Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

OSAHS Growth Impairment and Resolution after Adenotonsillectomy in Children

Document Type : Original

Authors
Antonina Mistretta 1
Domenico Michele Modica 2
Alessandro Pitruzzella 3
Stefano Burgio 3
Francesco Lorusso 4
Sebastiano Billone 5
Carla Valenti 3
Giulia Vita 3
Salvatore Poma 2
Marta Amata 6
Pietro Vita 3
Salvatore Gallina 7
1 Otolaryngology Unit, Department of Biomedicine and Advanced Diagnostic, University of Palermo, Palermo, Italy.
2 Otorhinolaryngology Unit, Villa Sofia-Cervello Hospital, Palermo, Italy.
3 Department of Biomedicine Neuroscience and Advanced Diagnostic-University of Palermo, Section of Human Anatomy, University of Palermo, Palermo, Italy.
4 Otolaryngology Unit, Department of Biomedicine and Advanced Diagnostic-University of Palermo, Palermo, Italy.
5 Clinica Pediatrica Università degli Studi di Palermo, Palermo, Italy.
6 Department of Biomedicine and Internal and Specialistic Medicine (DIBIMIS), University of Palermo, Palermo, Italy.
7 Otolaryngology Unit, Department of Biomedicine and Advanced Diagnostic - University of Palermo, Palermo, Italy.
10.22038/ijorl.2022.57642.2986
Abstract
Introduction:
One of the most important complications of OSAHS in children is growth delay. The aim of this study was to investigate changes in clinical body growth, and laboratory growth in children with OSAHS after adeno-tonsillar surgery.
 
Materials and Methods:
In our study, among 102 children suffering from sleep-disordered breathing, 70 met the inclusion criteria because they were affected by OSAHS and adenotonsillar hypertrophy. In total, 96 children affected by adeno-tonsillar hypertrophy (55 males and 41 females) underwent nocturnal cardiorespiratory monitoring with Embletta MPR, monitoring for post-operative 24 hours. Patients underwent blood sampling to evaluate preoperative GH and IGF-1 serum levels, “placement” in Cacciari’s growth charts and adenotonsillectomy and saturation monitoring for post-operative 24 hours. According to auxological parameters, 82.86% of the patients were below the fiftieth percentile of BMI Cacciari’s growth charts and IGF-1 preoperative serum levels were below the normal range. All patients underwent adenotonsillectomy.
Results:
All 70 patients recovered from OSAHS according to the results of nocturnal cardiorespiratory monitoring after six months. IGF-1 serum levels significantly increased after three months and one year after. All the auxological parameters showed a significant increase after surgery. We calculated the average annual growth in height of the patients before and after adenotonsillectomy (AT): the growth rate was impaired by OSAHS (5.4±1.3 cm/year), while in the following year post-surgery we found a significant growth speed acceleration (9.9±1.7 cm/year, P=0.001).
Conclusions:
In conclusion, growth delay in children can be caused by OSAHS, and when it is due to adenotonsillar hypertrophy, adenotonsillectomy is to be considered as the therapy of choice.
Keywords
Adeno-tonsillectomy
Adenotonsillar hypertrophy
GH. IGF-1
Growth failure
Obstructive sleep apnoea syndrome
Subjects
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Iranian Journal of Otorhinolaryngology
Volume 34, Issue 3
May and June 2022
Pages 145-153