Correlation between upper airways obstructive indexes in adenotonsilar hypertrophy with mean pulmonary arterial pressure

ABSTRACT

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. 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. 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 [P= 0.198]. Mean Adenoidal-nasopharyngeal ratio in patients with a normal mPAP [mPAP pulmonary hypertension; the difference was statistically significant [P=0.016]. 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: