Vinícius M Ramos1, Carolina Mff Nader2, Zilda Ma Meira3, Flávio D Capanema4, Letícia P Franco5, Mariana M Tinano6, Cláudia Pg Anjos7, Flávio B Nunes8, Isamara S Oliveira9, Roberto E Guimarães10, Helena M G Becker11. 1. UFMG (Universidade Federal de Minas Gerais), Av. Prof. Alfredo Balena, 190, Sala 199, Belo Horizonte, MG, Brazil. Electronic address: viniciusmalaquias@yahoo.com.br. 2. UFMG (Universidade Federal de Minas Gerais), Av. Prof. Alfredo Balena, 190, Sala 199, Belo Horizonte, MG, Brazil. Electronic address: nader_carolina@yahoo.com.br. 3. Department of Pediatric Cardiology, UFMG (Universidade Federal de Minas Gerais), Av. Prof. Alfredo Balena, 190 Sala 199, Belo Horizonte, MG, Brazil. Electronic address: zilda.m.a.meira@gmail.com. 4. Department of Pediatry, FASEH (Faculdade da Saúde e Ecologia Humana), Rua São Paulo 958, Jardim Alterosa, Vespasiano, MG, Brazil. Electronic address: fcapa@uol.com.br. 5. Department of Otolaryngology, UFMG (Universidade Federal de Minas Gerais), Av. Prof. Alfredo Balena, 190, Sala 199, Belo Horizonte, MG, Brazil. Electronic address: leticiafranco@uol.com.br. 6. Department of Odontology, UFMG (Universidade Federal de Minas Gerais), Av. Prof. Alfredo Balena, 190, Sala 199, Belo Horizonte, MG, Brazil. Electronic address: maritinano@yahoo.com.br. 7. UFMG (Universidade Federal de Minas Gerais), Av. Prof. Alfredo Balena, 190, Sala 199, Belo Horizonte, MG, Brazil. Electronic address: claudiapgalvao@gmail.com. 8. Department of Otolaryngology, UFMG (Universidade Federal de Minas Gerais), Av. Prof. Alfredo Balena, 190, Sala 199, Belo Horizonte, MG, Brazil. Electronic address: flaviobn42@gmail.com. 9. Department of Otolaryngology, UFMG (Universidade Federal de Minas Gerais), Av. Prof. Alfredo Balena, 190, Sala 199, Belo Horizonte, MG, Brazil. Electronic address: simasmed@yahoo.com.br. 10. Department of Otolaryngology, UFMG (Universidade Federal de Minas Gerais), Av. Prof. Alfredo Balena, 190, Sala 199, Belo Horizonte, MG, Brazil. Electronic address: resguimaraes@gmail.com. 11. Department of Otolaryngology, UFMG (Universidade Federal de Minas Gerais), Av. Prof. Alfredo Balena, 190, Sala 199, Belo Horizonte, MG, Brazil. Electronic address: helenabecker.becker@gmail.com.
Abstract
INTRODUCTION: Adenotonsillar hyperplasia (ATH) causing upper airway obstruction (UAO) may increase pulmonary artery systolic pressure (PASP). Early diagnosis and mouth breathing (MB) management may help in cases of high PASP. Total inspiratory nasal airflow (TINAF) obtained by active anterior rhinomanometry (AARM) is a means to quantify nasal patency. This study aimed to correlate TINAF with high PASP. METHODS: This is a prospective study involving 30 children between two and twelve years of age, with indication for adenotonsillectomy due to ATH, evaluated before and six months after surgery; and 29 nasal breathing (NB) children in the same age group. We obtained the PASP, calculated for tricuspid regurgitation, by means of a transthoracic echocardiography. We assessed nasal patency using the AARM to estimate the TINAF. RESULTS: The mean PASP among mouth breathing children was 25.99 mmHg, with a Standard Deviation of (±) 3.27, p = 0.01 in the preoperative period; and 21.79 mmHg (±2.48; p = 0.01) in the postoperative period. Among nasal breathers, this mean value was 21.64 mmHg (±3.87, p = 0.01). The mean pre-operative TINAF was 266.76 cm3/s (±112.21, p = 0.01); and 498.93 cm3/s (±137.80, p = 0.01) after surgery. Among nasal breathers it was 609.37 cm3/s (±109.16; p = 0.01). The mean nasal patency in the preoperative period was 42.85% (±17.83; p = 0.01); and 79.33% (±21.35; p = 0.01) in the post-op. Among nasal breathers it was 112.94% (±15.88, p = 0.01). There was a significant Spearman correlation value between TINAF and PASP (r = -0.459; p = 0.01) when we analyzed all the groups. CONCLUSION: PASP and TINAF values improved postoperatively and had an inverse correlation. This study suggests that by improving TINAF there was a decrease in PASP.
INTRODUCTION:Adenotonsillar hyperplasia (ATH) causing upper airway obstruction (UAO) may increase pulmonary artery systolic pressure (PASP). Early diagnosis and mouth breathing (MB) management may help in cases of high PASP. Total inspiratory nasal airflow (TINAF) obtained by active anterior rhinomanometry (AARM) is a means to quantify nasal patency. This study aimed to correlate TINAF with high PASP. METHODS: This is a prospective study involving 30 children between two and twelve years of age, with indication for adenotonsillectomy due to ATH, evaluated before and six months after surgery; and 29 nasal breathing (NB) children in the same age group. We obtained the PASP, calculated for tricuspid regurgitation, by means of a transthoracic echocardiography. We assessed nasal patency using the AARM to estimate the TINAF. RESULTS: The mean PASP among mouth breathing children was 25.99 mmHg, with a Standard Deviation of (±) 3.27, p = 0.01 in the preoperative period; and 21.79 mmHg (±2.48; p = 0.01) in the postoperative period. Among nasal breathers, this mean value was 21.64 mmHg (±3.87, p = 0.01). The mean pre-operative TINAF was 266.76 cm3/s (±112.21, p = 0.01); and 498.93 cm3/s (±137.80, p = 0.01) after surgery. Among nasal breathers it was 609.37 cm3/s (±109.16; p = 0.01). The mean nasal patency in the preoperative period was 42.85% (±17.83; p = 0.01); and 79.33% (±21.35; p = 0.01) in the post-op. Among nasal breathers it was 112.94% (±15.88, p = 0.01). There was a significant Spearman correlation value between TINAF and PASP (r = -0.459; p = 0.01) when we analyzed all the groups. CONCLUSION: PASP and TINAF values improved postoperatively and had an inverse correlation. This study suggests that by improving TINAF there was a decrease in PASP.