Download PDF
Adipositas - Ursachen, Folgeerkrankungen, Therapie 2013; 07(04): 244-246
DOI: 10.1055/s-0037-1618828
Übersichtsarbeit
Schattauer GmbH

Tonsillektomie: Ein neuer Risikofaktor für kindliche Adipositas?

Tonsillectomy: A new risk factor for childhood obesity?
M. Quante
1   Klinik und Poliklinik für Kinder- und Jugendmedizin und Zentrum für Pädiatrische Forschung, Dept. für Frauen- und Kindermedizin, Universität Leipzig
2   IFB AdipositasErkrankungen, Universität Leipzig
,
M. Fischer
3   Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universität Leipzig
,
F. Pulzer
1   Klinik und Poliklinik für Kinder- und Jugendmedizin und Zentrum für Pädiatrische Forschung, Dept. für Frauen- und Kindermedizin, Universität Leipzig
,
J. Kluge
1   Klinik und Poliklinik für Kinder- und Jugendmedizin und Zentrum für Pädiatrische Forschung, Dept. für Frauen- und Kindermedizin, Universität Leipzig
,
A. Merkenschlager
1   Klinik und Poliklinik für Kinder- und Jugendmedizin und Zentrum für Pädiatrische Forschung, Dept. für Frauen- und Kindermedizin, Universität Leipzig
,
W. Kiess
1   Klinik und Poliklinik für Kinder- und Jugendmedizin und Zentrum für Pädiatrische Forschung, Dept. für Frauen- und Kindermedizin, Universität Leipzig
2   IFB AdipositasErkrankungen, Universität Leipzig
› Author Affiliations
Further Information

Publication History

Publication Date:
21 December 2017 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Viele Beobachtungsstudien haben eine übermäßige Gewichtszunahme nach Tonsillektomie oder Adenotonsillektomie bei Kindern beschrieben. Folgende mögliche Gründe werden diskutiert: weniger Atemarbeit, vermehrte oder veränderte Nahrungszufuhr, weniger körperliche Aktivität, Operationszeitpunkt zu einer kritischen Phase für die Entwicklung einer Adipositas und hormonelle Veränderungen. Bis jetzt konnte aber noch keine Studie einen kausalen Zusammenhang herstellen. Dennoch sollten HNO- und Kinderärzte den postoperativen Gewichtsverlauf ihrer Patienten aufmerksam verfolgen.

Summary

Excessive weight gain after tonsillectomy or adenotonsillectomy has been described by many observational studies. Theories include decreased work of breathing, increased appetite or feeding, decreased physical activity, critical period for the development of obesity and hormonal alterations. So far, no causal effect has been established by existing research. However, the post-operative growth of children requires close follow-up by otolaryngologists and paediatricians.

Schlüsselwörter

Tonsillektomie - Obstruktives Schlafapnoe- Syndrom - Adipositas - Gewichtszunahme - Kinder

