Clin Exp Otorhinolaryngol.  2016 Jun;9(2):136-142. 10.21053/ceo.2015.00584.

Immediate and Sustained Improvement in Behavior and Life Quality by Adenotonsillectomy in Children With Sleep-Disordered Breathing

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea. binent@hanmail.net
  • 2Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 3Department of Otolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 4Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • 5Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.
  • 6Department of Dermatology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.

Abstract


OBJECTIVES
To investigate longitudinal changes in behavior and quality-of-life (QoL) in children with sleep disordered breathing (SDB) after adenotonsillectomy (AT).
METHODS
This study prospectively enrolled 148 children who underwent AT for SDB. Caregivers filled out Korean attention deficit hyperactivity disorder (ADHD) rating scale (K-ARS) and Korean version of the obstructive sleep apnea-18 (KOSA-18) at preoperative 1 day, postoperative 1 month, and postoperative 6 months. Longitudinal changes in K-ARS and KOSA-18 were evaluated and compared among subgroups.
RESULTS
Both K-ARS and KOSA-18 scores improved immediately at postoperative 1 month and were maintained at postoperative 6 months. The mean preoperative K-ARS scores of the non-ADHD, ADHD-trait, and overt-ADHD groups showed uniformly immediate and sustained improvements. Also, the mean preoperative KOSA-18 scores of the small, moderate, and large impact groups were significantly improved both at postoperative 1 month and 6 months. The changes in behavior and QoL showed no significant differences with regard to the aforementioned factors.
CONCLUSION
After AT, we may expect immediate and sustained improvements in behavior and QoL in children with SDB regardless of preoperative symptom severity. Moreover, by performing AT, improvements in behavior and QoL are expected regardless of sex, age, allergic trait, or concurrent coblation-assisted turbinoplasty. These findings may help our colleague physicians counselling pediatric SDB patients and their caregivers.

Keyword

Sleep Apnea Syndromes; Attention Deficit Disorder with Hyperactivity; Quality of Life; Tonsillectomy; Adenoidectomy

MeSH Terms

Adenoidectomy
Attention Deficit Disorder with Hyperactivity
Caregivers
Child*
Humans
Prospective Studies
Quality of Life*
Sleep Apnea Syndromes*
Tonsillectomy

Figure

  • Fig. 1. Comparison of longitudinal changes in Korean attention deficit hyperactivity disorder (ADHD) rating scale (K-ARS; A) and Korean version of the obstructive sleep apnea-18 (KOSA-18; B) scores. Postop, postoperative. *P<0.05, statistically significant differences among groups.

  • Fig. 2. Longitudinal changes in Korean attention deficit hyperactivity disorder (ADHD) rating scale (K-ARS; A) and Korean version of the obstructive sleep apnea-18 (KOSA-18; B) scores between males and females. *P<0.05, statistically significant differences among groups.

  • Fig. 3. Longitudinal changes in Korean attention deficit hyperactivity disorder rating scale (K-ARS; A) and Korean version of the obstructive sleep apnea-18 (KOSA-18; B) scores in different age groups: group 1, age<7 years; group 2, ≥7, <10 years; and group 3, age≥10 years. *P<0.05, statistically significant differences among groups.


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