title: Adenotonsillectomy improves the strength of respiratory muscles in children with upper airway obstruction.
abstract: OBJECTIVE
  The aim of this paper is to study the respiratory muscle strength by evaluating the maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP) and lung volume before and 3 and 6 months after adenotonsillectomy. This is an interventional, before and after trial. It was set at the Department of Otolaryngology, University of São Paulo, School of Medicine. We included 29 children (6-13 years old), both genders, consecutively recruited from the waiting list for adenotonsillectomy. Children were submitted to maximal inspiratory pressures (MIP), maximal expiratory pressure (MEP) evaluation using an analog manovacuometer, lung volume, using incentive expirotometer and thoracic and abdominal perimeter using a centimeter tape. Children were evaluated in 3 different moments: 1 week before and 3 and 6 months after surgery.
  
  
  RESULTS
  MIP improved significantly 3 months (p < 0.001) after adenotonsillectomy and MEP did not change (p = 1). There were increases in lung volume (p = 000), chest (p = 0.017) and abdominal perimeter (p = 0.05). Six months after surgery, all parameters improved. MIP (p = 0), MEP (p = 0), lung volume (p = 0.02), chest (p = 0.034) and abdominal perimeter (p = 0.23).
  
  
  CONCLUSIONS
  This study suggests that there was an improvement in respiratory muscular strength, once there was a significant improvement in maximal inspiratory pressure, lung volume and other parameters after adenotonsillectomy.
authors.affiliation: University of São Paulo, School of Medicine, Brazil.
authors.forename: Melissa Guerato Pires
authors.initials: MG
authors.lastname: Banzatto
authors.forename: Anete S
authors.initials: AS
authors.lastname: Grumach
authors.forename: João F
authors.initials: JF
authors.lastname: Mello
authors.forename: Renata C
authors.initials: RC
authors.lastname: Di Francesco
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D000293:Adolescent; D000402:Airway Obstruction / Q000150:complications* / Q000175:diagnosis; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007320:Inspiratory Capacity; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange; D012131:Respiratory Insufficiency / Q000209:etiology / Q000517:prevention & control; D012132:Respiratory Muscles / Q000502:physiology*; D012307:Risk Factors; D013997:Time Factors; D014068:Tonsillectomy / Q000379:methods*; D014109:Total Lung Capacity; D016896:Treatment Outcome