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Tonsillectomy improves quality of life

A new study justifies that children with sleep-disordered breathing suffer from behavioral and emotional difficulties. In addition, the study shows a tremendous improvement in behavior and quality of life after intervention. Between 2 percent and 6 percent of preschool and school-aged children suffer from pediatric obstructive sleep apnea, or upper airway obstruction. This condition is often associated with nighttime breathing difficulties and has been combined to behavioural, emotional and neurocognitive problems.//

In the study, researchers from University of New York Downstate Medical Center examined 50 children scheduled to undergo tonsillectomy and adenoidectomy. Most of the children suffered from sleep apnea while a small percentage suffered from periodic tonsillitis. Researchers used a series of standardized tests to determine the impact of the surgery on children's emotional and behavioral problems.

Parents of the children filled out The Child Behavior Checklist (CBCL), a standardized measure of children's behavior, and the OSA-18, an 18-item health-related survey measuring quality of life. The questionnaires were filled out prior to and 3 months after surgery.

Findings from the study show a vast improvement in quality of life after surgery. Before surgery, the health-related impact of sleep-disordered breathing on children's quality of life was small for 30 percent, moderate for 20 percent, and large for 45 percent. After surgery, the impact was considered small in 90 percent of children and moderate in 5 percent.

In addition, results show impact on quality of life significantly correlated with the total problem score, or the CBCL score. Preoperatively, all 20 children who said it only affected their life slightly had a CBCL total problem score in the normal range. Of the 12 children who said the condition had a moderate impact, 20 percent had a total problem score in the abnormal range. And of the 10 children who se lives were greatly impacted, 40 percent had a total problem score in the abnormal range. The total problem score significantly improved after surgery with only 10 percent of children remaining in the abnormal range.

Authors of the study conclude, that this is, to our knowledge, the first prospective study of pediatric obstructive sleep apnea correlating children's behavioral disturbances with QOL and documenting improvements in both after treatment.


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