Effect of Adenotonsillectomy on Peak Expiratory Flow Rate Among Children.

Unlabelled: 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.