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ORIGINAL RESEARCH

The Efficacy of Adenotonsillectomy in Patients With Pfapa Sydrome
PFAPA Sendromlu Hastalarda Adenotonsillektominin Etkinliği
Received Date : 01 Jan 2019
Accepted Date : 07 Feb 2019
Doi: 10.24179/kbbbbc.2019-64666 - Makale Dili: TR
KBB ve BBC Dergisi 2019;27(1):9-13
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 evaluate the efficacy of adenotonsillectomy in the treatment of PFAPA (periodic fever, aphthous stomatitis, pharyngitis and adenitis). Material and Methods: Eleven children with PFAPA diagnosed between November 2013-December 2017 were evaluated retrospectively after at least one year follow-up. Results: The mean age of the operated patients was 46.36±3.75 months. At the end of one-year follow-up, in 9 of 11 patients, the febrile periods ended completely. Time between fever periods in two patients, increased from 3-6 weeks to 4 months. FMF (familial Mediterranean fever) mutation gene was positive in both of these patients. Conclusion: Although the number of patients is small in this study, adenotonsillectomy can be offered to families as an effective solution for treatment, because surgery dramatically ended febrile periods in all children with PFAPA. In children having PFAPA together with FMF, adenotonsillectomy may be offered to families, as it extends the time between the periods, although it does not finish the attacks.
ÖZET
Amaç: Adenotonsillektominin, PFAPA (periyodik ateş, aftöz stomatit, farenjit ve adenit) tedavisindeki etkinliğini değerlendirmektir. Gereç ve Yöntemler: Kasım 2013-Aralık 2017 tarihleri arasında PFAPA tanısı almış ve adenotonsillektomi uygulanan 11 çocuk hastanın en az bir yıllık takip sonrasındaki ateşli periyotları retrospektif olarak değerlendirildi. Bulgular: Ameliyat edilen hastaların ortalama yaşı 46,36±3,75 ay idi. On bir hastanın dokuzunda bir yıllık izlem sonunda ateşli periyotlar tamamen sona erdi. İki hastada ateşli periyotlar üç-altı haftalık aralıktan dört aya kadar uzadı. Her iki hastada da FMF (ailesel Akdeniz ateşi) mutasyon geni pozitif saptandı. Sonuç: Hasta sayısı az olmasına karşın, bu çalışmadaki PFAPA tanısı almış tüm çocuklarda dramatik iyileşme sağladığından, adenotonsillektomi tedavide etkin bir çözüm olarak ailelere sunulabilmektedir. PFAPA ile FMF birlikteliği olan çocuklarda ise adenotonsillektomi, ateşli dönemleri bitirmese de dönemler arasındaki süreyi uzattığından ailelere önerilebilmektedir.
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