الفهرس | Only 14 pages are availabe for public view |
Abstract A denotonsillar hypertrophy is the predominant etiologic factor involved in pediatric OSA . As such, the severity of OSA correlates with adenoid and tonsillar size. In the past few years many studies found that adenotonsillar tissue of children with obstructive sleep-disordered breathing (SDB) has increased content of cysteinyl leukotrienes (CysLTs) and expression of CysLTs receptors. Furthermore, CysLTs concentrations in the nasal exhaled breath condensate of children with sleep apnea are elevated. This study aimed to assess plasma level of cysteinyl leukotrienes in children with adenotonsillar hypertrophy before and 1 month after adenotonsillectomy as well as to study any possible correlation between plasma level of cysteinyl leukotrienes and size of adenotonsillar hypertrophy. This study was conducted on (30) children with adenotonsillar hypertrophy (13 boys & 17 girls) aged 2 to 12 years and (20) age and sex matched clinically healthy children (9 boys& 11 girls) as controls. All the patients enrolled in the study were submitted to detailed history taking, clinical examination, laboratory assessment which include: CBC and cysteinyl leukotrienes level was measured in both groups and 1 month after adenotonsillectomy in case group. Also case group were subjected to radiological assessment in the form of plain X- ray lateral view of the skull to asses nasopharyngeal adenoid hypertrophy before operation. The results of this study revealed that: Children with adenotonsillar hypertrophy who had obstructive symptoms showed a highly significant increase in total leukocytic count and significant increase in absolute lymphocytic count. Obstructive symptoms in children with adenotonsillar hypertrophy showed positive relation with different grades of adenoid while showed no relation with different grades of tonsil. Total leukocytic count in children with adenotonsillar hypertrophy showed direct relation with different grades of adenoid. The mean plasma level of cysteinyle leukotrienes increased in children with adenotonsillar hypertrophy preoperative in comparison to healthy children. Children with adenotonsillar hypertrophy showed a highly significant decrease in the mean plasma levels of cysteinyl leukotrienes after adenotonsillectomy (T&A) (3.26 ± 0.91) compared to before the operation(31.3± 8.97). The mean plasma levels of cysteinyl leukotrienes in children with adenotonsillar hypertrophy showed positive relation with different grades of tonsil before adenotonsillectomy, while showed no relation after adenotonsillectomy. The mean plasma levels of cysteinyl leukotrienes in children with adenotonsillar hypertrophy showed no relation with different grades of adenoid before and after adenotonsillectomy. |