Keywords

Tonsillectomy - obstructive sleep apnoea - obesity - weight gain - children
 

  • Literatur

  • 1 Ahlqvist-Rastad J. et al. Body growth in relation to tonsillar enlargement and tonsillectomy. Int J Pediatr Otorhinolaryngol 1992; 24 (01) 55-61.
    CrossrefPubMedGoogle Scholar
  • 2 Amin R, Anthony L, Somers V. et al. Growth velocity predicts recurrence of sleep-disordered breathing 1 year after adenotonsillectomy. Am J Respir Crit Care Med 2008; 177 (06) 654-659.
    CrossrefPubMedGoogle Scholar
  • 3 Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2002; 109 (04) 704-712.
    CrossrefPubMedGoogle Scholar
  • 4 Aydogan M. et al. The effect of recurrent tonsillitis and adenotonsillectomy on growth in childhood. Int J Pediatr Otorhinolaryngol 2007; 71 (11) 1737-1742.
    CrossrefPubMedGoogle Scholar
  • 5 Barr GS, Osborne J. Weight gain in children following tonsillectomy. J Laryngol Otol 1988; 102 (07) 595-597.
    CrossrefPubMedGoogle Scholar
  • 6 Bartoshuk LM. et al. Taste damage (otitis media, tonsillectomy and head and neck cancer), oral sensations and BMI. Physiol Behav 2012; 107 (04) 516-526.
    CrossrefPubMedGoogle Scholar
  • 7 Bonuck K. et al. Growth failure and sleep disordered breathing: a review of the literature. Int J Pediatr Otorhinolaryngol 2006; 70 (05) 769-778.
    CrossrefPubMedGoogle Scholar
  • 8 Bonuck KA, Freeman K, Henderson J. Growth and growth biomarker changes after adenotonsillectomy: systematic review and meta-analysis. Arch Dis Child 2009; 94 (02) 83-91.
    PubMedGoogle Scholar
  • 9 Chu L, Yao H, Wang B. Impact of adenotonsillectomy on high-sensitivity C-reactive protein levels in obese children with obstructive sleep apnea. Otolaryngol. Head Neck Surg 2012; 147 (03) 538-543.
    CrossrefPubMedGoogle Scholar
  • 10 Clayburgh D, Milczuk H, Gorsek S. et al. Efficacy of tonsillectomy for pediatric patients with Dysphagia and tonsillar hypertrophy. Arch Otolaryngol Head Neck Surg 2011; 137 (12) 1197-1202.
    CrossrefPubMedGoogle Scholar
  • 11 Conlon BJ, Donnelly MJ, McShane DP. Tonsillitis, tonsillectomy and weight disturbance. Int J Pediatr Otorhinolaryngol 1997; 42 (01) 17-23.
    CrossrefPubMedGoogle Scholar
  • 12 Dietz WH. Critical periods in childhood for the development of obesity. Am J Clin Nutr 1994; 59 (05) 955-959.
    CrossrefPubMedGoogle Scholar
  • 13 Everett AD, Koch WC, Saulsbury FT. Failure to thrive due to obstructive sleep apnea. Clin Pediatr 1987; 26 (02) 90-92.
    CrossrefPubMedGoogle Scholar
  • 14 Gkouskou KK. et al. Dietary habits of preschool aged children with tonsillar hypertrophy, pre- and post-operatively. Eur Rev Med Pharmacol Sci 2010; 14 (12) 1025-1030.
    PubMedGoogle Scholar
  • 15 Gümüssoy M. et al. Changes in IGF-I, IGFBP-3 and ghrelin levels after adenotonsillectomy in children with sleep disordered breathing. Int J Pediatr Otorhinolaryngol 2009; 73 (12) 1653-1656.
    CrossrefPubMedGoogle Scholar
  • 16 Jakins PS. Remarkable Increase in Bodily Growth Following the Removal of Tonsils and Adenoids. J Laryngol Rhinol Otol 2007; 07 (09) 427.
    PubMedGoogle Scholar
  • 17 Jeyakumar A. et al. A systematic review of adenotonsillectomy as a risk factor for childhood obesity. Otolaryngol Head Neck Surg 2010; 144 (02) 154-158.
    PubMedGoogle Scholar
  • 18 Karalok ZS. et al. Leptin and Ghrelin Levels in Children before and after Adenoidectomy or Adenotonsillectomy. Horm. Res. Paediatr.. 2013 Nov 7 Epub ahead of print.
    PubMedGoogle Scholar
  • 19 Koc S, Ozturk K, Buyukbas S. et al. Ghrelin levels in children with adenoid or chronic tonsil hypertrophies before and after surgery. Int J Pediatr Otorhinolaryngol 2009; 73 (05) 685-7.
    CrossrefPubMedGoogle Scholar
  • 20 Levi J. et al. Evaluating tonsillectomy as a risk factor for childhood obesity. Arch. Otolaryngol. Head Neck Surg 2012; 138 (10) 897-901.
    CrossrefPubMedGoogle Scholar
  • 21 Marcus CL. et al. Determinants of growth in children with the obstructive sleep apnea syndrome. J Pediatr 1994; 125 (04) 556-562.
    CrossrefPubMedGoogle Scholar
  • 22 Nieminen P. et al. Growth and biochemical markers of growth in children with snoring and obstructive sleep apnea. Pediatrics 2002; 109 (04) e55.
    CrossrefPubMedGoogle Scholar
  • 23 Ramos SD, Mukerji S, Pine HS. Tonsillectomy and adenoidectomy. Pediatr Clin North Am 2013; 60 (04) 793-807.
    CrossrefPubMedGoogle Scholar
  • 24 Roemmich JN. et al. Increases in overweight after adenotonsillectomy in overweight children with obstructive sleep-disordered breathing are associated with decreases in motor activity and hyperactivity. Pediatrics 2006; 117 (02) e200-208.
    CrossrefPubMedGoogle Scholar
  • 25 Sarny S. et al. [The Austrian tonsil study 2010 – part 1: statistical overview]. Laryngorhinootologie 2012; 91 (01) 16-21.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Soultan Z. et al. Effect of treating obstructive sleep apnea by tonsillectomy and/or adenoidectomy on obesity in children. Arch Pediatr Adolesc Med 1999; 153 (01) 33-37.
    PubMedGoogle Scholar
  • 27 Statistisches Bundesamt Wiesbaden. Fallpauschalbezogene Krankenhausstatistik (DRG-Statistik). Operationen und Prozeduren der vollstationären Patientinnen und Patienten in Krankenhäusern. Ausführliche Darstellung. 2012 2013; 5231401127014..
    PubMedGoogle Scholar
  • 28 Topal K. et al. The risk of overweight and obesity in children after tonsillectomy. Eur Arch Otorhinolaryngol 2013; 270 (02) 689-694.
    CrossrefPubMedGoogle Scholar
  • 29 Wei JL. Weight gain after tonsillectomy: myth or reality? Interpreting research responsibly. Otolaryngol. Head. Neck Surg 2011; 144 (06) 855-857.
    CrossrefPubMedGoogle Scholar
  • 30 Wijga AH. et al. Adenotonsillectomy and the development of overweight. Pediatrics 2009; 123 (04) 1095-1101.
    CrossrefPubMedGoogle Scholar