Doppler echocardiography in adenotonsillar hypertrophy

Objective: Adenotonsillar hypertrophy causing upper airway obstruction may lead to the pulmonary hypertension and cor pulmonale. This study aimed to c larify the diagnostic methods of this complication, besides polysomnography , to find another objective criterion for surgical intervention and to demo nstrate the curative effect of adenotonsillectomy on this complication usin g this objective criterion. Methods: We studied the outcomes of 17 children with pulmonary hypertension secondary to the adenotonsillar hypertrophy. P ulmonary arterial pressure measurement was performed noninvasively by Doppl er echocardiography. Results: Mean preoperative pulmonary arterial pressure was 29.12 +/- 4.11 mmHg and decreased dramatically after relief of upper a irway obstruction by adenoidectomy and/or tonsillectomy to the normal level of 12.06 +/- 3.09 mmHg. These results were analyzed by equal variances t-t est and found very significant (P < 0.01). Regarding the symptoms of upper respiratory obstruction, symptom scores of these children decreased very si gnificantly and were analyzed by equal variances t-test (P < 0.01) in the p ostoperative period. For all the symptoms individually (snoring, mouth-brea thing during sleep and daytime, hyponasal voice, restless sleeping, daytime somnolence, enuresis nocturnal), comparing percentages of preoperative and postoperative symptoms by unequal variances t-test, we obtained very signi ficant decrease (P < 0.01). Conclusions: This study illustrates that Dopple r echocardiography is a safe, practical and noninvasive - method in diagnos ing cardiovasculary disturbances - one of the complications of adenotonsill ar hypertrophy and especially for measuring the pulmonary arterial pressure . All the symptoms and disorders due to the adenotonsillar hypertrophy may be reversible by performing early adeno- and/or tonsillectomy. (C) 2000 Els evier Science Ireland Ltd. All rights reserved.