Impact of adenotonsillectomy on ADHD and nocturnal enuresis in children with chronic adenotonsillar hypertrophy

Somuk, Battal Tahsin; Bozkurt, Hasan; Göktaş, Göksel; Demir, Osman; Gürbüzler, Levent; Eyibilen, Ahmet

doi:10.1016/j.amjoto.2015.08.003

Cited by 16 publications

(5 citation statements)

References 25 publications

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“…This may be because it is often difficult to measure sleep disruption in OSAS children owing to intermittent hypoxia associated with airway obstruction. 22 Based on these findings, we confirmed the role of UAO, induced by its negative effects on arousal response, in the pathophysiology of MPNE. 2 In OSAS, children also wake at a higher inspiratory resistance effort and have inhibited arousal response to hypercapnia.…”

Section: Discussionsupporting

confidence: 74%

“…This result indicates that OSAS is an important cause of enuresis, which has been confirmed by other studies. 2,3,22 NE resolution after adenotonsillectomy may be indeed associated with improved breathing during sleep rather than physiological maturation of bladder control alone and improvement in nocturnal oxygen desaturation. 22 However, the association of adenotonsillar hypertrophy and ANR with NE outcome was not confirmed in our study.…”

Section: Discussionmentioning

confidence: 99%

“…2,3,22 NE resolution after adenotonsillectomy may be indeed associated with improved breathing during sleep rather than physiological maturation of bladder control alone and improvement in nocturnal oxygen desaturation. 22 However, the association of adenotonsillar hypertrophy and ANR with NE outcome was not confirmed in our study. 23 In general, most authors showed that the greater the severity of obstructive SDB, the higher the risk of NE.…”

Section: Discussionmentioning

confidence: 99%

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The impact of adenotonsillectomy on monosymptomatic primary nocturnal enuresis in children with obstructive sleep apnea syndrome

Ghanem

Swaid

Adawi

et al. 2020

Journal of Clinical Urology

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Objectives: To analyze the outcome of monosymptomatic primary nocturnal enuresis (MPNE) after adenotonsillectomy in children with obstructive sleep apnea syndrome (OSAS). Methods: The study included 74 MPNE children with OSAS qualified for an adenotonsillectomy procedure. MPNE was assessed prior to surgical procedure as well as 3 and 6 months after surgery. In addition to polysomnographic parameters, serum antidiuretic hormone (ADH) and brain natriuretic peptide (BNP) levels were measured preoperatively and 3 months postoperatively. Results: The mean age was 9.8 years and the mean number of nocturnal wetting weekly was 4.1. Thirty-eight percent of patients had family history of MPNE. All the patients underwent a successful adenotonsillectomy. Nocturnal enuresis was still reported in 18% of children 6 months after adenotonsillectomy. An increased risk of MPNE was significantly demonstrated in children with high obstructive apnea-hypopnea index (O-AHI), high oxygen desaturation index (ODI), high frequent nocturnal enuresis and family history. After surgery, ADH levels were significantly lower, whereas BNP levels were significantly higher in non-resolution children. Univariate analysis showed that higher O-AHI, higher ODI, severe enuresis, low serum ADH and higher serum BNP levels were indicative of persistent nocturnal enuresis. Multivariate analysis showed that higher ODI and higher BNP levels are independent prognostic markers for MPNE. Conclusions: Adenotonsillectomy in MPNE children with OSAS is an effective treatment for resolution of MPNE. Also, higher ODI caused by apnea and elevated serum BNP levels are the most important factors affecting the outcome of MPNE patients. Level of evidence: Not applicable for this multicentre audit.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The impact of adenotonsillectomy on monosymptomatic primary nocturnal enuresis in children with obstructive sleep apnea syndrome

Ghanem

Swaid

Adawi

et al. 2020

Journal of Clinical Urology

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“…Another study found a high incidence of attention de cit and hyperactivity disorder (ADHD) and NE symptoms in children with adenoid hypertrophy. Adenotonsillectomy was found to be effective in the improvement of these symptoms [21]. There is no report to compare with in our study.…”

Section: Discussionmentioning

confidence: 47%

Results of Ultrasonography, Uroflowmetry, Voiding Diary Evaluation in Children With Monosymptomatic Primary Enuresis Nocturna

