The importance of pulmonary function tests in adenotonsillectomy indications
1Department of Pediatrics and Respiratory Medicine, Dokuz Eylül University, Faculty of Medicine, Izmir, Turkey.
Insights
Pulmonary function tests detected mild, temporary obstructive pulmonary disease in children undergoing adenotonsillectomy for recurrent infections. These obstructive findings resolved post-surgery, indicating the test
Area of Science:
- Pediatric Pulmonology
- Otolaryngology
Background:
- Recurrent adenotonsillitis in children can lead to adenotonsillar hypertrophy.
- Obstructive manifestations are not always clinically or radiologically apparent.
- Pulmonary function tests (PFTs) assess lung function and airflow.
Purpose of the Study:
- To evaluate the utility of PFTs in detecting subclinical obstructive effects in children with recurrent adenotonsillitis.
- To assess the impact of adenotonsillectomy on pulmonary function in these children.
Main Methods:
- Pulmonary function tests were performed on 45 children before and one month after adenotonsillectomy.
- Children had recurrent adenotonsillitis but no overt clinical or radiological signs of obstruction.
- Key spirometry parameters including FVC, PEF, FEV1, FEF25, FEF50, and FEF75 were measured.
Main Results:
- Sixty percent (27/45) of children exhibited transient mild obstructive pulmonary disease findings on PFTs.
- Significant improvements were observed in all measured PFT parameters post-adenotonsillectomy (p < 0.01).
- Mean FVC increased from 82.22% to 93.11%, PEF from 77.60% to 88.60%, and FEV1 from 74.28% to 90.15%.
- Airflow parameters like FEF25, FEF50, and FEF75 also showed significant increases.
Conclusions:
- PFTs can identify obstructive effects associated with adenotonsillar hypertrophy even without clinical or radiological signs.
- Adenotonsillectomy is effective in resolving these subclinical obstructive pulmonary findings.
- PFTs can aid in the surgical indication for adenotonsillectomy in children with recurrent infections.
Abstract:
Children who had undergone adenotonsillectomy for recurrent adenotonsillitis showing no signs of clinical or radiological obstructive manifestations were evaluated with pulmonary function tests before, and one month after the operation. In relation to the result obtained by function tests, 60% of 45 cases (27) had the findings of mild obstructive pulmonary disease whereby these findings were in transient character that vanished after the operation. The following parameters were measured and found that they were all increased, mean FVC from 82.22 +/- 6.82 to 93.11 +/- 7.81 (p < 0.01), mean PEF from 77.60 +/- 8.38 to 88.60 +/- 5.57 (P < 0.01), mean FEVI from 74.28 +/- 11.68 to 90.15 +/- 7.28 (p < 0.01), mean FEF 25 from 71.44 +/- 11.53 to 83.53 +/- 6.40 (p < 0.01), mean FEF 50 from 69.53 +/- 14.53 to 84.37 +/- 7.72 (p < 0.01), mean FEF 75 from 70.08 +/- 12.15 to 85.48 +/- 7.15 (p < 0.01). In conclusion, pulmonary function tests could reveal the obstructive effects of adenotonsillar hypertrophy with no clinical or radiological obstructive findings, and could be useful in surgical indications of adenotonsillar hypertrophy dur to recurrent infections in children.
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