Effect of adenotonsillectomy on ADHD symptoms of children with adenotonsillar hypertrophy and sleep disordered breathing.

BACKGROUND Adenotonsillar hypertrophy is the most common etiologic agent for the obstruction of the upper airways in children, which might be associated with attention-deficit hyperactivity disorder (ADHD), one of the most common psychiatric disorders of childhood. Despite the concurrence of these two conditions, i.e., obstruction of the airways and ADHD, no exact etiologic relationship has been established between adenotonsillectomy (AT) and ADHD symptoms. This study was undertaken to evaluate the effect of AT on the ADHD symptoms in children with adenotonsillar hypertrophy and sleep disordered breathing (SDB). METHODS The design of the present study consisted of pre-test and post-test, followed by post hoc tests. Fifty-three children aged 3-12 were included in this study, selected from those referring to the Pediatric Hospital of Tabriz University of Medical Sciences, with SDB, adenotonsillar hypertrophy and ADHD based on DSM-IV criteria, by availability of the subjects undergoing adenotonsillectomy after evaluation of the severity of ADHD symptoms. The scores of ADHD symptoms were evaluated before AT and at 3- and 6-month postoperative intervals based on Conner's Parent Rating Scale-Revised (CPRS-R) Questionnaire. Repeated-measures ANOVA and Fisher's exact test were used for data analysis. RESULTS AT resulted in a significant decrease in the severity of ADHD symptoms (oppositional behavior, cognitive disorders, inattention, hyperactivity and ADHD index) at 3- and 6-month postoperative intervals (P<0.001), with more significant decreases at 6-month postoperative interval compared to 3-month interval (P<0.001). CONCLUSIONS Based on the results of this pilot study, AT in children with SDB associated with ADHD resulted in a significant decrease in the severity of ADHD symptoms.