Adenotonsillar Hypertrophy in Children: Surgery Improves Right Ventricular Cardiac Functions

Objective: To determine the effect of surgical and conservative treatment of adenotonsillar hypertrophy on right ventricular functions in children. Methods: An interventional study was conducted in 50 children with a mean age of 8.72 ± 4.72 years and 7.32 ± 3.84 years and randomized in medical and surgical groups. Cardiac parameters were observed at the time of enrollment, first month, third month, and sixth month after medical or surgical intervention. Results: The patients in the medical group did not show any resolution of symptoms at the end of the third month, while 36% of patients had resolution of symptoms at the end of the sixth month. Patients of this group had improvement only in right ventricular outflow tract systolic excursion at the end of the final follow-up. However, the surgical group found 88% of patients with complete resolution of symptoms at the end of the sixth month. The echocardiographic parameters of both the groups had improvements in the number of cardiac parameters like tricuspid annular plane systolic excursion, right ventricular outflow tract systolic excursion, pulmonary artery pressure, and pulmonary flow acceleration time at the end of the final follow-up (6 months); however, the inter-group analysis found significant improvement in the surgical group compared to the medical group. Conclusion: Adenotonsillar hypertrophy is known to affect right ventricular functions, and these can be improved better with surgery than with conservative management. Hence, surgery should be prioritized in adenotonsillar hypertrophy to reduce the immediate or risks in adulthood of cardiovascular diseases in few selected patients.