Investigation of Factors Affecting Height and Weight Change after Tonsillectomy

Abstract

Aim: The aim of this study was to investigate the effect of parameters such as age, sex, indication, tonsillar grade, tonsil volume, tonsil weight on height and weight development in tonsillectomy patients.

Material and Methods: After the history and examination findings of all patients were recorded, preoperative height and weight were examined. At sixth postoperative month, patients’ height and weight were measured and recorded. Height and weight gain of the patients were calculated according to the increase in percentile. The effects of patient dependent parameters on height and weight were compared.

Results: Of the 45 patients, 25 were male and 20 were female. Patients were divided into two groups according to age, as below 7 years and above. The patients were evaluated in 3 groups according to the indications as sleep disturbed breathing (SDB), recurrent tonsillitis and SDB+recurrent tonsillitis. Patients were evaluated in three groups as Grade 1-2, Grade 3 and Grade 4 according to the tonsil size. The patients were divided into two groups according to the tonsil volume, below 7 cc and above. The patients were divided into two groups as below 7 grams and above according to tonsil weight. It was revealed that the variables related to the patients were not significant effect on the change of height and weight percentile.

Conclusion: There were no statistically significant differences in the evaluation of the factors that affected the development after tonsillectomy. In order to obtain more detailed information, large patient participation and longer follow-up periods are needed.

Keywords

• tonsillectomy,growth,pediatric

Tonsillektomi Sonrası Boy ve Kilo Değişimi Üzerine Etkili Faktörlerin Araştırılması

Abstract

Amaç: Bu çalışmanın amacı tonsillektomi hastalarında yaş, cinsiyet, endikasyon, tonsiller grade, tonsil hacmi ve tonsil ağırlığı gibi değişkenlerin boy ve kilo gelişimi üzerine etkisinin araştırılmasıdır.

Gereç ve Yöntemler: Tüm hastaların anamnez ve muayene bulguları kaydedildikten sonra, ameliyat öncesi boy ve kilolarına bakıldı. Postoperatif 6. ayda hastaların tekrar boy ve kiloları ölçülerek kaydedildi. Hastaların boy ve kilo gelişimleri persentil artışına göre hesaplandı. Hastaya bağlı değişkenlerin boy ve kilo gelişimine etkisi karşılaştırıldı.

Bulgular: Çalışmaya katılan toplam 45 hastanın 25’i erkek olup 20’si ise kızdır. Hastalar yaşa göre 7 yaş altı ve 7 yaş üstü olmak üzere iki gruba ayrıldı. Cerrahi endikasyona göre hastalar uykuda solunum bozukluğu (USB), rekürren tonsillit ve USB+rekürren tonsillit olmak üzere 3 grupta değerlendirildi. Hastalar tonsil büyüklüğüne göre Grade 1-2, Grade 3 ve Grade 4 olmak üzere üç grupta değerlendirildi. Hastalar tonsil hacmine göre 7 cc altı ve üstü olacak şekilde iki gruba ayrıldı. Hastalar tonsil ağırlığına göre 7 gr altı ve üstü olacak şekilde iki gruba ayrıldı. Bakılan hastaya bağlı değişkenlerin boy ve kilo persentil değişimi üzerine anlamlı etkisinin olmadığı görüldü.

Sonuç: Tonsillektomi sonrası gelişmeyi etkileyen hastaya bağlı faktörler açısından yapılan değerlendirmede istatistiksel olarak anlamlı sonuçlar çıkmamıştır. Bu konuda daha ayrıntılı bilgi edinebilmek için geniş hasta katılımının ve daha uzun takip sürelerinin olduğu çalışmalara ihtiyaç vardır.

Keywords

• tonsillektomi,büyüme-gelişme,pediatrik

References

1. Ramos SD, Mukerji S, Pine HS. Tonsillectomy and adenoidectomy. Pediatr Clin North Am. 2013;60(4):793-807.
2. Goldstein SJ, Wu RH, Thorpy MJ, Shprintzen RJ, Marion RE, Saenger P. Reversibility of deficient sleep entrained growth hormone secretion in a boy with achondroplasia and obstructive sleep apnea. Acta Endocrinol (Copenh). 1987;116(1):95-101.
3. Aydogan M, Toprak D, Hatun S, Yüksel A, Gokalp AS. The effect of recurrent tonsillitis and adenotonsillectomy on growth in childhood. Int J Pediatr Otorhinolaryngol. 2007;71(11):1737-42.
4. Brouillette RT, Morielli A, Leimanis A, Waters KA, Luciano R, Ducharme FM. Nocturnal pulse oximetry as an abbreviated testing modality for pediatric obstructive sleep apnea. Pediatrics. 2000;105(2):405-12.
5. Brodsky L, Moore L, Stanievich JF. A comparison of tonsillar size and oropharyngeal dimensions in children with obstructive adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol. 1987;13(2):149-56.
6. Richardson MA. Sore throat, tonsillitis, and adenoiditis. Med Clin North Am. 1999;83(1):75-83.
7. Farber JM. Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2002;110(6): 1255-7.
8. Aji DY, Sarıoğlu A, Sever L, Arısoy N. Pulmonary hypertension due to chronic upper airway obstruction: a clinical review and report of four cases. Turk J Pediatr. 1991;33(1):35-41.

9. Wilkinson AR, McCormick MS, Freeland AP, Pickering D. Electrocardiographic signs of pulmonary hypertension in children who snore. Br Med J (Clin Res Ed). 1981;282(6276):1579-81.
10. Williams EF 3rd, Woo P, Miller R, Kellman RM. The effects of adenotonsillectomy on growth in young children. Otolaryngol Head Neck Surg. 1991;104(4):509-16.
11. 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.
12. 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.
13. Kiris M, Muderris T, Celebi S, Cankaya H, Bercin S. Changes in serum IGF-1 and IGFBP-3 levels and growth in children following adenoidectomy, tonsillectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol. 2010;74(5):528-31.
14. Barr GS, Osborne J. Weight gain in children following tonsillectomy. J Laryngol Otol. 1988;102(7):595-7.
15. Conlon BJ, Donnelly MJ, McShane DP. Tonsillitis, tonsillectomy and weight disturbance. Int J Pediatr Otorhinolaryngol. 1997;42(1):17-23.
16. Yılmaz MD, Hoşal AS, Oğuz 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.
17. Hodges S, Wailoo MP. Tonsillar enlargement and failure to thrive. Br Med J (Clin Res Ed). 1987;295(6597):541-2.
18. Koycu A, Aydin E, Tulgar Kinik S. Changes in body composition and growth pattern after adenotonsillectomy in prepubertal children. Int J Pediatr Otorhinolaryngol. 2016;81:46-50.
19. Lewis TL, Johnson RF, Choi J, Mitchell RB. Weight gain after adenotonsillectomy: a case control study. Otolaryngol Head Neck Surg. 2015;152(4):734-9.
20. D'Esposito CF, Farhood Z, Baker AB, Nguyen SA, LaRosa AC, Lal C, et al. Assessment of weight gain following adenotonsillectomy in children with Down syndrome. Int J Pediatr Otorhinolaryngol. 2017;100:103-6.