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OSAHS Growth Impairment and Resolution after Adenotonsillectomy in Children

Antonina Mistretta1, Domenico Michele Modica2, Alessandro Pitruzzella3,4

  • 1Otolaryngology Unit, Department of Biomedicine and Advanced Diagnostic, University of Palermo, Palermo, Italy.

Iranian Journal of Otorhinolaryngology
|June 3, 2022
PubMed

Insights

Pediatric Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) can cause growth delay. Adenotonsillectomy significantly improves growth and IGF-1 levels in children with OSAHS due to adenotonsillar hypertrophy.

Area of Science:

  • Pediatric Endocrinology
  • Sleep Medicine
  • Otolaryngology

Background:

  • Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a significant complication in children, often leading to growth delay.
  • Adenotonsillar hypertrophy is a common cause of OSAHS in pediatric populations.

Purpose of the Study:

  • To investigate the impact of adenotonsillectomy on clinical and laboratory growth parameters in children with OSAHS.
  • To evaluate changes in Growth Hormone (GH) and Insulin-like Growth Factor 1 (IGF-1) serum levels post-surgery.

Main Methods:

  • A cohort of 70 children with OSAHS and adenotonsillar hypertrophy underwent nocturnal cardiorespiratory monitoring and pre-operative blood sampling for GH and IGF-1.
  • Patients' auxological parameters were assessed using Cacciari's growth charts.
  • All participants underwent adenotonsillectomy, followed by post-operative saturation monitoring and growth assessments at 3 months and 1 year.

Main Results:

  • Post-adenotonsillectomy, all 70 patients showed recovery from OSAHS.
  • Significant increases in IGF-1 serum levels were observed at 3 months and 1 year post-surgery.
  • Auxological parameters, including height growth rate, significantly improved, with an accelerated growth speed from 5.4±1.3 cm/year pre-surgery to 9.9±1.7 cm/year post-surgery.

Conclusions:

  • Growth delay in children can be attributed to OSAHS.
  • Adenotonsillectomy is an effective therapeutic choice for growth delay caused by adenotonsillar hypertrophy in pediatric OSAHS patients.
Abstract

Keywords:
Adeno-tonsillectomyAdenotonsillar hypertrophyGH. IGF-1Growth failureObstructive sleep apnoea syndrome

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