KBB-Forum 2011 , Cilt 10, Sayı 1

THE EVALUATION OF EFFECTS OF ADENOTONSILLECTOMY ON GROWTH WITH CLINICAL AND BIOCHEMICAL PARAMETERS

Dr. Onur ERDAL1, Dr. Taner Kemal ERDAĞ2, Dr. Mustafa Cenk ECEVİT2, Dr. Ayhan ABACI3, Dr. Dilek ÇIMRIN4, Dr. Emel ADA5, Dr. Atilla BÜYÜKGEBİZ6, Dr. Semih SÜTAY2
1Gaziantep Şehit Kamil Devlet Hastanesi , KBB, Gaziantep, Türkiye
2Dokuz Eylül Üniversitesi Tıp Fakültesi, KBB Anabilim Dalı, İzmir, Türkiye
3Dokuz Eylül Üniversitesi Tıp Fakültesi, Çocuk Endokrin ve Adolesan Bilim Dalı, İzmir, Türkiye
4Dokuz Eylül Üniversitesi Tıp Fakültesi Hastanesi, Merkez Laboratuvarı, İzmir, Türkiye
5Dokuz Eylül Üniversitesi Tıp Fakültesi , Radyoloji Anabilim Dalı, İzmir, Türkiye
6İstanbul Bilim Üniversitesi , Florence Nightingale Hastanesi Çocuk Endokrin ve Adolesan Bilim Dalı, İstanbul, Türkiye Objective: In this study the relation between growth and upper airway obstruction due to adenotonsillar hypertrophy and/or recurrent/chronic adenotonsillary infection was investigated by comparing clinical and biochemical parameters before and after adenoidectomy ± tonsillectomy. Body mass index, weight for height percent, height and weight standart deviation scores and serum IGF-I and IGFBP3 levels were evaluated respectively as clinical parameters and biochemical parameters of growth.

Material and Methods: With this aim, 42 children between the ages of 3 and 8 whose treatment was planned as adenoidectomy ± tonsillectomy with recurrent/chronic adenotonsillary infection and/or obstructive symptoms were included in the study. These children were divided into two groups as recurrent/chronic infection group and obstructive ± recurrent/chronic infection group depending on history, physical examination and radiological evaluation. The weight and height of the patients were measured with stadiometer and electronic scala preoperatively and postoperatively. Serum IGF-I and IGFBP3 levels were determined in venous blood samples obtained preoperatively and at the 6th month with chemiluminescent immunometric assay method.

Results: In group I, only 1 patient's weight was under normal levels. Height, body mass index and weight for height percent values were normal in all the patients. At the postoperative 6th month, other than group I there was a statistically significant increase in height measures of group II and total patients. When group I and group II were compared with each other, there were no statistically significant differences in the clinical parameters of growth, except for preoperative and postoperative weight mesures. In our study, we found a statistically significant increase in serum IGF-I and IGFBP3 levels postoperatively in the total group and group II. In group I while serum IGF-I levels increased significantly when compared with preoperative levels, there was no statistically significant increase in IGFBP3 levels.

Conclusion: When the results of this study and preoperative weight and height measures were considered together, it can be said that there is no growth retardation in these randomly selected children. In both groups and totally, increase in serum IGF-I levels has indicated that growth hormone-IGF-I axis was affected in a positive way and adenoidectomy and/or tonsillectomy accelerated the growth in the children with adenotonsillar problems. Keywords : Adenotonsillar hypertrophy, Adenotonsillectomy, Growth, Growth retardation, IGF-1, IGFBP-3, Recurrent tonsillitis