[Effects of adenotonsillectomy on pulmonary arterial pressure]

There are several studies which have shown that adenotonsillar hypertrophy can cause airway obstruction, chronic alveolar hypoventilation and even may lead to severe cardiopulmonary complications like pulmonary artery hypertension. The aim of this study was to evaluate the effects of adenotonsillectomy on pulmonary arterial pressure in children with hypertrophic tonsils and adenoids. fourty children [21 males, 19 females] aged between 4 and 14 [mean 7/9 +/- 2/3] years with a diagnosis of upper airway obstruction due to hypetrophied tonsils and adenoids were included in our study. Pulmonary arterial pressure was measured by Doppler echocardiography both preoperatively, and 6 weeks after operation. Preoperative pulmonary arterial pressure [PAP] was 26/1 +/- 3/9 mmHg and postoperative PAP was 25/9 +/- 5 mmHg. Although in two cases out of three ones who had raised preoperative PAP, adenotonsillectomy resulted in decreasing the pressure, but there was no statistically significant difference between pre-operative and post-operative echocardiographic findings. It seems that whilst increasing of pulmomary arterial pressure [owing to Adenotonsillar hypertrophy], adenotonsillectomy can be of beneficial outcomes in decreasing this pressure

Esophageal foreign bodies

Foreign body ingestion is a common occurrence in children and high risk groups of adults such as those with underlying esophageal disease, the mentally retarded, and those with psychiatric illnesses.For this existing data type study all patients who had referred during a 4-year period [1993-96] to Loghman Hakim and Taleghani hospitals with the diagnosis of esophageal foreign bodies were included.The study population included 77 children and 123 adults [89 females and 111 males]. Most of the affected subjects aged 2-6 years. The most frequently ingested objects were coins [45.5%], bones [meat, chicken, fish] [33%], vegetable objects [8.5%], dentures [5%] and other metal and non metal objects [8.5%]. The most prominent complaints were dysphasia with pain [54.5%], dysphasia without pain [21%], pain without dysphasia [8%], no dysphasia or pain [16.5%]. Radiographic studies revealed soft tissue in neck region and foreign bodies in 84% of the cases. Rigid esophagoscopy was performed to remove the foreign bodies, however, in 12% of cases complications including bleeding of hypopharynx and esophagus [3%], tearing of mucous membrane [8.5%], perforation of esophageal wall and mediastinitis [0.5%] did occur.Early detection of esophageal foreign bodies is of utmost importance since their complications are serious and can be life-threatening