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Obstructive hypertrophic adenoids and tonsils as a cause of infantile failure to thrive: reversed by tonsillectomy
Insights
This study describes an infant with failure to thrive due to chronic hypoventilation caused by enlarged tonsils and adenoids. Surgical removal of these tissues successfully treated the condition and improved growth.
Area of Science:
- Pediatrics
- Otolaryngology
- Respiratory Medicine
Background:
- Failure to thrive (FTT) in infants is a complex condition with various potential causes.
- Chronic hypoventilation can lead to FTT but is not typically associated with isolated upper airway obstruction in infants.
- Hypertrophic tonsils and adenoids are common but their role in causing significant hypoventilation and FTT in infants is rarely documented.
Abstract:
Isolated failure to thrive in an infant caused by chronic hypoventilation due to hypertrophic adenoids and tonsils, has not been previously described. A 9 month-old infant presented with weight loss and mild clinical respiratory signs. Hypoxemia and CO2 retention, however, were documented by transcutaneous gas measurement, and ENT examination revealed enlarged tonsils and adenoids. Adenoidectomy and tonsillectomy at 9 1/2 months of age completely reversed the patient's hypoventilation and growth pattern. While the exact mechanism of failure to thrive secondary to upper airway obstruction in infancy is not clear, we conclude that routine ENT evaluation should be a regular part of the workup of infants under one year who suffer from failure to thrive.
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