Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Assessment of Pulmonary Functions in Adenotonsillar Hypertrophy Patients Using a Newer Modality of Forced Oscillation Technique

Articles in Press

Document Type : Original

Authors
Vidya Shekar 1
Krishnaswamy Kothandapani Shyamala 2
Ashwini Shastry 3
Soumya Vedavyasa 4
1 Department of ENT Dr B R Ambedkar Medical college, Bengaluru
2 Professor and HOD Department of Respiratory Medicine Dr B R Ambedkar Medical college Bangalore
3 Department of ENT Dr.B R Ambedkar Medical college, Bengaluru
4 Department of ENT Apollo Hospital Bannerghatta Road Bengaluru
10.22038/ijorl.2026.95645.4147
Abstract
Introduction:
Adenotonsillar hypertrophy (ATH) is a common cause of upper airway obstruction in the paediatric population, resulting in sleep disturbances, chronic airway obstruction, and potential cardiopulmonary complications. The Forced Oscillation Technique (FOT) is a sensitive, non-invasive method for assessing pulmonary function and detecting abnormalities of the peripheral airways.
Materials and Methods:
This prospective pre–post cohort study included 35 patients aged 5–20 years with ATH who underwent FOT assessment before and six weeks after adenotonsillectomy. The parameters evaluated included total airway resistance (R5), central airway resistance (R20), peripheral airway resistance (R5–R20), reactance (X5), area of reactance (Ax), and resonant frequency (Fres).
Results:
Significant postoperative improvements were observed in R5 (0.46 ± 0.25 to 0.41 ± 0.25 kPa/L/s; p = 0.001), R20 (0.35 ± 0.19 to 0.30 ± 0.18 kPa/L/s; p = 0.001), X5 (−0.24 ± 0.16 to −0.12 ± 0.13 kPa/L/s; p < 0.001), Ax (2.93 ± 2.30 to 2.08 ± 1.71 kPa/L/s; p < 0.001), and Fres (24.89 ± 6.75 to 22.30 ± 6.00 Hz; p< 0.001). Although R5–R20 improved (0.10 ± 0.10 to 0.09 ± 0.10 kPa/L/s), the change was not statistically significant (p = 0.427). As R5–R20, X5, and Ax reflect peripheral airway function, improvements in these parameters suggest enhanced peripheral airway function following adenotonsillectomy. No significant association was found between pulmonary function and the degree of adenoid or tonsillar hypertrophy.
Conclusion:
FOT effectively detected improvements in pulmonary function following adenotonsillectomy and may be a valuable tool for evaluating respiratory changes in patients with ATH. Larger studies are warranted to better define its clinical utility.
Keywords
Adenotonsillar hypertrophy
Forced oscillation technique
Pulmonary function tests
Upper airway obstruction
Adenotonsillectomy
Subjects
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Iranian Journal of Otorhinolaryngology

Articles in Press, Accepted Manuscript
Available Online from 26 August 2026