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Abstract(s)
Introdução: A adenoamigdalectomia é um dos procedimentos cirúrgicos mais comummente realizados na idade pediátrica e as suas indicações são múltiplas, sendo as mais frequentes as infeções das vias aéreas superiores de repetição e os distúrbios respiratórios obstrutivos do sono. Do mesmo modo, a asma é uma das patologias mais prevalentes em crianças e tem um grande impacto na qualidade de vida das mesmas e das suas famílias. Sendo assim, é frequente haver indicação cirúrgica para adenoamigdalectomia em crianças com asma enquanto comorbilidade. Existe controvérsia na comunidade científica do impacto que a adenoamigdalectomia pode ter na asma, pelas potenciais alterações que pode causar no sistema imunológico da criança.
Objetivos: Com este trabalho, pretende-se analisar os estudos originais publicados sobre esta temática na última década, de forma a definir se a adenoamigdalectomia poderá ter algum prejuízo ou benefício na evolução da asma infantil.
Métodos: Realizou-se uma pesquisa nas bases de dados PubMed, Scielo e B-On de modo a identificar artigos que avaliassem o efeito da adenoamigdalectomia na evolução da asma em crianças. Após a aplicação dos critérios de inclusão e exclusão, foram selecionados cinco artigos, que serão o alvo de estudo deste trabalho.
Resultados: Todos os estudos demonstraram não haver agravamento da asma após a realização da adenoamigdalectomia. Pelo contrário, verificou-se um efeito benéfico da cirurgia no curso da doença asmática, com melhorias em parâmetros subjetivos, tais como questionários de avaliação qualidade de vida, e também objetivos, tais como a utilização de medicação respiratória, recurso aos cuidados de saúde ou ocorrência de episódios de crises asmáticas agudas (nível de evidência III).
Conclusão: Os pacientes asmáticos beneficiam da realização da adenoamigdalectomia, quer a indicação cirúrgica seja por infeções das vias aéreas superiores de repetição ou por distúrbios respiratórios obstrutivos do sono (grau de recomendação C).
Introduction: Adenotonsillectomy is one of the most commonly performed surgeries in childhood and its indications are multiple, the most frequent ones being recurrent upper airway infections and obstructive sleep breathing disorders. In the same way, asthma is one of the most prevalent diseases in infancy and has a great impact in the quality of life of these patients and their families. Therefore, it is frequent to have surgical indication to perform adenotonsillectomy in children with asthma as a comorbility. There is controversy in the scientific community about the impact that this surgery has on the course of asthma, due to the potential alterations that it may cause in the immune system. Objectives: With this dissertation, it is intended to analyze the original articles published about this thematic in the last decade, to define if adenotonsillectomy causes any prejudice or benefit in the evolution of childhood asthma. Methods: A research was made in PubMed, Scielo and B-On databases to identify articles that evaluated the effect of adenotonsillectomy in the course of asthma in the pediatric age. After the application of the exclusion and inclusion criteria, five articles were included, and will be the study target of this essay. Results: None of the studies included showed any signs of aggravation of asthma after performing adenotonsillectomy. On the contrary, a benefic effect on the course of the asthmatic disease was verified, either subjective parameters such as questionnaires to assess the life’s quality, and objective ones, such as the use of respiratory medication, the use health care or even the occurrence of acute asthma crisis episodes (evidence level III). Conclusion: Asthmatic patients benefit from adenotonsillectomy, either if surgical indication is due to recurrent upper airway infections or obstructive sleep breathing disorders (grade C recommendation).
Introduction: Adenotonsillectomy is one of the most commonly performed surgeries in childhood and its indications are multiple, the most frequent ones being recurrent upper airway infections and obstructive sleep breathing disorders. In the same way, asthma is one of the most prevalent diseases in infancy and has a great impact in the quality of life of these patients and their families. Therefore, it is frequent to have surgical indication to perform adenotonsillectomy in children with asthma as a comorbility. There is controversy in the scientific community about the impact that this surgery has on the course of asthma, due to the potential alterations that it may cause in the immune system. Objectives: With this dissertation, it is intended to analyze the original articles published about this thematic in the last decade, to define if adenotonsillectomy causes any prejudice or benefit in the evolution of childhood asthma. Methods: A research was made in PubMed, Scielo and B-On databases to identify articles that evaluated the effect of adenotonsillectomy in the course of asthma in the pediatric age. After the application of the exclusion and inclusion criteria, five articles were included, and will be the study target of this essay. Results: None of the studies included showed any signs of aggravation of asthma after performing adenotonsillectomy. On the contrary, a benefic effect on the course of the asthmatic disease was verified, either subjective parameters such as questionnaires to assess the life’s quality, and objective ones, such as the use of respiratory medication, the use health care or even the occurrence of acute asthma crisis episodes (evidence level III). Conclusion: Asthmatic patients benefit from adenotonsillectomy, either if surgical indication is due to recurrent upper airway infections or obstructive sleep breathing disorders (grade C recommendation).
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Keywords
Adenoamigdalectomia Amigdalectomia Amigdalite Asma Inflamação das Vias Aéreas Obstrução das Vias Aéreas