Chronic Snoring Remains After Surgery For Obese And African-American

A new study of the Cincinnati Children's Hospital Medical Center
reports that the surgery to remove the tonsils and adenoids children to be treated
sleep-disordered breathing (SDB) can be successful in the short term.
However, children who are quick to weight and African-American children
tilt to recur, or even worse. The study is published in the American
Journal of Respiratory and Critical Care Medicine
.

Adenotonsillectomy - or removal of the tonsils and adenoids - is a
surgery, often on children. About 19 per 10,000 children in
Canada, 50 per 10000 in the United States and 115 per 10000 in the Netherlands
receive the surgery. Although it is often the first
SDB option for the treatment of children, many patients only under the condition
short-term relief from SDB.

Author Raouf Amin, MD, who is head of pulmonary medicine at the hospital
, writes: "The high rate of re-we observed in the two
Adiposen and non-obese
SDB Children pointed out that this is a chronic condition. "

Amin and colleagues with a sample of 40 healthy children aged between 7 and 13,
Their parents and otolaryngologists agreed to treat chronic snoring

Adenotonsillectomy. Thirty sex-and age-matched groups of children who are not
After the surgery were recruited as a control group. At the time of
setting, each child was given a polysomnography (PSG) -
multi-parametric test for the sleep study. PSGs were back in
Six weeks, six
months, and one year after the operation, both for the treatment and control groups
.

Six weeks after the surgery, most of the children improved their SDB
apnea-hypopnea index (AHI) scores. However, the rate of relapse after one year
had no correlation with the six-week score. Traits like
obesity, SDB worse than initial value, fast body mass index (BMI) win, and
African-Americans, were in connection with children who relapse.

"Most post adenotonsillectomy outcome studies have focused on the assessment of the SDB
six to 16 weeks after the surgery. Dissolution of the SDB
During this window, as a rule as a remedy for the
disorder. "Dr. Amin pointed out that "We report [ed] for the first time of the longitudinal
-
adenotonsillectomy result in healthy children, the important influence of BMI
gain speed and Afro-American race to repeat
The SDB. "

Before the operation, about 50% of the non-obese children and 67% of children
Adiposen
AHI had a score of more than 3rd One year after surgery, 27% and 79%, Respectively
.
Had AHI score of more than 3rd These changes indicate that the surgery
War
Significantly effective and non-obese children over the years.
Adiposen children who are at the base line and independently, children
Had rapid win BMI were more likely relapse than those who
If these properties.

Amin clarifies, "These results underline the differential
disease mechanisms between
due to obesity and by the rapid changes in the body language
composition, BMI accelerated with the win. "Moreover,
relapse was significantly associated with children who had higher blood pressure
.

"SDB appears to be a chronic disorder that is clearly in the context of other medical problems
. Given the rate of recidivism, we advocate long time -
Follow - up of children with SDB, monitoring the BMI win, and
revaluation of the children, showing rapid BMI win, especially
Those who are African-American, "the researchers conclude.

Growth Velocity Predicts Recurrence of sleep-disordered Breathing
1 year after Adenotonsillectomy


Raouf Amin, Leonard Anthony, Virend Somers, Matthew fennel, Keith
McConnell, Jenny Jefferies, Paul Willging, Maninder Kalra, and Stephen Daniels

American Journal of Respiratory and Critical Care Medicine
(2008 ). 177 :654-659.

Doi: 10.1164/rccm.200706-841OC

Written by: Peter M Crosta

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