Crescimento pôndero-estatural de crianças após adenoamigdalectomia

Abstract

A hiperplasia adenoamigdaliana é a principal causa de obstrução das vias aéreas superiores em crianças, sendo muitas vezes associada à apnéia do sono. Esta, por sua vez, resulta em uma série de comprometimentos: baixo rendimento escolar, cor pulmonale, distúrbios de comportamento não específicos, hiperatividade, sonolência diurna, distração e atrasos de desenvolvimento, sendo o déficit pôndero-estatural o mais grave. A adenoamigdalectomia é o tratamento de escolha. O objetivo deste trabalho é mensurar o crescimento e desenvolvimento das crianças antes e depois da adenoamigdalectomia através da comparação dos percentis pré e pós operatórios. Forma de Estudo: Clínico prospectivo randomizado. Material e Método: Cinquenta e cinco crianças de 2 a 12 anos, com histó-ria de obstrução das vias aéreas superiores por hiperplasia adenoamigdaliana foram submetidas a exame antropométrico (peso e altura), antes e 6 meses após a adenoamigdalectomia. Os dados foram transformados em percentil para peso e altura, de acordo com a idade e comparados através de análise estatísti-ca. Resultados: No pré-operatório, encontramos a seguinte distribuição para o percentil altura: 78,2%, abaixo de p75 e para peso 70,9% abaixo de p50. No pós-operatório observouse melhor distribuição das crianças: para altura 34,6% abaixo de p75, 32,8% entre p75-95 e 32,6% para p95 e acima e para peso: 35,5% abaixo de p50, 36,4% para p50-95 e 29,1% acima de p95. Conclusão: Observou-se uma melhora considerável do desenvolvimento pôndero-estatural das crianças após a adenoamigdalectomia. Tonsi l and adenoid hyperplasia is one of the most common causes of upper airway obstruction in children; and generally comes along with sleep apnea. It is usually associated to poor school performance, non-specific behavioral disturbs, hyperactivity, daytime sleepiness, distraction and failure to thrive. This one is a very serious consequence for the child. The purpose of this study is to compare height and weight percentiles before and after surgery. Study Design: Clinical prospective randomized. Material and Method: We studied 55 children (male and female) from 2 to 12 years old; with upper airway obstruction due to tonsil and adenoid hyperplasia. All of them were measured (height and weight) before and 6 months after adenotonsillectomy. Height and weight percentiles were plotted in graphics and compared with statistical analysis. Results. Before surgery, the majority of the children, 78.2% were under p75 for height and 70.9% were under p50 for weight. Three months after surgery there was a better distribution of the children throughout the percentil ranges. For height: 34.6% were under p75; 32.85 were between p75-95 and 32.6% were above p95. For weight 35.5% were under p50; 36.4% were under p50-95 and 29.1% were above p95. Conclusion: After surgery, children presented an improvement in their height and weight percentiles. They develop better after the treatment of upper airway obstruction, with T&A surgery. Rev Bras Otorrinolaringol. V.69, n.2, 193-6, mar./abr. 2003 Ren...

Avaliação da pressão inspiratória em crianças com aumento do volume de tonsilas

“…It is known that 90% of the craniofacial growth occurs up to 12 years old 5 . Therefore, at this age, when tonsil enlargement occurs, adjustment of bone structures regarding palatine and/or pharyngeal tonsils have already occurred.…”

Melhora da qualidade de vida em crianças após adenoamigdalectomia

“…Although we still do not know all consequences of adenoid and tonsil enlargement, we believe that obstructive sleep apnea accounts for the highest morbidity 1 . Other consequences, described as minor ones, include weight and height developmental disorders, craniofacial problems resulting from mouth breathing, chewing and swallowing difficulties and high susceptibility to upper airway infections [4][5][6] . The disease's high morbidity and its impact over the patient's life should be considered when choosing the best treatment approach.…”

“…Other important consequences are associated with developmental abnormalities, behavioral disorders, poor school performance and cor pulmonale 6,7 . Although the indications for adenotonsillectomy are well established, there are few studies about the impact of surgery in the quality of life of patients 8 .…”

Relação entre a etiologia da respiração oral e a pressão máxima da língua

“…Although the prevalence of individuals with allergic rhinitis was higher, there was no statistically significant relation to the maximum tongue pressure. On the other hand, there are studies in the literature that point to hypertrophy of the pharyngeal tonsils and palatine tonsils, as important causes of upper airway obstruction in children (24,25) , and these structures have greater impact for the case.…”