Results of surgical treatment of diseases of the pharynx in overweight and obese children.

Abstract

оne of the most common non-infectious diseases in the world is overweight and obesity, especially in children. The incidence of obesity is constantly increasing and leads to the amplification of complications and associated diseases. A disorder of immunological homeostasis is manifested in children with this pathology by an increase in the frequency of ENT-diseases, one of which is the pathology of the tonsils of the pharynx. The purpose of the study: to determine the peculiarities of the course of diseases of the pharynx in children with excess body weight and obesity before surgery on the pharynx and palatine tonsils and in the postoperative period. 69 children with hypertrophy of pharyngeal tonsils participated in the study, who were divided into 3 groups depending on the body mass index: overweight (group 1), obese (group 2) and normal weight (group 3). All patients underwent a questionnaire using the Pediatric Throat Disorders Outcome Test (T-14) before and after surgical treatment (tonsillectomy, tonsillotomy, or adenotonsillotomy) after 3 and 6 months. In addition to questionnaires, patients underwent thorough ENT-examination. The preoperative examination showed that the average number of points of indicators of complaints of patients, respectively T-14, was the lowest in patients of the 3rd group, the highest number of points was shown by the testing of the 2nd group (p<0.001). 6 months after the operation, the statistically significant ratio among the groups of patients according to the average number of points did not change: the best in the 3rd group - 1.60 (p<0.05), the worst in the group of obese patients - 14.0 (p<0 .05), in the 1st group – 7.38 (p=0.05). In most cases - 88.9% of cases, patients with obesity continued to complain about snoring, in 77.8% of cases - irregular breathing during sleep, in 44.4% - periodic breathing through the mouth, in 27.7% - problems with appetite, in 22.2% - recurrence of hypertrophy of the palatine tonsils, secretory otitis media of recurrent course in 22.2% of cases as well. In the 1st group, 6 months after the operation, patients continued to complain about loud snoring in 38.5% of cases, apnea - 26.9%, problems with appetite - 42.3%, short-term throat infections - 61.5%, recurrence hypertrophy of palatine tonsils -15.4%. As for the results of treatment of patients with normal weight, only 4.0% of cases had complaints about periodic snoring, sore throat, and recurrent secretory otitis media.