Mehmet İlhan ŞAHİN, İsmail KÜLAHLI, Levent KARTAL, Mustafa KENDİRCİ

Çocuklarda kronik adenotonsiller hipertrofinin büyüme üzerine etkilerinin adenotonsillektomi öncesi ve sonrası dönemde değerlendirilmesi

Amaç: Büyüme, genetik, beslenme ve çevresel etmenlerin rol oynadığı çok yönlü bir süreçtir. Büyüme geriliğine neden olabilecek etmenler arasında üst hava yolu tıkanıklığı yapan adenotonsiller hipertrofi de yer almaktadır. Adenotonsiller hipertrofinin cerrahi tedavisinin büyüme üzerine olumlu etkisi olduğu düşünülmektedir. Bu çalışmada, adenotonsillektomi öncesi ve sonrası dönemde ölçülen ağırlık, boy, beden kitle indeksi , kemik yaşı, serum insülin benzeri büyüme faktörü 1 (IGF-1) ve insülin benzeri büyüme faktörü bağlama protein 3 (IGFBP-3) değerleriyle kronik adenotonsiller hipertrofinin büyüme üzerine etkilerinin gösterilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışma için etik kurul onayı (04.05.2004; no: 04/170) ve çocukların velilerinden bilgilendirilmiş gönüllü olur formu alındı. Kronik adenotonsiller hipertrofi tanısı konan 40 ergenlik öncesi çocuk çalışmaya dahil edildi. Ameliyat öncesi tıkayıcı belirtiler sorgulandı. Hastaların ağırlık, boy, beden kitle indeksi ve kemik yaşı değerleri kaynak değerlerle karşılaştırıldı. Ameliyat öncesi ölçülen serum IGF-1 ve IGFBP-3 değerleri, 27 sağlıklı çocuktan oluşan kontrol grubununkilerle karşılaştırıldı. Adenotonsillektomiden yedi ay sonra, bulguların görülme oranı ve ağırlık, boy, beden kitle indeksi, kemik yaşı, serum IGF-1 ve IGFBP-3 değerleri saptanarak ameliyat öncesi değerlerle karşılaştırıldı. Bulgular: Tıkayıcı belirtilerin ameliyattan sonra belirgin şekilde azaldığı saptandı. Hastaların kemik yaşı ortalamaları, sağlıklı kaynak değerlere göre düşük bulundu (p

Evaluation of the effects of adenotonsillar hypertrophy and adenotonsillectomy on growth in children

Aim: Several factors including genetic factors, nutrition and environment play a critical role in the growth of children. Adenotonsillar hypertrophy (ATH) can cause growth retardation by obstructing the upper airway. Surgical treatment of ATH has been considered to have a positive effect on growth. The aim of this study was to evaluate the role of chronic ATH on growth by measuring weight, height, body mass index (BMI), bone age, serum insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) values before and after adenotonsillectomy. Material and Method: The study was approved by the Ethics Committee (4.5.2004; 04/170) and written informed consents were obtained from parents of the participants. A total of 40 prepubertal children who were diagnosed as chronic ATH were enrolled. Obstructive symptoms were questioned in the medical history before surgery. Weight, height, BMI and bone age values were measured and compared with reference values. Preoperative serum IGF-1 and IGFBP-3 values were compared with the control group which consisted of healthy children. Rates of obstructive symptoms, weight, height, BMI, bone age, serum IGF-1 and IGFBP-3 values of the patients were determined seven months after adenotonsillectomy and were compared with preoperative values. Results: Obstructive symptoms in children with ATH decreased remarkably after surgery. Preoperative mean value of bone age of the patients was statistically lower than reference values (p

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