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Otolaryngol Head Neck Surg. 2014 Jan;150(1):126-32. doi: 10.1177/0194599813509780. Epub 2013 Oct 29.

Adenotonsillectomy vs observation for management of mild obstructive sleep apnea in children.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA.

Abstract

OBJECTIVE:

To determine the impact of adenotonsillectomy vs observation on quality of life (QOL) in children with mild obstructive sleep apnea (OSA).

STUDY DESIGN:

Prospective, nonrandomized trial.

SETTING:

Tertiary children's hospital.

SUBJECTS AND METHODS:

Sixty-four children (ages 3-16 years) with mild OSA (apnea hypopnea index between 1 and 5 on polysomnogram) completed the study. Caregivers chose between management options of adenotonsillectomy and observation and completed validated QOL instruments (OSA-18 and Children's Health Questionnaire) at baseline, early, and late follow-ups. The primary outcome measure was QOL.

RESULTS:

Thirty patients chose adenotonsillectomy, while 34 were observed. Total OSA-18 scores at baseline were significantly poorer (P = .01) in the surgery group (72.3) compared with the observation group (58.5). Four months following surgery, OSA-18 scores improved by 39.1 points over baseline (P = .0001), while there was no change for the observation group (P = .69). After 8 months, OSA-18 scores remained improved in the surgery group, and observation group scores improved by 13.4 points over baseline (P = .005). While OSA-18 scores at the late follow-up visit were poorer in the observation group, the difference was not statistically significant (P = .05). Six observation patients opted for adenotonsillectomy during the study.

CONCLUSION:

Quality of life significantly improves in children with mild OSA after adenotonsillectomy. In children with mild OSA who are observed, QOL improvements at early follow-up are less pronounced, but significant improvements in QOL are evident after 8 months. QOL instruments may be useful tools to help providers determine which children with mild OSA may benefit from early intervention.

KEYWORDS:

adenoidectomy; child; obstructive; quality of life; sleep apnea; tonsillectomy

PMID:
24170659
DOI:
10.1177/0194599813509780
[Indexed for MEDLINE]

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