The effect of recurrent tonsillitis and adenotonsillectomy on growth in childhood.

ABSTRACT

OBJECTIVE: Tonsil 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. METHODS: Thirty-eight prepubertal children 24 boys and 14 girls participated in this study. The mean age at surgery was 6.66+/-1.84 years (range 4-10 years). Weight, height, IGF-1 and IGFBP-3 levels and standard deviation scores were evaluated before and 12-18 months after adenotonsillectomy (T&A). RESULTS: The number of infections in a year reduced from 8.6+/-4.4 to 0.37+/-0.68 after operation. The mean weight standard deviation score (SDS) increased significantly after T&A (p<0.01). The mean IGFBP-3 level increased from 1912+/-511.5 to 2989+/-1125ng/ml (p<0.001) and IGFBP-3 SDS increased from -3.0+/-0.58 SDS to -1.96+/-1.27 SDS (p 0.001). However, the mean serum IGF-1 level increased from 80.3+/-48.5 to 116.8+/-105.9ng/ml (p 0.135), and IGF-1 SDS increased from -1.36+/-0.51 SDS to -1.31+/-1.14 SDS (p 0.701), which were both not statistically significant. CONCLUSIONS: We have demonstrated postoperative weight gain and significant increase in IGFBP-3 concentrations and IGFBP-3 SDS, accompanying significant decrease in the number of tonsillitis episodes after adenotonsillectomy.