Association between adenoidal-nasopharyngeal ratio and right ventricular diastolic functions in children with adenoid hypertrophy causing upper airway obstruction.
OBJECTIVE
Adenoid hypertrophy causing upper airway obstruction can cause cardiovascular complications, including pulmonary hypertension and right heart failure in children. Adenoidal-nasopharyngeal ratio (ANR) is a practical, non-invasive and reliable method to evaluate adenoid enlargement. Our aim was to evaluate a possible association between ANR and echocardiographic parameters of right ventricle.


METHODS
Twenty-one children who were affected by upper respiratory obstruction symptoms due to adenoid hypertrophy were included in this study (male/female: 12/9; mean age was 6.0 +/- 1.5 years). ANRs were calculated as the ratio of adenoidal depths to the nasopharyngeal depths on lateral cephalometric radiographs. Pulmonary arterial pressures, right ventricular diastolic filling parameters (peak E, peak A, E/A ratio), right ventricular end-diastolic diameters, and left ventricular ejection fractions were measured using echocardiography both preoperatively and also 3 months after the operation.


RESULTS
Preoperative pulmonary arterial pressure, E/A ratio, right ventricular end-diastolic diameter, and left ventricular ejection fraction values were 23.10 +/-3.43 mmHg, 1.01 +/- 0.20, 1.95 +/- 0.16 cm, and 69.43 +/- 3.68%, respectively. Postoperative pulmonary arterial pressure, E/A ratio, right ventricular end-diastolic diameter, and left ventricular ejection fraction values were 16.94 +/- 1.45 mmHg, 1.24 +/- 0.14, 1.72 +/- 0.15 cm, and 69.77 +/- 2.17%, respectively. There were significant differences between preoperative and postoperative pulmonary arterial pressures, E/A ratios, and right ventricular end-diastolic diameters (p < 0.01 for each), while left ventricular ejection fraction values did not significantly change after the operation (p > 0.05). There was a negative correlation between E/A ratio and ANR-Ba (p < 0.05, r = -0.44).


CONCLUSIONS
ANR can give information about the right ventricular functions in children with enlarged adenoids causing obstructive symptoms.
Tezer
Mesut S
MS
Department of Otorhinolaryngology, Fatih University School of Medicine, Ankara, Turkey. mtezer2000@yahoo.com
Karanfil
Aydin
A
Aktaş
Davut
D
D000233:Adenoidectomy; D000234:Adenoids / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D000402:Airway Obstruction / Q000209:etiology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D006984:Hypertrophy / Q000150:complications / Q000601:surgery; D008297:Male; D009305:Nasopharynx / Q000000981:diagnostic imaging*; D018579:Patient Selection; D011651:Pulmonary Artery / Q000502:physiology; D011669:Pulmonary Wedge Pressure; D011859:Radiography; D016896:Treatment Outcome; D016278:Ventricular Function, Right