Effects of Adenotonsillectomy on Weight Gain in Children with Adenotonsillar Hypertrophy: A Randomized Clinical Trial

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Adenotonsillar hypertrophy (ATH) is the most prevalent cause of chronic upper airway obstruction and sleep-disordered breathing. It is also associated with growth delay in children. Adenotonsillectomy is the most common surgical treatment of sleep disordered breathing in children. This study evaluated the effects of adenotonsillectomy on weight, height, and body mass index (BMI) changes in children with ATH.Methods: In this randomized clinical trial study, 96 children (48 healthy and 48 ATH patients) aged 3-10 years old were enrolled. Weight, height, and BMI were measured before, and 6 and 9 months after surgery.Findings: Both groups were similar in age and sex dispensation. Height and weight significantly increased in both groups (P < 0.001). Increase in BMI was only significant in ATH patients. Mean values of weight and BMI were higher among ATH patients than the healthy group 6 and 9 months after the operation (P < 0.001). Mean height was similar in both groups but was a little more in the control group (P = 0.8). Conclusion: Adenotonsillectomy increases weight and BMI in children with ATH.

Keywords


  1. Kang JM, Auo HJ, Yoo YH, Cho JH, Kim BG. Changes in serum levels of IGF-1 and in growth following adenotonsillectomy in children. Int J Pediatr Otorhinolaryngol 2008; 72(7): 1065-9.
  2. Ersoy B, Yuceturk AV, Taneli F, Urk V, Uyanik BS. Changes in growth pattern, body composition and biochemical markers of growth after adenotonsillectomy in prepubertal children. Int J Pediatr Otorhinolaryngol 2005; 69(9): 1175-81.
  3. Bar A, Tarasiuk A, Segev Y, Phillip M, Tal A. The effect of adenotonsillectomy on serum insulin-like growth factor-I and growth in children with obstructive sleep apnea syndrome. J Pediatr 1999; 135(1): 76-80.
  4. Bonuck KA, Freeman K, Henderson J. Growth and growth biomarker changes after adenotonsillectomy: systematic review and meta-analysis. Arch Dis Child 2009; 94(2): 83-91.
  5. Greenfeld M, Tauman R, DeRowe A, Sivan Y. Obstructive sleep apnea syndrome due to adenotonsillar hypertrophy in infants. Int J Pediatr Otorhinolaryngol 2003; 67(10): 1055-60.
  6. Gozal D. Sleep-disordered breathing and school performance in children. Pediatrics 1998; 102(3 Pt 1): 616-20.
  7. Tran KD, Nguyen CD, Weedon J, Goldstein NA. Child behavior and quality of life in pediatric obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 2005; 131(1): 52-7.
  8. Ahlqvist-Rastad J, Hultcrantz E, Melander H, Svanholm H. Body growth in relation to tonsillar enlargement and tonsillectomy. Int J Pediatr Otorhinolaryngol 1992; 24(1): 55-61.
  9. Williams EF, III, Woo P, Miller R, Kellman RM. The effects of adenotonsillectomy on growth in young children. Otolaryngol Head Neck Surg 1991; 104(4): 509-16.
  10. Bate TW, Price DA, Holme CA, McGucken RB. Short stature caused by obstructive apnoea during sleep. Arch Dis Child 1984; 59(1): 78-80.
  11. Yilmaz MD, Hosal AS, Oguz H, Yordam N, Kaya S. The effects of tonsillectomy and adenoidectomy on serum IGF-I and IGFBP3 levels in children. Laryngoscope 2002; 112(5): 922-5.
  12. Aydogan M, Toprak D, Hatun S, Yuksel A, Gokalp AS. The effect of recurrent tonsillitis and adenotonsillectomy on growth in childhood. Int J Pediatr Otorhinolaryngol 2007; 71(11): 1737-42.
  13. Bland RM, Bulgarelli S, Ventham JC, Jackson D, Reilly JJ, Paton JY. Total energy expenditure in children with obstructive sleep apnoea syndrome. Eur Respir J 2001; 18(1): 164-9.
  14. Koc S, Ozturk K, Buyukbas S, Kocabas V, Ozer B, Kara M. Ghrelin levels in children with adenoid or chronic tonsil hypertrophies before and after surgery. Int J Pediatr Otorhinolaryngol 2009; 73(5): 685-7.
  15. Darrow DH, Siemens C. Indications for tonsillectomy and adenoidectomy. Laryngoscope 2002; 112(8 Pt 2 Suppl 100): 6-10.
  16. Vontetsianos HS, Davris SE, Christopoulos GD, Dacou-Voutetakis C. Improved somatic growth following adenoidectomy and tonsillectomy in young children. Possible pathogenetic mechanisms. Hormones (Athens) 2005; 4(1): 49-54.
  17. Soultan Z, Wadowski S, Rao M, Kravath RE. Effect of treating obstructive sleep apnea by tonsillectomy and/or adenoidectomy on obesity in children. Arch Pediatr Adolesc Med 1999; 153(1): 33-7.
  18. Hodges S, Wailoo MP. Tonsillar enlargement and failure to thrive. Br Med J (Clin Res Ed) 1987; 295(6597): 541-2.
  19. Conlon BJ, Donnelly MJ, McShane DP. Tonsillitis, tonsillectomy and weight disturbance. Int J Pediatr Otorhinolaryngol 1997; 42(1): 17-23.
  20. Barr GS, Osborne J. Weight gain in children following tonsillectomy. J Laryngol Otol 1988; 102(7): 595-7.
  21. Selimoglu E, Selimoglu MA, Orbak Z. Does adenotonsillectomy improve growth in children with obstructive adenotonsillar hypertrophy? J Int Med Res 2003; 31(2): 84-7.
  22. Nieminen P, Lopponen T, Tolonen U, Lanning P, Knip M, Lopponen H. Growth and biochemical markers of growth in children with snoring and obstructive sleep apnea. Pediatrics 2002; 109(4): e55.
  23. Camilleri AE, MacKenzie K, Gatehouse S. The effect of recurrent tonsillitis and tonsillectomy on growth in childhood. Clin Otolaryngol Allied Sci 1995; 20(2): 153-7.
  24. Kohler MJ, van den Heuvel CJ. Is there a clear link between overweight/obesity and sleep disordered breathing in children? Sleep Med Rev 2008; 12(5): 347-61.