ORIGINAL RESEARCH
Early Postoperative Weight and Height Gain After Adenoidectomy and Parental Satisfaction
Adenoidektomi Sonrası Kilo Alımı, Boy Artışı ve Ebeveyn Memnuniyeti
Received Date : 31 Jan 2019
Accepted Date : 08 May 2019
Pelin KOÇDORa,c,d,, Elif ELHAKANc, Evrim ŞENKALb,c,, Arzu TATLIPINARa,c
aKulak Burun Boğaz Hastalıkları AD,
bÇocuk Sağlığı ve Hastalıkları AD,
cİstanbul Okan Üniversitesi Tıp Fakültesi,
dKulak Burun Boğaz Hastalıkları AD,
Başkent Üniversitesi İstanbul Sağlık Uygulama ve Araştırma Merkezi Hastanesi, İstanbul, TÜRKİYE
Doi: 10.24179/kbbbbc.2019-65218 - Makale Dili: TR
KBB ve BBC Dergisi 2019;27(2):45-50
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: To assess the effect of adenoidectomy on weight and height gain with postoperative
parental satisfaction about sleep disordered breathing at early postoperative period in
children. Material and Methods: The weight, height and Z-scores of children who underwent adenoidectomy
at Okan University hospital were measured preoperative and postoperatively at 3rd
month. Parents were asked to fill out Pediatric Sleep Questionnaires preoperative and postoperatively
at 3rd month. The data of some healthy childs who were followed by pediatric department at
Okan University department of pediatrics were used as the control group. Results: Preoperative
weight and height of the kids with adenoidectomy (n=32) were statistically different than postoperative
measures. There was also statistically significant difference in the control group between first
and and second check-ups (3rd month visit). Z-scores of the weight and height of the adenoidectomy
group was significantly different between preoperative and postoperative measures, on the other
hand there was no difference in the control group measures between first and 3rd month visit. Preoperative
Pediatric Sleep Questionnaires score mean was 9.23±3.73 and postoperative Pediatric
Sleep Questionnaires score mean was 2.77±2.55. Conclusion: Adenoidectomy has an effect on
weight and height gain and in the improvement of Pediatric Sleep Questionnaires scores in the
early postoperative period. To know that the adenoidectomy alone may improve the symptoms of
sleep-disordered breathing and obstructive sleep apnea at some patients instead of adenotonsillectomy,
can help the surgeon and the parents in the decision making process.
Keywords: Adenoidectomy; weight; height; parental satisfaction
ÖZET
Amaç: Çocuklarda adenoidektomi sonrası erken postoperatif dönemde, uyku bozukluğu açısından
ebeveyn memnuniyeti ve fiziksel değişimi (kilo, boy) araştırmaktır. Gereç ve Yöntemler:
Okan Üniversitesi Tıp Fakültesi Hastanesi Kulak Burun Boğaz Kliniğinde adenoidektomi olan pediatrik
hastalarda, ameliyat öncesi ve sonrası üçüncü ayda boy, kilo, ayrıca Z skorlarına bakıldı. Bu
hastaların ebeveynlerine Pediatrik Uyku Anketi uygulandı. Kontrol grubu olarak; aynı dönemde
Pediatri Kliniği Sağlıklı Çocuğa başvuran bir grup hastanın; ilk başvuru kilo, boy, Z skorları ve
üçüncü ay değerleri belirlendi. Bulgular: Adenoidektomi olan bireylerde (n=32), preoperatif ve
postoperatif kilo ve boy ortalamaları arasında istatistiksel olarak anlamlı farklılık mevcuttur.
Aynı şekilde, kontrol grubunda da (n=37) birinci ay ve üçüncü ay ölçümler arasında istatistiksel
anlamlı fark bulundu. Adenoidektomi grubundaki postoperatif kilo Z-skor ortancaları, preoperatif
kilo Z-skor ortancalarına göre daha yüksek iken, kontrol grubunda ilk muayene ve
üçüncü ay muayene kilo Z-skor ortancaları arasında istatistiksel olarak anlamlı fark bulunmadı.
Adenoidektomi grubundaki bireylerin postoperatif boy Z-skor ortancaları, preoperatif boy Zskor
ortancalarına göre daha yüksek idi, kontrol grubundaki bireylerde ise ilk muayene ve
üçüncü ay muayene boy Z-skor ortancaları arasında istatistiksel olarak anlamlı fark belirlenmedi.
