Improved somatic growth following adenoidectomy and tonsillectomy in young children. Possible pathogenetic mechanisms.

The effect of Adenotonsillectomy on somatic growth was studied prospectively in 57, randomly selected children (31 boys, 26 girls), aged 5.03+/-1.32 (mean+/-1SD) years. The indication for surgery was adenotonsillar hypertrophy with or without recurrent infections. Weight, height, triceps skinfold thickness, and Body Mass Index were measured prior to the operation and 6-13 months afterwards. Weight was significantly improved following T&A in all children. The improvement in height was significantly only for children under 5 years. In an attempt to uncover the pathogenetic mechanisms, lactic acid, pyruvic acid, somatomedin-C (IGF-I), growth hormone(GH), insulin, glucose, pH, hemoglobin (Hbeta). and white cell count (WBC) were also determined in the last 18 children, prior to and 6-8 months post operatively. For the comparison of pre and post operative values the paired t test was applied. Although the values of GH and IGF1 did not significantly increase post-op the IGF-1/GH ratio increased, possibly indicating improved IGF1 generation. There was also a rise in Hbeta values and a lowering of WBC, probably reflecting the lower frequency of infections. All other metabolic indices did not change. In conclusion, linear grow post-Adenotonsillectomy improved in children aged <5 years and was associated with improved with IGF-1/GH ratio, increased Hbeta values and decreased in WBC.