Evaluation of the effects of adenotonsillar hypertrophy and adenotonsillectomy on growth in children

Sum mary Aim: Several factors including genetic factors, nutrition and environment play a critical role in the growth of children. Adenotonsillar hypertrophy (ATH) can cause growth retardation by obstructing the upper airway. Surgical treatment of ATH has been considered to have a positive effect on growth. The aim of this study was to evaluate the role of chronic ATH on growth by measuring weight, height, body mass index (BMI), bone age, serum insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) values before and after adenotonsillectomy. Material and Method: The study was approved by the Ethics Committee (4.5.2004; 04/170) and written informed consents were obtained from parents of the participants. A total of 40 prepubertal children who were diagnosed as chronic ATH were enrolled. Obstructive symptoms were questioned in the medical history before surgery. Weight, height, BMI and bone age values were measured and compared with reference values. Preoperative serum IGF-1 and IGFBP-3 values were compared with the control group which consisted of healthy children. Rates of obstructive symptoms, weight, height, BMI, bone age, serum IGF-1 and IGFBP-3 values of the patients were determined seven months after adenotonsillectomy and were compared with preoperative values. Results: Obstructive symptoms in children with ATH decreased remarkably after surgery. Preoperative mean value of bone age of the patients was statistically lower than reference values (p<0.05) and mean value of serum IGF-1 was lower than than the control group (p<0.05). IGF-1 and IGFBP3 values did not increase significantly after surgery (p>0.05). However, growth retardation was detected in three out of 40 patients based on the anthropometric measurements. Conclusions: In this study, antropometric findings showed that chronic ATH did not cause significant growth retardation in prepubertal children. In addition, we could not prove that surgical treatment of ATH improved the growth in the postoperative follow-up period of seven months. This result may be related with our study population with a limited number of patients who had baseline growth retardation and short postoperative follow up period. Further studies with large number of patients and longer postoperative follow-up periods are required to determine the exact role of chronic ATH in growth retardation. (Turk Arch Ped 2012; 47: 257-262)