Adenoidektomili bireylerde, Pediatrik Uyku Anketi preoperatif uyku anketi skor ortalaması
9,23±3,73 iken, Pediatrik Uyku Anketi postoperatif uyku anketi skor ortalamasının
2,77±2,55 olduğu saptandı. Sonuç: Adenoidektomi kilo alımı, boy artışına erken dönemde katkı
sağlamakta, uyku anket skorlarında düzelmeye neden olmaktadır. Uyku bozuklukları veya tıkayıcı
uyku apnesi nedeni ile adenotonsillektomi planlanan bazı hastalarda adenoidektominin
de tek başına belirgin bir iyileşme sağlayabildiğini bilmek, cerrahiye karar vermede, gerek cerraha
gerekse ebeveyn beklentilerine yardımcı olacaktır.
Anahtar Kelimeler: Adenoidektomi; kilo; boy; ebeveyn memnuniyeti
KAYNAKLAR
- Lee CH, Kang KT, Weng WC, Lee PL, Hsu WC. Quality of life after adenotonsillectomy for children with sleep-disordered breathing: a linear mixed model analysis. Int J Pediatr Otorhinolaryngol. 2014;78(8):1374-80. [Crossref] [PubMed]
- Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc. 2008;5(2):242-52. [Crossref] [PubMed] [PMC]
- Marcus CL. Sleep-disordered breathing in children. Am J Respir Crit Care Med. 2001;164 (1):16-30. [Crossref] [PubMed]
- Tran KD, Nguyen CD, Weedon J, Goldstein NA. Child behavior and quality of life in pediatric obstructive sleep apnea. Arch Otolaryngol Head Neck Surg. 2005;131(1):52-7. [Crossref] [PubMed]
- Ericsson E, Lundeborg I, Hultcrantz E. Child behavior and quality of life before and after tonsillotomy versus tonsillectomy. Int J Pediatr Otorhinolaryngol. 2009;73(9):1254-62. [Crossref] [PubMed]
- Baldassari CM, Mitchell RB, Schubert C, Rudnick EF. Pediatric obstructive sleep apnea and quality of life: a meta-analysis. Otolaryngol Head Neck Surg. 2008;138(3):265-73. [Crossref] [PubMed]
- Gottlieb DJ, Vezina RM, Chase C, Lesko SM, Heeren TC, Weese-Mayer DE, et al. Symptoms of sleep-disordered breathing in 5-year-old children are associated with sleepiness and problem behaviors. Pediatrics. 2003;112 (4):870-7. [Crossref] [PubMed]
- Yüksel H, Söğüt A, Yılmaz Ö, Kutluay E. Reliability and validity of the Turkish version of the pediatric sleep questionnaire: a tool for prediction of sleep related breathing disorder. Tuberk Toraks. 2011;59(3):236-41. [Crossref] [PubMed]
- Mohsen N, Susan A, Shahin B, Soheila D. Sleep related quality of life before and after adenotonsillar surgery in pediatric population. Int J Pediatr Otorhinolarygol. 2014;78(2):330-3. [Crossref] [PubMed]
- Lewis TL, Johnson RF, Choi J, Mitchell RB. Weight gain after adenotonsillectomy: a case control study. Otolaryngol Head Neck Surg. 2015;152(4):734-9. [Crossref] [PubMed]
- Domany KA, Dana E, Tauman R, Gut G, Greenfeld M, Yakir BE, et al. Adenoidectomy for obstructive sleep apnea in children. J Clin Sleep Med. 2016;12(9):1285-91. [Crossref] [PubMed] [PMC]
- Randall DA, Hoffer ME. Complications of tonsillectomy and adenoidectomy. Otolaryngol Head Neck Surg. 1998;118(1):61-8 [Crossref]
- Brodsky L. Modern assessment of tonsils and adenoids. Pediatr Clin North Am. 1989;36(6): 1551-69. [Crossref]
- Neyzi O, Bundak R, Gökçay G, Günöz H, Furman A, Darendeliler F, et al. [Body weight, body height, head circumference and body mass index references for Turkish children]. Turkish J Pediatr. 2008;51(1):1-14.
