Relation of mean platelet volume with obstructive adenoid hypertrophy in children Serap Onder *, Basak Caypinar, Asli Sahin-Yilmaz, Sema Zer Toros, Cagatay Oysu Umraniye Research and Education Hospital, Department of Otolaryngology, Istanbul, Turkey A R T I C L E I N F O Article history: Received 10 January 2014 Received in revised form 3 June 2014 Accepted 5 June 2014 Available online 16 June 2014 Keywords: Mean platelet volume Adenoid hypertrophy Adenoidectomy Pediatric obstructive sleep apnea A B S T R A C T Objective: Adenoid hypertrophy (AH) is a common etiology of chronic upper airway obstruction. Upper respiratory tract obstruction may cause chronic alveolar hypoventilation and pulmonary vasoconstric- tion. In one previous study in patients with obstructive sleep apnea (OSA), it has been claimed that mean platelet volume (MPV), an indicator of platelet activation is increased and that MPV has an important role in the pathophysiology of cardiovascular diseases. We investigated in our study if MPV can be used as an indicator of obstruction due to adenoid hypertrophy. Methods: Our study includes 61 children that underwent adenoidectomy with a mean age of 7.12 (2.373). White blood cell, platelet count, MPV, platelet crit and platelet distribution width levels were measured before and 3 months after adenoidectomy. Children’s symptoms for upper airway obstruction (UAO) (presence of snoring, mouth breathing or difficulty in breathing during sleep, obstructive breathing or apnea during sleep) were questioned in the preoperative and postoperative period by a standardized questionnaire. Results: There was no significant difference between preoperative and postoperative mean values of MPV, hemoglobin, platelet count (p > 0.05). White blood cell levels were significantly higher in the preoperative period values compared with postoperative period values (p < 0.05). Preoperative UAO scores were significantly higher than the postoperative UAO scores. After stratification of the degree of obstruction (as mild, moderate and severe) there was no significant difference in between groups in terms of MPV values. Conclusion: There was no significant relation between MPV levels and obstructive adenoid hypertrophy. ã 2014 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Adenoidectomy is one of the most frequently performed surgeries in children. Major indications for this procedure are upper airway obstruction causing snoring and chronic infection involving the upper respiratory tract. Adenoidectomy is currently the most efficient treatment of adenoid hypertrophy. Adenoid hypertrophy is an important disease in childhood period because it is the most common cause of upper airway obstruction, obstructive sleep apnea and hypoxia in children. Obstructive sleep apnea syndrome (OSAS) is defined as the cessation of ventilation during sleep and is usually associated with hypoxia and/or hypercapnia [1]. OSA exists in 1–3% of children and can occur at any age [2]. Untreated OSA causes cardiovascular complications, impaired growth, and learning and behavior problems. One recent study showed that chronic alveolar hypoventilation due to chronic upper airway obstruction causes right ventricle (RV) dysfunction induced by hypoxemic pulmonary vasoconstriction [3]. Adenotonsillectomy or adenoidectomy with- out tonsillectomy should be the first line therapy for children with OSA and adenotonsillary or adenoid hypertrophy [4]. Mean platelet volume (MPV) indicates platelet activation. Platelet activation is associated with cardiovascular complications. Larger platelets show more activity and have greater prothrom- botic potential [5]. MPV levels increase in hypertension, hyper- cholesterolemia, diabetes mellitus, acute myocardial infarction and acute ischemic stroke [6]. One recent study showed that MPV levels are higher in patients with severe obstructive sleep apnea than healthy patients [7]. A study by Sagit et al. showed that MPV is increased in patients who have septal deviation and marked upper airway obstruction with snoring [8]. * Corresponding author. Tel.: +90 05448553680. E-mail addresses: serap_sahin1985@hotmail.com, m_onder83@mynet.com (S. Onder). http://dx.doi.org/10.1016/j.ijporl.2014.06.001 0165-5876/ ã 2014 Elsevier Ireland Ltd. All rights reserved. International Journal of Pediatric Otorhinolaryngology 78 (2014) 1449–1451 Contents lists available at ScienceDirect International Journal of Pediatric Otorhinolaryngology journal homepage: www.elsevier.com/locate/ijporl