Long-term results of sleep-related quality-of-life and behavioral problems after adenotonsillectomy

Laryngoscope. 2020 Feb;130(2):546-550. doi: 10.1002/lary.27951. Epub 2019 Apr 5.

Abstract

Objectives: Improvements in sleep-related quality of life (QOL) and behavioral problems have been observed in children with obstructive sleep apnea (OSA) during a short-term follow-up after adenotonsillectomy. Whether this trend continues beyond the short term remains unclear. Therefore, we aimed to evaluate the long-term effects of surgery in children with OSA.

Methods: The study participants comprised 20 children with OSA who underwent adenotonsillectomy. We used the scores from the Attention Deficit and Hyperactivity Disorder Rating Scale (ADHD-RS) and total scores from the Korean OSA-18 Survey (KOSA-18) before and after adenotonsillectomy to compare and analyze behavioral problems and OSA-specific health-related QOL, respectively, during a long-term follow-up. Respiratory disturbance parameters from standard polysomnography and subjective symptom scores for snoring and apnea were also investigated.

Results: The mean patient age was 6.6 ± 3.4 years (range, 3-13), and the male-to-female ratio was 15:5. The mean follow-up period was 54.5 months (range, 27-98). The total scores for both ADHD-RS (from 17.6 to 10.5; P = 0.006) and KOSA-18 (from 74.3 to 40.7; P = 0.001) decreased significantly from before to after surgery. Significant decreases were also observed in the subjective symptom scores for snoring (from 5.4 to 2.4; P = 0.000) and apnea (from 3.3 to 0.8; P = 0.002).

Conclusion: Significant improvement was observed in sleep-related QOL and behavioral problems in children with OSA during long-term follow-up after adenotonsillectomy.

Level of evidence: 4 Laryngoscope, 130:546-550, 2020.

Keywords: Pediatric obstructive sleep apnea; adenotonsillectomy; behavior problem; long-term effect; quality of life.

MeSH terms

  • Adenoidectomy*
  • Adolescent
  • Child
  • Child Behavior Disorders / epidemiology*
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Polysomnography
  • Postoperative Complications / epidemiology*
  • Quality of Life*
  • Republic of Korea / epidemiology
  • Sleep Wake Disorders / epidemiology*
  • Tonsillectomy*