Effect of adenoidectomy and/or tonsillectomy on cardiac functions in children with obstructive sleep apnea.
OBJECTIVE
We aimed to determine the effects of adenoidectomy and/or tonsillectomy (AT) on cardiac functions in children with adenoid and/or tonsillary hypertrophy and obstructive sleep apnea syndrome (OSAS) by using echocardiography with tissue Doppler imaging facility (TDI).


METHODS
Twenty-nine children with adenoid and/or tonsillary hypertrophy and OSAS and 26 children with primary snoring entered the study. Cardiac functions were assessed by echocardiography with TDI in both groups. Tests were repeated in the OSAS group 6 months after treatment with AT.


RESULTS
Echocardiography showed a decrease in estimated pulmonary artery systolic pressure from 31 +/- 4.2 to 13.1 +/- 2.3 (p < 0.001). In TDI, tricuspid E(m) and E(m)/A(m) increased from 11.0 +/- 2.7 to 13.5 +/- 2.7 cm/s (p < 0.001), and 1.46 +/- 0.52 to 1.82 +/- 0.53 (p = 0.004), respectively, following AT, indicating improvement in right ventricular diastolic dysfunction. Similarly, mitral E(m) and E(m)/A(m) increased from 12.3 +/- 2.1 to 16.3 +/- 2.7 cm/s, and from 1.65 +/- 0.51 to 2.30 +/- 0.54, respectively (p < 0.001). There was no significant difference between postoperative values and control group values.


CONCLUSIONS
TDI is a technique able to detect diastolic dysfunction unnoticeable by conventional echocardiography. Following AT, we observed improvement in both left and right ventricular diastolic functions using TDI.
Ugur
Mehmet Birol
MB
Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey. mehmetbirolugur@gmail.com
Dogan
Sait Mesut
SM
Sogut
Ayhan
A
Uzun
Lokman
L
Cinar
Fikret
F
Altin
Remzi
R
Aydin
Mustafa
M
D000233:Adenoidectomy; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011184:Postoperative Period; D011651:Pulmonary Artery / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000601:surgery*; D013599:Systole; D014068:Tonsillectomy; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*