Impacto da adenotonsilectomia na pressão arterial pulmonar e no fluxo nasal inspiratório total de respiradores orais medidos por ecodopplercardiografia e rinomanometria anterior ativa

Abstract

Introduction: Adenotonsillary hyperplasia (ATH) is the most common causes of Mouth Breathing Syndrome (MBS) due to upper airway obstruction in children and adolescents. Such affection can lead to chronic alveolar hypoventilation, pulmonary vasoconstriction and pulmonary hypertension. Objective: To evaluate pulmonary arterial pressure and total inspiratory nasal flow (FNIT) in children aged from two to twelve years with MBS due to severe ATH before being submitted to adenoidectomy and / or tonsillectomy and six months after surgery. Methods: Thirty patients with ATH severe and indication of adenoidectomy and/or tonsillectomy were submitted to Doppler echocardiography and active anterior rhinomanometry (AAR) before surgery and six months after the procedure. Pulmonary artery systolic pressure (PSAP) was determined by tricuspid regurgitation and mean pulmonary artery pressure (PMAP) was calculated from the (PMAP = 0.61 x PSAP + 2mmHg) formula. Results: Both PSAP and PMAP were reduced after adenoidectomy and/or tonsillectomy. It was observed an increase of the FNIT, evidencing improvement in the nasal patency after the surgical procedure. A negative correlation was found between PSAP and FNIT and nasal patency in the postoperative period. Conclusion: MBS influences PSAP and PMAP. Adenoidectomy and/or tonsillectomy when there is severe obstruction reduce this pressure. The reduction of the FNIT and of the nasal patency in the AAR correlates with the increase of the PSAP in the postoperative period.