الفهرس 
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Abstract
Adenoidectomy and tonsillectomy are common surgical procedures in young children with recurrent upper respiratory tract infections .Only scarce data are available on their long-term effects. Asthma is one of the most prevalent chronic diseases of childhood. The global burden of asthma has been rising steadily over the past few decades.
There is controversy in literature whether adenotonsillectomy has a beneficial effect in controlling manifestations of bronchial asthma in children or not, thus clarifying the nature of the relationship between adenotonsillectomy and control of asthma through a prospective study is of a great importance and will have therapeutic implication.
This was a prospective case series study. The Patients studied were recruited from the outpatient clinic of Department of Otolaryngology–Head and Neck Surgery- Menoufia University Hospital. After exclusion and inclusion criteria were applied, 76 children with diagnosis of chronic adenotonsillitis associated with bronchial asthma were enrolled in the study. Patients were assessed by history taking, general examination, local ENT and chest examination and laboratory investigations. All patients were assessed preoperatively using Asthma control survey adopted by GINA association. Adenotonsillectomy was performed for all patients under using standard technique. Three months after doing the adenotonsillectomy operation, patients were re-assessed using the Asthma control survey to re-evaluate the current asthma condition.
In the current study, patients were 34 males (44.7%) and 42 females (55.3%). The age of the selected cases ranged between 2.5 and 13 years with mean 5.93±2.93 SD. Two main age groups were identified , 5 years or younger and this group included 36 patients(47.4%) and more
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than 5 years age group which included 40 patients(52.6%). Patients were equally distributed between urban and rural residence with 38 patients in each category.
In the current study, there was a highly significant difference between preoperative and postoperative condition regarding asthma Control test results which was in favor of overall improvement of asthma control. There was a significant improvement regarding asthma control test results comparing preoperative and postoperative status for patients suffering from obstructive manifestations, as well as disappearance of obstructive manifestations and significant improvement regarding quality of sleep.
There was a significant improvement of asthma control test results in both urban and rural inhabitants comparing preoperative and postoperative state. There was a non-significant difference between urban and rural residence regarding improvement of bronchial asthma after. There was a significant improvement in both sexes regarding asthma control test results comparing preoperative and postoperative state. On the other hand, there was a non-significant difference between male and female gender regarding such improvement after ATE.
There was a significant improvement in both age categories regarding asthma control test results comparing preoperative and postoperative state whether 5 years or younger age group, or more than 5 years of age group .On the other hand, there was a significant difference between age 5 years or younger and age more than 5 years regarding such favor of the 5 years or younger age category.
This study led to the conclusions that adenotonsillectomy in asthmatic patients with chronic tonsillitis may lead to significant
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improvement in asthma symptoms control and most of the patients are able to eliminate their medications and improve their life style. Also, adenotonsillectomy in asthmatic patients suffering from obstructive sleep apnea leads to significant improvement in obstructive manifestations, quality of sleep and asthma symptoms control.