Among children presenting for T&A or having sleep symptoms assessed, growth failure was at least twice the expected rate in six of eight published studies. Across these six studies, this rate ranged from a low of 6%of children <3rd percentile for weight and 6%<3rd percentile for height in one study, to a high of 52%who were <3rd percentile in weight in a second study, and 44%who were 
5th percentile for height in a third. Among children presenting for T&A at our own institution, 14%were 5th percentile in height, and 11%were 5th percentile in weight. Among children under 6 years of age, 21%were either 5th percentile in weight and/or height.
Published studies, as well as our own pilot data support the hypothesis that SDB, secondary to adenotonsillar hypertrophy increases the risk of growth failure in children. Adenotonsillar hypertrophy and sleep disordered breathing may be unrecognized risk factors in the etiology of growth failure. Otolaryngologists can play an important role in identifying growth failure, and referring children to the appropriate specialists.
Purchase PDF (217 K) | The effect of recurrent tonsillitis and adenotonsillect... International Journal of Pediatric Otorhinolaryngology |
International Journal of Pediatric Otorhinolaryngology, Volume 71, Issue 11, November 2007, Pages 1737-1742 Metin Aydogan, Demet Toprak, Şükrü Hatun, Atilla Yüksel, Ayse Sevim Gokalp Abstract SummaryObjectiveTonsil and adenoid hypertrophy may cause recurrent tonsillitis and upper airway obstruction in children. A reduced dietary intake and failure to gain weight is frequently reported by parents of children with a history of recurrent acute tonsillitis and adenotonsiller hypertrophy. The purpose of this prospective study was to evaluate whether surgical treatment of adenotonsillar hypertrophy affects the circulating concentrations of insulin-like growth factor-1 (IGF-1) and IGF-binding protein 3 (IGFBP-3) along with IGF-1 SDS and IGFBP-3 SDS's adjusted to age which are more important in evaluating growth in childhood. |
| The prevalence, anatomical correlates and treatment of ... Sleep Medicine Reviews |
Sleep Medicine Reviews, In Press, Corrected Proof, Available online 11 April 2008 Stijn L. Verhulst, Luc Van Gaal, Wilfried De Backer, Kristine Desager Abstract SummaryThe prevalence of childhood obesity is increasing worldwide. One of the obesity-related complications that has received increasing attention in recent years is sleep-disordered breathing. Obese children are at a higher risk of developing sleep-disordered breathing, including habitual snoring, obstructive sleep apnea syndrome and desaturations preceded by central apneas. Both adiposity and upper airway factors, such as adenotonsillar hypertrophy, modulate the severity of sleep-disordered breathing in these children. Adenotonsillectomy seems to be effective against obstructive sleep apnea syndrome in obese children. On the other hand, there are limited data on the effects of weight loss and of treatment with continuous positive airway pressure on the severity of sleep apnea in obese children and adolescents. Purchase PDF (181 K) |
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Changes in serum levels of IGF-1 and in growth following adenotonsillectomy in children
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