Assessment of sleep-disordered breathing in pediatric otitis media with effusion

Chien-Chia Huang; Pei-Wen Wu; Cheng-Hsun Chiu; Ta-Jen Lee; Chyi-Liang Chen

doi:10.1016/j.pedneo.2021.06.013

Assessment of sleep-disordered breathing in pediatric otitis media with effusion

Pediatr Neonatol. 2022 Jan;63(1):25-32. doi: 10.1016/j.pedneo.2021.06.013. Epub 2021 Jul 30.

Authors

Chien-Chia Huang¹, Pei-Wen Wu², Cheng-Hsun Chiu³, Ta-Jen Lee⁴, Chyi-Liang Chen⁵

Affiliations

¹ Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: agar@cgmh.org.tw.
² Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Keelung, Taiwan.
³ Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
⁴ Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
⁵ Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

PMID: 34391662
DOI: 10.1016/j.pedneo.2021.06.013

Abstract

Background: Given the role of adenoid in the pathogenesis of otitis media with effusion (OME) and sleep-disordered breathing (SDB), the present study aimed to investigate the sleep quality and the impact of adenoidectomy on improvement of sleep symptoms in children with OME.

Methods: Children with SDB or OME, aged 3-12 years, were prospectively enrolled before undergoing adenoidectomy in a tertiary medical center. The symptom severity of obstructive sleep apnea syndrome (OSAS) was evaluated by OSA-18 questionnaire on the day before and 6 months after surgery.

Results: In total, 79 pediatric patients including 50 children with SDB and 29 children with OME were enrolled. The mean total OSA-18 score was 56.5 ± 15.1 and ten (34.5%) children experienced moderate to severe symptoms of OSAS as indicated by OSA-18 score ≥ 60 in OME group. After surgery, patients in both SDB and OME groups experienced improvement (both p < 0.001) and presented no difference in the scores of OSA-18. The proportional change in OSA-18 scores after surgery was related to pre-operative OSA-18 scores and BMI in OME patients (r_s = 0.400 and 0.542, p = 0.047 and 0.008), and to pre-operative OSA-18 scores in patients with SDB (r_s = 0.393, p = 0.008).

Conclusion: Children with OME experienced significant symptoms of OSAS and associated impairment of quality of life. Adenoidectomy is effective in the improvement of sleep symptoms in these patients. Comprehensive assessment of sleep breathing as planning surgery for OME children is suggested.

Keywords: adenoidectomy; obstructive sleep apnea syndrome; otitis media with effusion; sleep-disordered breathing.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adenoidectomy
Child
Child, Preschool
Humans
Otitis Media with Effusion* / complications
Otitis Media with Effusion* / surgery
Quality of Life
Sleep Apnea Syndromes* / diagnosis
Sleep Apnea Syndromes* / etiology
Sleep Apnea Syndromes* / surgery
Tonsillectomy*