higher in the ATH group than that in the controls (66.44±37.63 pg/mL vs. 27.85±8.89 pg/mL, P=0.001). The echocardiographic parameters were not significantly different between the groups.ConclusionWe were unable to confirm the significance of echocardiographic evidence of RV dysfunction in the management of children with ATH. However, the plasma NT-proBNP level was significantly higher in the ATH group than that in the control, suggesting that chronic airway obstruction in children may carry a risk for cardiac dysfunction. Therefore, more patients should be examined using transthoracic echocardiography. In addition, pediatricians and otolaryngologists should consider cardiologic aspects during the management of children with severe ATH.

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“…33 Although several studies have reported that adenotonsillar size does not reliably predict SBD, many clinicians still use ATH as a clinical indicator for SDB in children. 34 So, in this study, we tried to investigate the association among sAA activity, OSA severity, and ATH (tonsil size and AN ratio) in children.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Salivary Alpha Amylase Level and Adenotonsillar Hypertrophy with Sleep Disordered Breathing in Pediatric Subjects

Park

Guilleminault

Park

et al. 2014

Journal of Clinical Sleep Medicine

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Recently, salivary proteins have gained become of interest in diagnosing a variety of diseases, and several salivary proteins have been suggested as biomarkers to predict a variety of diseases. Among them, salivary cortisol may indicate a chronically stressed HPA axis and be a useful biomarker for OSAS. 10Salivary protein α-amylase (sAA) regulated by the sympathetic nervous system has been suggested as a biomarker for sympathetic activity because sAA activity is a readily accessible, noninvasive parameter that refl ects human responses to physiological and psychological stress. [11][12][13] For example, sAA activity can be used with moderate sensitivity and specifi city to detect acute myocardial infarction in patients with acute chest pain.14 A few studies have been published on α-amylase (AA) related to Study Objectives: Obstructive sleep apnea syndrome (OSAS) and sleep disordered breathing (SDB) can affect the sympathetic adrenomedullary system (SAM). As a biomarker of SAM activity, salivary α-amylase (sAA) in pediatric subjects was evaluated whether it has any correlation with polysomnographic (PSG) parameters related to SDB. Methods: Sixty-seven children who attended our clinic during 1 year were enrolled prospectively and underwent clinical examinations and in-lab polysomnography. The sAA was measured at 2 points-at night before PSG and in the early morning after PSG Results: Subjects were divided into control (n = 26, apneahypopnea index [AHI] < 1) and OSAS (n = 41, AHI ≥ 1) groups. The OSAS group was subdivided according to AHI (mild-moderate, 1 ≤ AHI < 10; severe, AHI ≥ 10). The sAA subtraction and ratio (p = 0.014 and p < 0.001, respectively) were signifi cantly higher in severe OSAS than in the mildmoderate and control groups. Although oxygen desaturation index (ODI) and AHI were signifi cantly associated with sAA, sAA in the OSAS group was not related to lowest oxygen saturation or adenotonsillar hypertrophy. Conclusion: sAA was well related to polysomnographic (PSG) parameters related to SDB, such as AHI and ODI. Therefore, screening test for sAA in children suspected to have SBD may help to identify OSAS patients from control. S C I E N T I F I C I N V E S T I G A T I O N SO bstructive sleep apnea (OSA) is a relatively common disorder, with an estimated frequency of 2% to 3% in children. Sleep disordered breathing (SDB) has a wide spectrum of respiratory abnormalities from primary snoring to OSA, and its prevalence is estimated to be from 0.9% to 13% in children. Reduced airfl ow (fl ow limitation, hypopnea), increased respiratory effort, and repetitive cessation of airfl ow (apnea) are usually observed in subjects with SDB. As a result, SDB can cause intermittent hypoxia and hypercapnia followed by successive restoration of normo-oxygenation after arousals, which can activate stress responses mediated by the hypothalamic-pituitary-adrenocortical (HPA) axis and the autonomic nervous system (ANS). 2-5It is well known that ANS parasympathetic tone is elevated by apnea and hypopnea, and sympathetic t...

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Adenotonsillar hypertrophy: Correlation between obstruction types and cardiopulmonary complications

Abstract: Patients with adenoid and tonsil hypertrophy are at a higher risk for cardiopulmonary complications, poorer quality of life, and more severe UAO symptoms and should have priority for surgical treatment to prevent cardiopulmonary complications.

Cited by 31 publications

References 25 publications

The Cardiac effect of Rapid Maxillary expansion Patients with Maxillary Deficiency

The Cardiac effect of Rapid Maxillary expansion Patients with Maxillary Deficiency

Effect of adenotonsillar hypertrophy on right ventricle function in children

Correlation of Salivary Alpha Amylase Level and Adenotonsillar Hypertrophy with Sleep Disordered Breathing in Pediatric Subjects

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