Improved behavior and sleep after adenotonsillectomy in children with sleep-disordered breathing: long-term follow-up.
نویسندگان
چکیده
OBJECTIVE To determine whether previously published changes are maintained over time in children after adenotonsillectomy for sleep-disordered breathing using the validated Pediatric Sleep Questionnaire (PSQ) and the Conners Parent Rating Scale-Revised: Short Form (CPRS-R:S). DESIGN Prospective, nonrandomized interventional study. SETTING Ambulatory surgery center affiliated with an academic medical center. PATIENTS Long-term follow-up data were available (ranging from 2.4 to 3.6 years after adenotonsillectomy) for 44 of the 71 patients who completed our initial study comparing PSQ and CPRS-R:S data before and 6 months after surgery. INTERVENTIONS Parents completed the PSQ and CPRS-R:S at least 2 years after surgery. MAIN OUTCOME MEASURES Follow-up PSQ data and long-term changes in age- and sex-adjusted T scores for all 4 CPRS-R:S behavior categories (oppositional behavior, cognitive problems or inattention, hyperactivity, and the attention-deficit/hyperactivity disorder [ADHD] index) were determined for each patient. Linear mixed models were used to analyze the data. RESULTS Globally, across time, most variables remained below baseline levels (P < .05). There was a significant increase in PSQ scores during follow-up, but over this period they did not reach baseline levels. Comparing short-term with long-term follow-up, the Conners scores in all behavioral categories did not increase significantly (ADHD index, P = .61; cognitive problems or inattention, P = .02; hyperactivity, P < .001; and oppositional behavior, P < .001). The ADHD index at long-term follow-up was not different from that at baseline, a finding that might be attributable to the high degree of variability in this measure. CONCLUSIONS Improvements in sleep experienced by children after adenotonsillectomy for sleep-disordered breathing were not as great 2.5 years after surgery as they were 6 months after surgery but were still significant compared with baseline levels. Improvements in behavior were maintained in all categories of the Conners scores except for the ADHD index.
منابع مشابه
The Effect of Adenotonsillectomy on Children's Quality of life
Introduction: Adenoid hypertrophy is the most common cause of chronic airway obstruction in children. The aim of this study was to evaluate the effect of adenotonsillectomy on sleep and behavioral disorders in children with adenotonsillar hypertrophy. Materials and Methods: In a prospective observational study, all children with an indication of adenotonsillectomy based on American Academy of...
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BACKGROUND Limited studies suggest that pubertal development may lead to a recurrence of sleep-disordered breathing (SDB) despite previous curative surgery. Our study evaluates the impact of myofunctional reeducation in children with SDB referred for adenotonsillectomy, orthodontia, and myofunctional treatment in three different geographic areas. METHODS A retrospective investigation of child...
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OBJECTIVES Adenotonsillar hypertrophy is the most common etiology in pediatric obstructive sleep apnea syndrome (OSAS), and adenotonsillectomy is the mainstay of treatment modalities. This study evaluates the long-term effectiveness of adenotonsillectomy in children with OSAS. METHODS Subjective symptoms evaluated with a 7-point Likert scale and objective respiratory disturbances evaluated by...
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OBJECTIVES Most children with sleep-disordered breathing (SDB) have mild-to-moderate forms, for which neurobehavioral complications are believed to be the most important adverse outcomes. To improve understanding of this morbidity, its long-term response to adenotonsillectomy, and its relationship to polysomnographic measures, we studied a series of children before and after clinically indicate...
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ورودعنوان ژورنال:
- Archives of otolaryngology--head & neck surgery
دوره 135 7 شماره
صفحات -
تاریخ انتشار 2009