Yener

İlçe

2023

Preprint

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Objective To assess examine the results of urinary system ultrasonography, uroflowmetry and voiding diary for children patients presenting with primary monosymptomatic enuresis nocturna. Patients and methods Patients aged 5-17 years with enuresis nocturna were retrospectively analyzed. Urinary system ultrasonography (USG), uroflowmetry (UFM), complete urinalysis and two-day voiding diary were recorded for all patients. Comorbid diseases and surgeries were determined with a detailed history. Results A total of 842 patients were identified. History of previous surgery was present in 113 (13.4%) patients. Abnormal USG findings were detected in 117 (13.9%) patients.Urinary system USG findings of 17 patients with urinary tract infection were abnormal. In the two-day voiding diary, the bladder volume was found to be equivalent to the expected bladder volume in 54.2% of the patients, while the bladder volume detected in the first uroflowmetry was low in 65% of the patients. Conclusion Although the patients do not have urinary system symptoms other than night urinary incontinence at the time of admission, there may be accompanying pathologies. In addition, we think that a voiding diary measurement that has been properly explained and described to the family may be more reliable in cases where UFM cannot be repeated.

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“…Children with AH are also found to have increased association with nocturnal enuresis, attention deficit hyperactivity disorder, pulmonary hypertension and right heart failure. [4][5][6][7] In spite of all the symptoms that may be associated with AH an objective method to calculate the adenoidal nasopharyngeal ratio (ANR) was introduced by Fujioka, which is an easy non-invasive procedure for measurement of adenoid hypertrophy. ANR is the ratio of adenoid size (A) to nasopharyngeal depth (N), where A is the distance between the maximum convexity of the adenoid and a line drawn along the basiocciput and N is the distance between the posterosuperior edge of the hard palate and the anteroinferior edge of the sphenobasioccipital synchondrosis.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Symptoms of Adenoid Hypertrophy and Adenoidal Nasopharyngeal Ratio in Children at a Tertiary Hospital

et al. 2023

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Adenoid hypertrophy (AH) is a common problem in the paediatric age group causing nasal obstruction, snoring, waking up at night, nasal discharge, mouth breathing and decrease in hearing. This causes considerable morbidity in children along with various sequalae. The adenoidal nasopharyngeal ratio (ANR) is an objective method to assess AH and is calculated using a lateral neck x-ray. The study assessed the relationship between symptoms of AH and ANR. A cross-sectional, hospital-based study was conducted in children between the ages of 2 to 14 years. History of the symptoms was obtained and ANR was calculated using a lateral neck x-ray. There was a male preponderance of 1.3:1, with the majority of children between 6 to 10 years of age (67.3%). The common symptoms were nasal discharge (81.1%), mouth breathing (79.8%), snoring (76%) and decrease in hearing (66.3%). The largest mean adenoid size was 18.20 ± 2.63 mm in the 6-10 years, while the greatest mean nasopharyngeal depth was in the 11-14 years old age group (34.50 ± 2.88 mm). The maximum mean ANR of 0.71 ± 0.11 was in the 2-5 years old. All the symptoms of AH showed statistically significanct relationship with high ANR; snoring (p=0.003), waking up at night (p=0.001), nasal discharge (p=0.001), mouth breathing (p=0.034), decrease in hearing (p=0.030). It was seen that the highest number of children affected was in the younger age group where ANR was higher. ANR on nasopharyngeal x-ray (lateral view) correlated well and showed significant relationship with symptoms of AH.

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Impact of adenotonsillectomy on ADHD and nocturnal enuresis in children with chronic adenotonsillar hypertrophy

Cited by 16 publications

References 25 publications

The impact of adenotonsillectomy on monosymptomatic primary nocturnal enuresis in children with obstructive sleep apnea syndrome

The impact of adenotonsillectomy on monosymptomatic primary nocturnal enuresis in children with obstructive sleep apnea syndrome

Results of Ultrasonography, Uroflowmetry, Voiding Diary Evaluation in Children With Monosymptomatic Primary Enuresis Nocturna

Relationship between Symptoms of Adenoid Hypertrophy and Adenoidal Nasopharyngeal Ratio in Children at a Tertiary Hospital

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