Correlation Between Upper Airways Obstructive Indexes in Adenotonsilar Hypertrophy with Mean Pulmonary Arterial Pressure

Abstract

<em>Introduction:</em> Hypertrophied tonsils and adenoids may cause upper airway obstruction and cardio-pulmonary complications due to pulmonary arterial hypertension. The aim of this study was to determine the correlation between mean pulmonary arterial pressure (mPAP) and selected adenotonsilar hypertrophy indexes. <em>Materials and Methods: </em> Thirty two patients with upper-airway obstruction resulting from hypertrophied tonsils and adenoids were included in our study. Mean pulmonary arterial pressure was measured by a non-invasive method using color doppler echocardiography. Upper airway obstruction was evaluated by clinical OSA (obstructive sleep apnea) scoring and also adenoidal-nasopharyngeal (A/N) ratio in the lateral neck radiography. <em>Results:</em> Fifty percent of the patients with a normal OSA score, 20% of those with a suspected OSA score and also 50% of cases with OSA had pulmonary hypertension (mPAP>20mmHg) which was not statistically significant (<em>P</em>=0.198). Mean Adenoidal-nasopharyngeal ratio in patients with a normal mPAP (mPAP≤20mmHg) was 0.61±0.048 and it was 0.75±0.09 in those with pulmonary hypertension; the difference was statistically significant (<em>P</em>=0.016). <em>Conclusion:</em> It seems that A/N ratio could be used as a predicting factor for increased mPAP in children with upper airway obstruction and a pediatric cardiologist consultation may be necessary before some surgical interventions.