Children with sleep disordered breathing (SDB) may have a better  quality of life (QOL) and diminished cardiovascular (CV) disease risk  from the decreased endothelin 1 (ET-1) levels after adenotonsillectomy,  according to new research  published in the journal Otolaryngology–Head and Neck Surgery.

SDB is an increasingly common indication for tonsillectomy and  adenoidectomy due to obstructive sleep apnea (OSA). Cardiovascular  disease frequently has been reported in patients with moderate to severe  OSA. Related abnormalities include: systematic hypertension, pulmonary  hypertension with cor pulmonale, left ventricular hypertrophy or  dysfunction, cardiac arrhythmias, atherosclerosis, and coronary artery  disease.

The study sample included an OSA survey and a detailed personal and  family history. All subjects underwent a complete otolaryngologic  examination, otoscopy, and anterior rhinoscopy. Thirty-seven children  with a diagnosis of upper airway obstruction caused by adenotonsillar  hypertrophy (ATH) were included in the study. Twenty female and 17 male  patients, between 3 and 13 years old, participated in the study.

Surgical procedures included: 20 tonsillectomies and adenoidectomies  (54%), 15 adenoidectomies only (40.6%), and 2 tonsillectomies only  (5.4%). Study results show when comparing moderate and severe cases to  mild cases according to Brouilette scores, ET-1 levels were  significantly higher in moderate and severe cases (P < 0.01). There  was a significant correlation between ET-1 and the OSA-18 survey scale  (r=0.442; P=0.001).

The researchers set out to evaluate the influence of  adenotonsillectomy on the plasma concentration of ET-1 levels and  C-reactive protein (CRP) in children with SDB. The primary goal of this  research study was to investigate the effect of ATH and  adenotonsillectomy on the possible pathogenic mechanisms (endothelial  dysfunction and inflammation) that lead to cardiovascular complications.

According to the study’s authors, the findings indicate that  “children with SDB who undergo adenotonsillectomy may have a better QOL,  and the positive influence of adenotonsillectomy on CV function might  be mediated by the decrease in ET-1 levels.”

They further acknowledge that more research is needed. “Further  studies with longer follow-up and a larger population sample are  warranted to demonstrate the association between SDB due to ATH and ET-1  levels and to confirm the influence of adenotonsillectomy on ET-1 and  CRP levels to prevent cardiovascular disease in children,” noted the  authors.

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Filed under: Cardiovascular DiseaseClinical ResearchHypertensionObstructive Sleep ApneaOther DisordersSleepSleep ApneaSleep Apnea EffectsSleep Apnea in ChildrenSleep Apnea ResearchSleep Disordered BreathingSleep DisordersSleep Problems

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