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The effect of recurrent tonsillitis and adenotonsillectomy on growth in childhood

Metin Aydogan1, Demet Toprak, Sükrü Hatun

  • 1Department of Pediatrics, Kocaeli University, School of Medicine, Kocaeli, Turkey.

International Journal of Pediatric Otorhinolaryngology
|September 14, 2007
PubMed

Insights

Adenotonsillectomy improved children's weight gain and reduced tonsillitis. Surgery also significantly increased Insulin-like Growth Factor-Binding Protein 3 (IGFBP-3) levels, crucial for childhood growth.

Area of Science:

  • Pediatric Endocrinology
  • Otolaryngology
  • Pediatric Growth and Development

Background:

  • Tonsil and adenoid hypertrophy can lead to recurrent tonsillitis and airway obstruction in children.
  • Affected children often experience reduced appetite and failure to gain weight.
  • Growth assessment in children is critical and relies on parameters like IGF-1 and IGFBP-3.

Purpose of the Study:

  • To evaluate the impact of adenotonsillectomy on growth parameters in children.
  • To assess changes in circulating insulin-like growth factor-1 (IGF-1) and IGF-binding protein 3 (IGFBP-3) levels post-surgery.
  • To analyze age-adjusted IGF-1 and IGFBP-3 standard deviation scores (SDS) after surgical intervention.

Main Methods:

  • A prospective study involving 38 prepubertal children (24 boys, 14 girls) with a mean age of 6.66 years.
  • Measurements of weight, height, IGF-1, and IGFBP-3 levels (including SDS) were taken before and 12-18 months after adenotonsillectomy (T&A).

Main Results:

  • Post-surgery, the annual number of tonsillitis infections decreased significantly from 8.6 to 0.37.
  • Mean weight standard deviation score (SDS) showed a significant increase (p<0.01) after T&A.
  • IGFBP-3 levels increased significantly from 1912 ng/ml to 2989 ng/ml (p<0.001), with a significant rise in IGFBP-3 SDS from -3.0 to -1.96 (p=0.001).
  • Serum IGF-1 levels and IGF-1 SDS did not show statistically significant changes post-surgery (p>0.135 and p>0.701, respectively).

Conclusions:

  • Adenotonsillectomy leads to significant postoperative weight gain in children.
  • Surgical treatment results in a significant increase in IGFBP-3 concentrations and IGFBP-3 SDS.
  • These findings correlate with a marked reduction in the frequency of tonsillitis episodes.
Abstract

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