The effect of recurrent tonsillitis and adenotonsillectomy on growth in childhood

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-tike 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, 1GF-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 125 ng/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 +/- 105.9 ng/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. (c) 2007 Elsevier Ireland Ltd. All rights reserved.