What is the clinical evidence from this study?

Study design: Observational. Population: Adenotonsillar hypertrophy (n=23). Intervention: Adenotonsillectomy vs. Preoperative baseline. Primary outcome: Mean pulmonary artery pressure (PAP) in mm Hg (p=0.77).

What question did this study set out to answer?

The aim is to assess cardiopulmonary changes in children with adenotonsillar hypertrophy and evaluate the necessity of adenotonsillectomy without significant complications.

March 24, 2026Open Access

Evaluating the Overprescription Trend of Adenotonsillectomy Considering Cardiopulmonary Changes

Q: What does this research mean for the field?

Adenotonsillectomy does not significantly alter pulmonary artery pressure or right ventricular dimensions in children with moderate adenotonsillar hypertrophy lacking severe obstructive sleep apnea. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Adenotonsillectomy did not significantly alter pulmonary artery pressure or right ventricular dimensions in children with moderate adenotonsillar hypertrophy lacking severe obstructive sleep apnea.

Key Points

The aim is to assess cardiopulmonary changes in children with adenotonsillar hypertrophy and evaluate the necessity of adenotonsillectomy without significant complications.
Included 23 children aged 4-14 years with adenotonsillar hypertrophy
Conducted clinical evaluations, ECG, and echocardiography preoperatively and 3 months postoperatively
Measured pulmonary artery pressure, right ventricular end-systolic diameter, and right ventricular end-diastolic diameter
Mean age of participants was 7.43 years
Common symptoms included mouth breathing (100%) and snoring (95.6%)
Mild obstructive sleep apnea was observed in 8.7% of children
No significant postoperative changes in ECG or echocardiographic parameters were noted
Findings suggest adenotonsillectomy may not be necessary for moderate adenotonsillar hypertrophy alone

Study Design

Type

Observational (n=23)

Blinding

Single-blind

Multicenter

Structured PICO

Does adenotonsillectomy improve cardiopulmonary parameters in children with moderate adenotonsillar hypertrophy?

Population

Children aged 4-14 years with adenotonsillar hypertrophy (ATH)

Intervention

Adenotonsillectomy

Outcome

Cardiopulmonary changes assessed by ECG and echocardiography (pulmonary artery pressure, RVESD, and RVEDD)surrogate

In children with moderate adenotonsillar hypertrophy without significant OSA, adenotonsillectomy does not significantly alter cardiopulmonary parameters, suggesting a conservative approach may be appropriate.

Main Result

Absolute Event Rate: 16.83% vs 16.96%

p-value: p=0.77

Limitations

Relatively small sample size attributed to the constraints of a limited time period

Abstract

Background: Adenotonsillectomy is commonly performed in children, increasingly even in those with moderate adenotonsillar hypertrophy (ATH) without obesity, obstructive sleep apnea (OSA), or cardiopulmonary disease, to prevent possible cardiopulmonary complications.Objectives: To assess cardiopulmonary changes in children with ATH and evaluate the necessity of adenotonsillectomy in the absence of significant OSA or cardiopulmonary involvement.Materials and methods: This observational study included 23 children aged 4-14 years with ATH.Clinical evaluation, ECG, and echocardiography were performed preoperatively and 3 months postoperatively, assessing pulmonary artery pressure (PAP), RVESD, and RVEDD.Results: The mean age was 7.43 3.13 years.Mouth breathing (100%) and snoring (95.6%) were common.Mild OSA was observed in two patients (8.7%).ECG and echocardiographic parameters remained normal with no significant postoperative changes.Conclusion: Most children with moderate ATH showed no OSA or cardiopulmonary abnormalities.ATH alone may not warrant adenotonsillectomy, supporting a conservative, individualized treatment approach.

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