K A Bonuck1, K Freeman, J Henderson. 1. Department of Family and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Mazer, Bronx, NY 10461, USA. bonuck@montefiore.org
Abstract
OBJECTIVE: To determine the effect of adenoidectomy and/or tonsillectomy ("adenotonsillectomy") upon growth and growth biomarkers, in the context of sleep disordered breathing (SDB). SDB in children, primarily due to adenotonsillar hypertrophy, increases the risk of growth failure. DESIGN: Systematic review and meta-analysis. PubMed, ERIC and Cochrane Reviews databases from January 1980 to November 2007 were searched for studies reporting: pre/post-adenotonsillectomy height and weight changes as percentage increased or decreased, raw data, z scores or centiles, or: IGF-1 and/or IGFBP-3 serum-level changes as z scores or raw data. For anthropometrics, the meta-analysis included studies presenting z scores or centiles. SETTING: Observational studies. PATIENTS: Otherwise healthy children, not selected for obesity. MAIN OUTCOME MEASURES: Pre/post-surgery changes in standardised height and weight, and IGF-1 and IGFBP-3. RESULTS: Of 211 citations identified, 20 met systematic review criteria. SDB was an enrolment criterion in 13 of the studies, and one of several enrolment criteria in three. Meta-analysis findings for pre/post-surgery changes were: standardised height: 10 studies, 363 total children, pooled standardised mean differences (SMD) = 0.34 (95% CI 0.20 to 0.47); standardised weight: 11 studies, 390 total children, pooled SMD = 0.57 (95% CI 0.44 to 0.70); IGF-1: 7 studies, 177 total children, pooled SMD = 0.53 (95% CI 0.33 to 0.73); IGFBP-3: 7 studies, 177 total children, pooled SMD = 0.59 (95% CI 0.34 to 0.83). CONCLUSIONS: Standardised height and weight, and IGF-1 and IGFBP-3 increased significantly after adenotonsillectomy. Findings suggest that primary care providers and specialists consider SDB secondary to adenotonsillar hypertrophy when screening, treating and referring children with growth failure.
OBJECTIVE: To determine the effect of adenoidectomy and/or tonsillectomy ("adenotonsillectomy") upon growth and growth biomarkers, in the context of sleep disordered breathing (SDB). SDB in children, primarily due to adenotonsillar hypertrophy, increases the risk of growth failure. DESIGN: Systematic review and meta-analysis. PubMed, ERIC and Cochrane Reviews databases from January 1980 to November 2007 were searched for studies reporting: pre/post-adenotonsillectomy height and weight changes as percentage increased or decreased, raw data, z scores or centiles, or: IGF-1 and/or IGFBP-3 serum-level changes as z scores or raw data. For anthropometrics, the meta-analysis included studies presenting z scores or centiles. SETTING: Observational studies. PATIENTS: Otherwise healthy children, not selected for obesity. MAIN OUTCOME MEASURES: Pre/post-surgery changes in standardised height and weight, and IGF-1 and IGFBP-3. RESULTS: Of 211 citations identified, 20 met systematic review criteria. SDB was an enrolment criterion in 13 of the studies, and one of several enrolment criteria in three. Meta-analysis findings for pre/post-surgery changes were: standardised height: 10 studies, 363 total children, pooled standardised mean differences (SMD) = 0.34 (95% CI 0.20 to 0.47); standardised weight: 11 studies, 390 total children, pooled SMD = 0.57 (95% CI 0.44 to 0.70); IGF-1: 7 studies, 177 total children, pooled SMD = 0.53 (95% CI 0.33 to 0.73); IGFBP-3: 7 studies, 177 total children, pooled SMD = 0.59 (95% CI 0.34 to 0.83). CONCLUSIONS: Standardised height and weight, and IGF-1 and IGFBP-3 increased significantly after adenotonsillectomy. Findings suggest that primary care providers and specialists consider SDB secondary to adenotonsillar hypertrophy when screening, treating and referring children with growth failure.
Authors: Merrill S Wise; Cynthia D Nichols; Madeleine M Grigg-Damberger; Carole L Marcus; Manisha B Witmans; Valerie G Kirk; Lynn A D'Andrea; Timothy F Hoban Journal: Sleep Date: 2011-03-01 Impact factor: 5.849
Authors: Eliot S Katz; Renee H Moore; Carol L Rosen; Ron B Mitchell; Raouf Amin; Raanan Arens; Hiren Muzumdar; Ronald D Chervin; Carole L Marcus; Shalini Paruthi; Paul Willging; Susan Redline Journal: Pediatrics Date: 2014-08 Impact factor: 7.124