CC BY 4.0 · Int Arch Otorhinolaryngol 2024; 28(04): e603-e607
DOI: 10.1055/s-0044-1786832
Original Research

The Impact of Adenotonsillectomy on the Quality of Life of Children with Obstructive Sleep Apnea

1   Department of ENT, Government Medical College, Kottayam, Kerala, India
,
1   Department of ENT, Government Medical College, Kottayam, Kerala, India
,
1   Department of ENT, Government Medical College, Kottayam, Kerala, India
› Author Affiliations
Funding The author(s) received no financial support for the research.

Abstract

Introduction In children, obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is caused by adenotonsillar hypertrophy and is characterized by upper airway obstruction disturbing sleep.

Objective We conducted this study to evaluate health-related quality of life (QoL) in children with OSA before and after adenotonsillectomy.

Methods A descriptive, observational study was conducted among 43 children in the 4-to-12 years old age group who had symptoms of OSA due to adenotonsillar hypertrophy and who underwent adenotonsillectomy at a tertiary care center during the period from February 2020 to February 2021. The QoL was assessed using the OSA-18 questionnaire preoperatively and at 2 and 6 months postoperatively.

Results Among the study population, males (72)%) were more affected with OSA, with a male-to-female ratio of 2.6:1. Based on the OSA-18 questionnaire assessment, the most severe and frequently observed symptoms were in the domains of sleep disturbance and physical symptoms, in which the mean score was 77 preoperatively. After adenotonsillectomy, the mean OSA-18 score decreased to 28.605 and 22.465 at 2 and 6 months, respectively. At 2 months postsurgery, more significant improvement was noticed in sleep disturbances, physical symptoms, and parent's concern while at 6 months postsurgery, all domains showed equal improvement. Therefore, following adenotonsillectomy, the QoL improved significantly.

Conclusion Obstructive sleep apnea can adversely affect sleep quality as well as neurocognitive and cardiovascular functions. Adenotonsillectomy resulted in significant improvement in the QoL.



Publication History

Received: 09 July 2023

Accepted: 31 March 2024

Article published online:
25 October 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • References

  • 1 Carroll JL. Obstructive sleep-disordered breathing in children: new controversies, new directions. Clin Chest Med 2003; 24 (02) 261-282
  • 2 Jambhekar S, Carroll JL. Diagnosis of pediatric obstructive sleep disordered breathing: beyond the gold standard. Expert Rev Respir Med 2008; 2 (06) 791-809
  • 3 Mitchell RB, Kelly J. Behavior, neurocognition and quality-of-life in children with sleep-disordered breathing. Int J Pediatr Otorhinolaryngol 2006; 70 (03) 395-406
  • 4 Stewart MG, Friedman EM, Sulek M. et al. Validation of an outcomes instrument for tonsil and adenoid disease. Arch Otolaryngol Head Neck Surg 2001; 127 (01) 29-35
  • 5 Robb PJ, Bew S, Kubba H. et al. Tonsillectomy and adenoidectomy in children with sleep related breathing disorders: consensus statement of a UK multidisciplinary working party. Clin Otolaryngol 2009; 34 (01) 61-63
  • 6 Ali A. et al. Int J Otorhinolaryngol Head Neck Surg 2018; 4 (01) 50-55
  • 7 Andersen IG, Holm J-C, Homøe P. Obstructive sleep apnea in obese children and adolescents, treatment methods and outcome of treatment – a systematic review. Int J Pediatr Otorhinolaryngol 2016; 87: 190-197
  • 8 Ahmed AO, Aliyu I, Kolo ES. Indications for tonsillectomy and adenoidectomy: our experience. Niger J Clin Pract 2014; 17 (01) 90-94
  • 9 de Serres LM, Derkay C, Astley S, Deyo RA, Rosenfeld RM, Gates GA. Measuring quality of life in children with obstructive sleep disorders. Arch Otolaryngol Head Neck Surg 2000; 126 (12) 1423-1429
  • 10 De Serres LM, Derkay C, Sie K. et al. Impact of adenotonsillectomy on quality of life in children with obstructive sleep disorders. Arch Otolaryngol Head Neck Surg 2002; 128 (05) 489-496
  • 11 Mitchell R, Kelly J. Quality of life after adenotonsillectomy for SDB in children. Otorhinolaryngol Head Neck Surg 2005; 133 (04) 569-572
  • 12 Franco Jr RA, Rosenfeld RM, Rao M. First place–resident clinical science award 1999. Quality of life for children with obstructive sleep apnea. Otolaryngol Head Neck Surg 2000; 123 (1 Pt 1): 9-16
  • 13 Farhad JK, Lawan AT. Association between size of adenoid and serous otitis media among a sample of primary school age children in Erbil city. Diyala J Medicine 2013; (02) 1-10
  • 14 Mitchell RB, Kelly J, Call E, Yao N. Long-term changes in quality of life after surgery for pediatric obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 2004; 130 (04) 409-412
  • 15 de Lima Júnior JM, da Silva VC, de Freitas MR. Long term results in the life quality of children with obstructive sleep disorders submitted to adenoidectomy/adenotonsillectomy. Rev Bras Otorrinolaringol (Engl Ed) 2008; 74 (05) 718-724
  • 16 Lorusso F, Martines F, Mistretta A. et al. Effects of adenotonsillectomy on neurocognitive and behavioural function in pediatric obstructive sleep apnea syndrome. B-ENT 2018; 14: 113-118