Children with asthma can control their symptoms better after having surgery to remove their adenoids and tonsils, according to researchers from the University of Chicago, IL.
In the study, published in PLoS Medicine, the authors compared the hospital admissions and prescriptions of children with asthma before and after having adenotonsillectomy surgery, in order to assess whether the control of their asthma improved following the operation.
Adenotonsillectomy (AT) is a procedure that is commonly used as a primary form of treatment for symptoms of obstructive sleep apnea (OSA) – a condition affecting approximately 2-3% of children, whereby the upper airway becomes inflamed and episodically obstructed during sleep.
The American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNS) refer to the adenoids and tonsils as the body’s first line of defense – as part of the immune system – against bacteria and viruses that enter the body through the mouth and nose.
At present, most forms of asthma control focus on the daily use of anti-inflammatory medication, typically through inhalers. Other treatments can involve avoiding substances that trigger asthma attacks such as allergens. Recent studies, however, have suggested treatment strategies that target coexisting conditions with overlapping symptoms, such as obesity and sleep-disordered breathing.
The authors of the new study state that they set out “to examine whether the proposed overlap of two commonly inflammatory conditions in children, namely, asthma and OSA, leads to interdependent effects on the severity of the disease.”
Previous findings suggest that the presence of OSA could worsen asthma in children, and thus the treatment of OSA could reduce the severity of asthma and lessen the need for anti-asthmatic medication.
- Asthma is the third most prevalent chronic disease in children
- It is believed that asthma affects 7.1 million children under the age of 18 in the US
- In 2010, around 640,000 pediatric emergency room visits were attributable to asthma.
Utilizing the 2003-2010 MarketScan US database, the researchers identified a total of 13,506 children with asthma for their study who had undergone AT surgery. The data for these children were compared with those for another 27,012 children with asthma who had not had the operation.
Among the children who had the surgery, the researchers found that the total of acute asthma exacerbations fell from 2,243 incidences before AT to 1,566 afterward – a sharper decline than that occurring among the children who did not have surgery.
Compared with the children who did not undergo surgery, severe, sustained asthma attacks (episodes of acute status asthmaticus) also fell, alongside asthma prescriptions in the children who had AT.
The authors acknowledge that their study was limited by the sample they used; the information that they assessed only featured children whose health care was covered by private insurance and thus did not represent those who were uninsured or covered by public health insurance.
“Although randomized controlled studies are needed to prove cause and effect between OSA and asthma,” write the authors, “the present findings provide a compelling argument in favor of such studies, considering the putative improvements that emerged in asthma-related health care utilization following AT.”
They conclude that future research is necessary in order to understand further the connections between OSA and asthma. It may then be possible to establish criteria for identifying children with asthma who are at an increased risk of developing OSA and could benefit from AT surgery.
Recently, Medical News Today reported on a study that linked prenatal phthalate exposure to an increased risk of childhood asthma.