- Jeyakumar A, Fettman N, Armbreccht ES, Mitchell R. A systematic review of adenotonsillectomy as a risk factor for childhood obesity. Otolaryngol Head Neck Surg. 2011;144 (2):154-8. [Crossref] [PubMed]
- Czechowicz JA, Chang KW. Analysis of growth curves in children after adenotonsillectomy. JAMA Otolaryngol Head Neck Surg. 2014;140(6):491-6. [Crossref] [PubMed]
- Katz ES, Moore RH, Rosen CI, Mitchell RB, Amin R, Arens R, et al. Growth after adenotonsillectomy for OSA: a RCT. Pediatrics. 2014;134(2):282-9. [Crossref] [PubMed] [PMC]
- Chervin RD, Weatherly RA, Garetz SL, Ruzicka DL, Giordani BJ, Hodges EK, et al. Pediatric sleep questionnaire: prediction of sleep apnea and outcomes. Arch Otolaryngol Head Neck Surg. 2007;133(3):216-22. [Crossref] [PubMed]
- Lewandowski AS, Toliver-Sokol M, Palermo TM. Evidence-based review of subjective pediatric sleep measures. J Pediatr Psychol. 2011;36(7):780-93. [Crossref] [PubMed] [PMC]
- Kukwa W, Kukwa A, Galazka A, Czarnecka AM, Krzeski A, Migacz E, et al. Long-term parental satisfaction with adenotonsillectomy: a population study. Sleep Breath. 2015;19(4): 1425-9. [Crossref] [PubMed] [PMC]
- Brietzke SE, Gallagher D. The effectiveness of tonsillectomy and adenoidectomy in the treatment of pediatric obstructive sleep apnea/hypopnea syndrome: a meta-analysis. Otolaryngol Head Neck Surg. 2006;134(6): 979-84. [Crossref] [PubMed]
- Özmen S, Özmen ÖF. Failure rate of adenoidectomy and reasons of failure in the short term. Int J Otolaryngol Head Neck Surg. 2012;1:14-7. [Crossref]
- Fischer Y, Rettinger G, Dorn M. [Long term change in quality of life after adenotonsillectomy for pediatric obstructive sleep disorders]. Laryngorhinootologie. 2006;85(11):809-18. [Crossref] [PubMed]
- Cheng J, Elden L. Outcomes in children under 12 months of age undergoing adenotonsillectomy for sleep-disordered breathing. Laryngoscope. 2013;123(9):2281-4. [Crossref] [PubMed]
- Windfuhr JP, Chen YS. Post-tonsillectomy and-adenoidectomy hemorrhage in nonselected patients. Ann Otol Rhinol Laryngol. 2003;112(1):63-70. [Crossref] [PubMed]
- Erickson BK, Larson DR, St. Sauver JL, Meverden RA, Orvidas LJ. Changes in incidence and indications of tonsillectomy and adenotonsillectomy, 1970-2005. Otolaryngol Head Neck Surg. 2009;140(6):894-901. [Crossref] [PubMed]
- Shatz A. Indications and outcomes of adenoidectomy in infancy. Ann Otol Rhinol Laryngol. 2004;13(10):835-8. [Crossref] [PubMed]
- Thadikonda KM, Shaffer AD, Stapleton AL. Outcomes of adenoidectomy-alone in patients less than 3-years old. Int J Pediatr Otorhinolaryngol. 2018;106:46-9. [Crossref] [PubMed]
- Kay DJ, Bryson PC, Casselbrant M. Rates and risk factors for subsequent tonsillectomy after prior adenoidectomy: a regression analysis. Arch Otolaryngol Head Neck Surg. 2005;131(3):252-5. [Crossref] [PubMed]
- Gov-Ari E, Mills JC, Basler KJ. Predictors of tonsillectomy after previous adenoidectomy for upper airway obstruction. Otolaryngol Head Neck Surg. 2012;146(4): 647-52. [Crossref] [PubMed]
- Cohen-Levy J, Quintal MC, Abela A, Rompré P, Almeida FR, Huynh N. Persistent sleep disordered breathing after adenoidectomy and/or tonsillectomy: a long-term survey in a tertiary pediatric hospital. Sleep Breath. 2018;22(4): 1197-205. [Crossref] [PubMed]