Introduction : Pulmonary Hypertension is characterized by normal pulmonary artery wedge pressure(<15mmHg), mean pulmonary arterial pressure(mPAP)>25mmHg at rest, andmPAP>30mmHg during exercise. If severe upper airways obstruction occurs, there will be symptoms such as severe alveolar hypoventilation, hypoxemia and the hypercarbia, secondary pulmonary arterial hypertension, right ventricular hypertrophy, and potent excretion of pulmonary vasoconstrictors. The characteristic clinical signs of upper air way obstruction in childhood are noisy breathing such as snoring or stridor, chest wall recession, restless sleep with frequent arousal, excessive daytime somnolence, nocturnal enuresis, behavioral changes and morning headache, systemic hypertension and failure to thrive. The aim of this study is to evaluate the changes of PAP after tonsillectomy and adenoidectomy and its contributing factors.
Methology : 13 patients were selected who were diagnosed as tonsilar and adenoidal hypertrophy at Chungnam National University Hospital. Each patient underwent echocardiogram at 1st, 2nd, 3rd and 30th day after operation. We checked mPAP and tricuspid valve E/A ratio measured in room air and O2 supply(5L/min via mask) state. The proBNP checked before operation. Statistical analysis was made by chai square test.
Result : The mean age of patient were 7.69±3.22 year (4-12). mPAP is markedly reduced after surgery(P<0.05). Tricuspid Valve E/A ratio was not reduced after surgery. O2 supplmentation reduced mPAP before surgery, but did not reduce mPAP after surgery.E/A ratio didn't influenced by O2 supplmentation.
Conclusion : The hypertrophy of tonsil and adenoid produced the pulmonary arterial hypertension. The pulmonary hypertension by airway obstruction is improved by tonsillectomy and adenoidectomy.