Effect of Adenotonsillectomy on Peak Expiratory Flow Rate Among Children

• Published in: Indian journal of otolaryngology, and head, and neck surgery Vol. 74; no. Suppl 3; pp. 6491 - 6496
• Main Authors: Singhal, Akshi, Kumar, Lovneesh, Agarwal, Vinish Kumar, Bist, Sampan Singh, Agrawal, Nitika
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01.12.2022; Springer Nature B.V
• Subjects: Airway management; Head and Neck Surgery; Medicine; Medicine & Public Health; Original; Original Article; Otolaryngology; Otorhinolaryngology; Peak expiratory flow rate; Pulmonary function test; Adenotonsillectomy; Upper airway obstruction
• ISSN: 2231-3796; 0973-7707
• DOI: 10.1007/s12070-021-02748-w

Adenotonsillar hypertrophy is one of the commonest causes of upper airway obstruction in children. It can cause hypoxic state by impairing pulmonary functions. Peak expiratory flow rate is a basic, convenient and reliable indicator of pulmonary function in children. To study the improvement in pulmonary functions by assessing Peak expiratory flow rate, before and after adenotonsillectomy in children. Design: Cross sectional, prospective, observational study. Setting: Department of otorhinolaryngology in tertiary care centre. Subjects: Included 40 children aged between 5 and 15 years, who had adenotonsillar hypertrophy and underwent adenotonsillectomy. Method: Diagnostic nasal endoscopy and X-ray, nasopharynx, was done to assess the grade of adenoid hypertrophy endoscopically and radiologically respectively. Peak expiratory flow rate was assessed using Mini Wright peak expiratory flow meter pre-operatively and 1 month post-operatively and both the readings were compared. Subjective improvement was also compared pre-operatively and post-operatively using visual analogue score. This study included 40 patients with male to female ratio of 1.6:1, 92.5% presented with mouth breathing. 92.5% presented with grade III tonsillar hypertrophy and 70% with grade III adenoid hypertrophy endoscopically. After adenotonsillectomy, improvement in Peak expiratory flow rate ranged from 16 to 25.3% which was statistically significant. Patients with grade III tonsillar and grade IV adenoid hypertrophy showed 25.3% improvement. Subjective improvement was 98.8% in the complaint of snoring. Adenotonsillectomy significantly improves pulmonary functions. This may help to improve physical and cognitive development in children and decrease chances of getting cardiopulmonary problems in later life.