Clin Exp Otorhinolaryngol.  2016 Jun;9(2):163-167. 10.21053/ceo.2015.00087.

The Effect of Tonsillectomy and Adenoidectomy on Right Ventricle Function and Pulmonary Artery Pressure by Using Doppler Echocardiography in Children

• Acar OC
• Ãœner A
• Garça MF
• Ece I
• Epçaçan
• Turan M
• Kalkan F

• KMID: 2165060
• DOI: http://doi.org/10.21053/ceo.2015.00087

Abstract

OBJECTIVES
The purpose of the present study is to emphasize the efficacy of the myocardial performance index and tricuspid annular plane systolic excursion (TAPSE) in the determination of impaired cardiac functions and recovery period following the treatment in children with adenoid and/or tonsillar hypertrophy.
METHODS
Fifty-three healthy children after routine laboratory, imaging and clinical examinations, with adenoid and/or tonsillar hypertrophy were evaluated before and 3 months after adenotonsillectomy for cardiac functions using M mode and Doppler echocardiography.
RESULTS
The mean age of cases was 6.4±3.0 years, 34 (65%) were male, and 19 (35%) were female. Pulmonary hypertension was observed to be mild in 3 patients and moderate in 1 patient preoperatively. When the preoperative and postoperative echocardiographic measurements of the patients were compared, the tricuspid valve E wave velocity, the E/A ratio (E, early diastolic flow rate; A, late diastolic flow rate), and the TAPSE values were determined to be significantly higher postoperatively (P<0.05). The tricuspid valve deceleration time, the isovolumetric relaxation time and the systolic pulmonary artery pressure were found to be significantly lower compared to the preoperative values (P<0.05).
CONCLUSION
Adenoidectomy and/or tonsillectomy may prevent cardiac dysfunctions that can develop in the later periods due to adenoid and/or tonsil hypertrophy in children, before the appearance of the clinical findings of cardiac failure.

Keyword

Adenotonsillectomy; Right Ventricular Failure; Myocardial Performance Index; Tricuspid Annular Plane Systolic Excursion

MeSH Terms

Adenoidectomy*
Adenoids
Child*
Deceleration
Echocardiography
Echocardiography, Doppler*
Female
Heart Failure
Heart Ventricles*
Humans
Hypertension, Pulmonary
Hypertrophy
Male
Palatine Tonsil
Pulmonary Artery*
Relaxation
Tonsillectomy*
Tricuspid Valve

Figure

• 

  Fig. 1. Pre- and postoperative changes in myocardial performance index (MPI) of tricuspid valve. Echo, echocardiography.

• 

  Fig. 2. Pre- and postoperative changes in tricuspid annular plane systolic excursion (TAPSE) of tricuspid valve. Echo, echocardiography.

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