EVALUATION OF THE PRE AND POST-OPERATIVE CARDIAC AND PULMONARY FUNCTIONS IN CHILDREN WITH ADENOTONSILLARY HYPERTROPHY

Amaç: Üst solunum yolu obstrüksiyonu, çocuklarda çoğu geri dönüşümlü olan kardiyak ve pulmoner fonksiyon bozukluklarına yol açabilmektedir. Bu çalışmada hipertrofik tonsil ve/ veya adenoid nedeniyle ameliyat kararı alınan, üst solunum yolu obstrüksiyonu olan çocukların kardiyak ve pulmoner fonksiyonlarının değerlendirilmesi amaçlanmıştır. Yöntem: Haziran 2000 - Nisan 2001 tarihleri arasında Dokuz Eylül Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Hastalıkları AD tarafından izlenen, klinik olarak tonsil ve/veya adenoid hipertrofisi tanısı konulan, bu nedenle ameliyat edilen, 5 ile 12 yaşları arasındaki üst solunum yolu obstrüksiyonlu 25 hasta, kardiyak ve pulmoner fonksiyonlar açısından ameliyat öncesi ve ameliyattan 3 ay sonra değerlendirildi. Bulgular: Olguların yaş ortalaması 8,1 ± 2,0 yıl olup, 14'ü (%56) erkek, 11'i (%44) kız idi. Hiçbirinde ameliyat öncesinde klinik olarak kardiyopulmoner sisteme ait herhangi bir patoloji saptanmamıştır. Tüm olgularda elektrokardiyografi ve telekardiyografi bulguları normal olarak değerlendirilmiştir. Ekokardiyografi ile ameliyat öncesi sağ ventrikül preejeksiyon periyodu / sağ ventrikül ejeksiyon zamanına oranı, sağ ventrikül sistolik basıncı ve sağ ventrikül diyastolik boyutu değerleri, bir olgu hariç normal sınırlarda olup, ameliyat sonrasında bu değerlerde istatistiksel olarak anlamlı bir azalma saptanmıştır (p=0,001). Ameliyat öncesi %88'inde solunum fonksiyon testlerinde hafif obstrüktif bozukluk bulgusu saptanan hastaların ameliyat sonrası bu değerleri normale dönmüştür. Sonuç: Üst solunum yolu obstrüksiyonu bulguları olan çocuklarda pulmoner fonksiyonlardaki obstrüktif bozulma, klinik bulgular henüz ortaya çıkmadan solunum fonksiyon testleri ile saptanabilir. Bu çalışmada klinik bulgu vermeyen ancak laboratuvar bulgularla gösterilebilen kardiyopulmoner fonksiyonlardaki değişikliklerin çoğunun geriye dönüşümlü olduğu ve obstrüksiyon ameliyat ile giderildikten kısa süre sonra normale döndüğü gösterilmiştir. Objective: In this study, evaluation of cardiac and pulmonary functions were aimed in the children who underment tonsillectomy due to upper airway obstruction secondary to hypertrophic tonsils and / or adenoids. Methods: Twenty five children who have been followed up due to hypertrophic tonsils and / or adenoids in Dokuz Eylül University Medical Faculty, Department of Ear-Nose &Throat in, between June 2000 and April 2001 were enrolled in the study. All of the patients were decided to be operated due to significant upper airway obstruction. Cardiac and pulmonary functions of these children were evaluated before and three months after the operation. Results: Mean age of the patients were 8.1 ± 2.0 years. None of the patients had any pathology related to cardiopulmonary system before the operation. The ratio of right ventricular preejection period / right ventricular ejection time, right ventricle systolic pressure and diastolic dimensions were within normal ranges, except one patient, echocardiographically before the operation. However, all of these parameters decreased statistically significant after operation (p=0.001 for all of these parameters). Pulmonary function tests were compatible with mild obstructive disorders in 88 % of the patients preoperatively. On the other hand, all of the patients had normal pulmonary function tests postoperatively. Conclusion: This study demonstrated that clinically undetectable cardiopulmonary function changes were reversible and returns to normal shorty time after the relief of airway obstruction

WATSON SYNDROME

Watson sendromu, café-au-lait lekeleri, pulmoner stenoz, mental retardasyon, boy kısalığıile karakterizedir. Bu makalede, moleküler temeli henüz tartışmalı olan ve seyrek görülen bubirlikteliği hatırlatmak amacıyla Watson sendromlu 13 yaşında bir kız olgu sunuldu.Watson syndrome is characterized by café-au-lait spots, pulmonary valvular stenosis,mental retardation and short stature. In this report, we present a thirteen-year-old girl withWatson syndrome to remind this disease which is seldom encountered and the molecularbasis is still controversial

Watson Sendromu

Watson syndrome is characterized by café-au-lait spots, pulmonary valvular stenosis,mental retardation and short stature. In this report, we present a thirteen-year-old girl withWatson syndrome to remind this disease which is seldom encountered and the molecularbasis is still controversial.</p

Cardiac Inflammatory Myofibroblastic Tumor Causing Pulmonary Artery Obstruction: A Rare Case Report

Inflammatory myofibroblastic tumor (IMT) is a rare soft tissue tumor of the heart. In the literature, cardiac IMT is often described as an endocardial-based cavitary mass originating from the right side of the heart in infants and adolescents. In this article, we present a 5-year-old boy with a rare cardiac IMT who had no complaints and was diagnosed with murmur during his routine examination. Transthoracic echocardiography showed a homogeneous polypoid mass originating from the pulmonary valve, extending into the main pulmonary artery during systole and causing obstruction of the pulmonary artery and right ventricular outflow tract. Surgical resection of the tumor was performed successfully. There was no tumor recurrence in the control echocardiography at the postoperative first month

Cardiac Inflammatory Myofibroblastic Tumor Causing Pulmonary Artery Obstruction

Inflammatory myofibroblastic tumor (IMT) is a rare soft tissue tumor of the heart. In the literature, cardiac IMT is often described as an endocardial-based cavitary mass originating from the right side of the heart in infants and adolescents. In this article, we present a 5-year-old boy with a rare cardiac IMT who had no complaints and was diagnosed with murmur during his routine examination. Transthoracic echocardiography showed a homogeneous polypoid mass originating from the pulmonary valve, extending into the main pulmonary artery during systole and causing obstruction of the pulmonary artery and right ventricular outflow tract. Surgical resection of the tumor was performed successfully. There was no tumor recurrence in the control echocardiography at the postoperative first month